The Tribune

By NEIL HARTNELL

Tribune Business Editor

nhartnell@tribunemedia.net

The Government is hoping to enroll 65 per cent of Bahamians in the National Health Insurance (NHI) scheme by April 2016, although its main advisers acknowledged the “scepticism” surrounding any commercial venture run by the public sector.

Sanigest Internacional executives told Tribune Business that they hoped to register nearly two-thirds of the Bahamian population within the scheme’s first three months, with 85 per cent enrolled by 2016 year-end.

And James Cercone, its president, said there were “three things in our favour” as to why NHI would operate differently from other Government-owned and operated agencies/initiatives that could be described as commercial ventures.

He was responding after this newspaper pointed out that the NHI scheme on paper ‘appeared an academic beauty to behold’, yet the reality of many government initiatives once executed and implemented proved far different from the theory.

“I understand that scepticism,” Mr Cercone responded. “I think it’s understandable, given the overall policy environment, but we have three things in our favour.”

He listed these as the invitation to private health insurers to offer NHI benefits packages and provide competition to the publicly-owned insurer; the Government’s decision to phase-in the scheme’s implementation; and the move to finance it from existing taxpayer monies and make it non-contributory for the first several years.

“It’s not an exclusively Government-run system,” Mr Cercone told Tribune Business. “We are inviting the private insurers to compete. If they do a spectacular job, they may get 75 per cent of the market.

“The scepticism in government is an oversight based on the way the system is designed, or they’re [the private sector] not confident they can compete with the public insurer.

“If they buy-in, there’s an essential role for them. On the provider side, we are opening up the provider market from primary care to the hospital.”

Mr Cercone said the NHI scheme had been designed to offer freedom of choice, adding: “People have the chance never to go to the public system if they decide under NHI. It’s in no way government-run at all.

“In reality, the Government is doing them a favour by not having contributions in the initial phase. This initial phase is a gradual introduction of the system, benefits and all the IT.

“Because of that, the Government recognises it cannot charge a premium in the initial phase. The fact the Prime Minister decided to introduce non-contributory financing in the initial stages shows this is not impactful,” Mr Cercone said.

“This is the gradual introduction of a dramatic system change that’s needed to improve the Bahamian healthcare system.”

While Mr Christie had suggested that it might take five to 10 years to achieve a comprehensive NHI scheme, Mr Cercone expressed optimism that the Bahamas could “leapfrog” other nations by learning lessons from their operational and implementation experiences.

“This is a dramatic change. There’s no question,” he told Tribune Business. “Everybody is resistant to change. Even if you agree with it, people are still resistant. There’s always this stage of opposition.

“We’re not afraid of that. The Government is not afraid of that, and knows that change needs to happen. The numbers on the lack of value for money are so drastic that something has to be done.

“So many people are dying, and hundreds of millions of dollars are being spent that could be used for other things - paying mortgages, sending children to college, buying a home, expanding a business,” Mr Cercone said.

“When you’re paying $10,000 for a premium it adds up. It cuts down on household spending, cuts down on foreign exchange reserves. These are all things that needs to be done, but will not be done overnight.

“The Prime Minister has already said it will take five to 10 years to make the transition. Our feeling is that we can leapfrog other countries, and learn so much from the likes of South Korea and Belize. We should be able to leapfrog the time other countries have taken.”

When Tribune Business pointed out the problems currently being encountered by countries with existing universal healthcare systems, such as the UK and Canada, and questioned why NHI would be any different, Mr Cercone said it was imperative to end “the two-tiered system” that exists now.

He added that under the current Bahamian healthcare system, and its financing, some gained access to the treatment and services that they needed while others did not.

“We want to avoid this two-tier system of the rich getting access to this, while nobody whose poor does,” Mr Cercone said.