The Tribune

By NEIL HARTNELL

Tribune Business Editor

nhartnell@tribunemedia.net

The Bahamian insurance industry finally ended its year-long wait for a meeting with the Prime Minister on National Health Insurance (NHI) on Monday, amid concerns that the numbers produced by the scheme’s consultants “don’t make any sense”.

Tribune Business can confirm that Perry Christie and a large contingent of Cabinet ministers met with the principals from the Bahamas’ key health insurance underwriters and others for what was billed as “an introductory meeting” designed to improve communications and feedback between the Government and private sector.

Lyrone Burrows, Family Guardian’s president, confirmed the meeting to this newspaper after other contacts revealed it took place, adding that the industry “basically outlined the concerns we’ve already expressed” over NHI to the Prime Minister.

“He has agreed to move the matter forward,” Mr Burrows told Tribune Business of the Prime Minister’s response, adding that a further meeting between the two sides has been scheduled for next week.

Monday’s meeting occurred after an increasingly public spat between the Bahamian health insurance industry and the NHI scheme’s main architects and consultants, Sanigest Internacional.

The Bahamas Insurance Association (BIA), in a July 27 letter to the Ministry of Health’s permanent secretary, warned that the Government’s assumptions about NHI’s impact on private insurers are “misplaced, unrealistic and disconnected from reality”, and that it was mounting a “hostile takeover” of the sector.

It added that the scheme’s costs would be “more than double” the suggested $400 million, adding that implementation as-is will have “consequences of catastrophic proportions”.

Taking up the Government’s offer to look at Aruba as an example of what was proposed for the Bahamas, the BIA obtained data from a presentation by Aruba’s chief medical officer that showed 2012 healthcare system spending there was equivalent to $197.4 million in US dollar terms.

Given that the Bahamas’ population is 3.6 times’ greater than Aruba’s, Rhonda Chipman-Johnson, the BIA’s co-ordinator, wrote that multiplying the $197.4 million by this figure meant “we in the Bahamas should expect annual healthcare expenditure of approximately $713.8 million”.

And, taking the National Insurance Board’s (NIB) administrative costs as a percentage of contribution income, 24.65 per cent, the BIA came up with $947.3 million as the total annual healthcare expenditure under NHI.

This figure fell in the middle of the BIA’s previous $895 million to $965 million cost estimates for NHI, but was immediately refuted by Sanigest president, James Cercone.

He said the BIA had been comparing “apples with oranges” because it had based its calculations on Aruba’s much larger benefits package, whereas the $400 million cost estimate was for NHI’s much-slimmer Vital Benefits Package.

Mr Cercone added that there would be a role for the private health insurance industry under NHI, and accused the sector of presiding over a high-cost, inefficient and “dysfunctional” marketplace that priced out most Bahamians and where it wanted no competition.

Family Guardian’s Mr Burrows yesterday told Tribune Business that the Bahamian insurance industry was “very hopeful” that it would be brought into NHI’s development, and allowed to give feedback via a proper consultation framework, as a result of Monday’s meeting with Mr Christie.

He added that the BIA and its members were likely to tone down their public comments to see if their approach to the Government bore fruit, having been drawn into the open by the need to “refute” Sanigest’s comments.

“We’re hopeful that we’ll be able to get to the table and work out any issues we have,” Mr Burrows said. “The issue really is that we have not been provided with any hard data to support the information coming from the consultant.

“We’re hopeful we’ll be able to have a better exchange of information so we can more readily respond to or contribute to the positions put forward by the consultant and the Ministry of Health. The devil is in the details.”

The Family Guardian president, though, still pointed to the discrepancy between the $800 million total Bahamian healthcare cost cited by Dr Perry Gomez, minister of health, and the $400 million Vital Benefits Package pricing.

“On the face of it, the costing indicated by the consultant doesn’t seem to make any sense to us,” Mr Burrows told Tribune Business.

“You’re doubling the number of covered people for half the cost you’re currently paying. The difference in the numbers is staggering.”

Still, he added: “We’ve been asking for this meeting for a year. We’re happy he obliged us. The fact all Cabinet Ministers who have some connection and role with the implementation of NHI were present. It’s a step in the right direction.”

Apart from Mr Christie and Dr Gomez, other ministers present included Dr Bernard Nottage, minister of national security (previous minister of health under the first Christie administration; Michael Halkitis, minister of state for finance; Shane Gibson, minister of labour and national insurance; and attorney general Allyson Maynard-Gibson.

The private sector group was headed by BIA chairman, Emmanuel Komolafe. Also present were Colina vice-chairman Emanuel Alexiou; Mr Burrows; Atlantic Medical chief, Linda Gibson; a Generali representative; and the Bahamas Insurance Brokers Association’s (BIBA) president.