The Tribune

WE HAVE been told that the report for the introduction of a National Health scheme, prepared by Sanigest Internacional, a Costa Rican firm, which was delivered to the government on October 12 last year, is not for general consumption.

In the report, a 5.8 per cent payroll tax has been recommended in addition to increased taxes on such luxury items as alcohol and tobacco to pay for the proposed universal health insurance to be introduced in January, 2016. However, it would seem that the public is to be fed the information about the scheme through a test tube on a “need to know basis”.

It is estimated that the scheme will cost taxpayers about $650m to implement. We have also been told that $650 million is a conservative figure, and that if the plan goes through it could be the financial ruin of this country.

However, what is even more disturbing is the news that the few person who have a copy of the report have had to “sign confidentiality agreements barring them from publicly speaking on the document or releasing it”.

This is seen by some in the industry as a way for the Christie administration to control the discussion on the controversial initiative and limit “public push back” on the scheme.

If true, this is where we pause to ask our own questions. What right do the people’s employees have to withhold a document that concerns the people’s welfare, paid for by the people’s taxes, and, according to the opinion of many, could adversely affect their future?

The Bahamas has no Freedom of Information Act. We can understand why, especially when there are some government members who don’t believe they should be accountable to the people – their employers.

The Freedom of Information Act — the one intended for implementation in 2012, which was only awaiting a date for enactment — although not approved by the Christie government, is still in the Attorney General’s office ostensibly for redrafting. However, in that document, many records were exempt from disclosure, among them those touching on security, defence and international relations. Also included were records that if prematurely disclosed “would, or could reasonably be expected to have a substantial adverse effect on the Bahamian economy, or the government’s ability to manage the economy”. This included duties, monetary policy or “records that are not liable to disclosure under any written law”.

We discount all of these points as a legitimate reason to withhold this document. Even though government schools are graduating mainly D grade students, who might not be employable, surely they can read for themselves — and should be allowed to do so.

In others words, if true, government has no right to withhold these documents. They certainly should be available to the press — and before the day was out we did get a copy.

“It is a very ambitious project,” said a source who spoke to a Tribune reporter on the condition of anonymity. “They are already behind schedule. We are talking about a total revamping of how healthcare is delivered. It’s huge. VAT was a massive undertaking . . .now you are talking about a net reduction of spending of 10 per cent of pocket money for NHI. What you are talking about is impacting the buying power of the middle class and creating a socialist state.”

Bahamians are now very nervous about how their taxes are being spent. We were told that VAT was being exclusively collected to bring down the more than $5 billion public debt. But with all of this easy spending in government circles what proof do we have that this is where the tax will go?

Let’s take for example the BAMSI project at Andros. Bahamians still do not know the true costs. In September last year, Agriculture Minister V Alfred Grey told the press that up to that point $50m had been spent on the agricultural project. However, after a press tour of the project, our reporter returned not having been able to identify on what or where $50m could possibly have been spent.

“We have spent almost $50m already and we have just begun,” Mr Grey boasted last September, obviously trying to impress a sceptical press. “And so those who would like to see it fail, tell them keep on looking.”

However, the following month Prime Minister Christie had to correct his minister. No more than $23m had been spent, said Mr Christie. He suggested that by the time the project is completed $100m would have been invested in Andros.

Four months later, BAMSI’s male dormitory crumbled in flames. A man was charged with arson. The estimated cost of repairs has varied from $120,000 to $3m.

Last month Deputy Prime Minister Philip “Brave” Davis told the House that the building was not insured at the time of the fire. He said it had been insured by Southern Alliance, but that the insurance had lapsed because the contractor had failed to pay the annual premium. However, FNM Leader Dr Hubert Minnis dropped a bombshell by tearing everybody’s rose-tinted glasses off with the announcement that the project had never been insured. The insurance company — not registered in the Bahamas — does not exist, he said.

Is this the manner in which Bahamians’ taxes are managed? Are Bahamians expected to continue to pay taxes without an assurance that their money is not being wasted? And how can a minister of government stand up in the House and lull Bahamians to sleep with an untruth? How can Bahamians continue to have confidence?

And then there is the Critical Care Block, an addition to the Princess Margaret Hospital, which opened this year, two years late and over budget.

This block, which should have been opened by the end of 2012, early 2013, was planned to relieve the pressure on the Princess Margaret Hospital whose Emergency services were being swamped by nightly shootings and stabbings as crime escalated. PMH corridors were overflowing with patients for whom there were no beds.

But by the time the new block opened in January, it was discovered that because the Christie government had changed the original design a critical care unit — the step down unit – had been eliminated – 10 beds gone to make room for administration offices. It is understood that there were nine beds for critical care at PMH. In the new block they have gained only one more bed. There are now 10 beds in the new wing, instead of the 20 that was in the original plan. Also there is not enough staff to provide full service, therefore there are still beds that are closed with none of the six operating theatres yet open.

Still, by introducing national health insurance, which promises equal medical treatment to all those who can’t afford it, the hospital will be further swamped. Where are the staff and the beds coming from to provide this first class service?

As the report pointed out, patients admitted to PMH’s private wards have to pay for health care while treatment is free on the overcrowded public wards. It was obvious that paying patients were getting better treatment, probably from their own private doctors. However, on the non-paying wards overworked staff was trying to cope. With the new insurance all patients will get equal treatment. However, it is fooling the people to believe that the medical care will be any better. There are not sufficient beds, nor will there be enough doctors and nurses to cope.

The only change will be that the waiting lines for the operating theatres and available rooms will lengthen. Patients will probably be dead before their operating dates can be scheduled.

Government’s performance to date with the management of our taxes should not give Bahamians confidence that their health service will improve, despite this new tax.

As we wrote this article, a friend e-mailed a quote with the comment that we would enjoy it. Yes, we do appreciate it. And so we shall share the wisdom of Winston Churchill with our readers. It is quite appropriate for the situation in which Bahamians now find themselves.

“We contend,” said Sir Winston, ” that for a nation to try to tax itself into prosperity is like a man standing in a bucket and trying to lift himself up by the handle.”