By RASHAD ROLLE
Tribune Staff Reporter
rrolle@tribunemedia.net
HEALTH consultants from Sanigest Internacional estimate that more than 100,000 Bahamians – 30 per cent of the population – will not be guaranteed access to health care next year, nor will they be guaranteed protection from financial hardship if they should face a “catastrophic health event”.
This highlights one of the many inequities of health care in the Bahamas that National Health Insurance (NHI) could improve, the Costa Rican consultants note in a report on the matter obtained by The Tribune.
In discussing disparities within the country’s health care system, the consultants note existing legislation that mandates that certain groups receive free healthcare services are not fully followed.
For example, according to the Health Services Act, indigent people, inmates and staff of prisons, members of the police force and those seeking care in connection with childbirth are exempt from health care services charges.
However, people that fall into these categories are often subject to charges relating to various services, including medication and MRIs.
The consultants also note that while in principle, health care services are available to many people, “the process to actually receiving the care is vulnerable to both political influences and inefficiencies.”
The report said: “For example, in order for a low-income individual to be eligible to receive free care, they must first be processed by Social Services and receive a med-card identifying them as an indigent individual.”
The process of receiving a med-card, however, raises questions about efficiency, as it often takes considerable time and requires a lot of labour to complete. Furthermore, the consultants note that labelling people as “indigent” and presenting them with a card that defines them as such before providing them with access to health care “may create multiple barriers to access as a sense of dignity may prevent certain individuals from accessing that card, and therefore forgo receiving needed care.”
Similarly, the consultants note that in many countries, people labelled as low income are given lower levels of health care than those who pay for their care.
As another potential barrier to health care services, the consultants note that low-income people who need med-cards for payment assistance to continue their ongoing care must go to the Department of Social Services for renewal.
“Individuals must return to Social Services on the corner of Shirley and Elizabeth Streets, regardless of where they live,” the report notes. “So if a low income patient, with no means of transportation, lives in South Beach and they need the med-card to assist with their blood tests which they get done every three months because they are a diabetic, that means they would have to travel to Shirley Street to obtain the card. That both reduces the likelihood of them being compliant with their visit, and increases the likelihood of increased utilisation at PMH, while the desire is to move these sorts of outpatient cases to the clinics as much as possible,” the report said.
The government intends to roll out NHI next January. The consultants estimate that it will cost more than $600 million to implement the scheme as a comprehensive plan.
Comments
Honestman 9 years, 1 month ago
So let's fix the problem by looking more critically at how our hard earned dollars are spent at PMH and at hospitals and clinics around the country. Let's cut out the corruption, put a stop to the millions of dollars lost on missing drugs, sack the inefficient health administrators and raise the level of public health care. If after all that there is still a need for additional funding then let's look at sensible funding options such as using proceeds from a National Lottery, increasing the ceiling on NIB contributions. What is NOT needed is a mandatory NHI scheme supported by higher taxes and the effective abolition of the private health covers that many employed persons are accustomed to (and for the most part work reasonably well). I am sure all Bahamians want to see a better public health care system but we should be seeking to raise the level of service in the public sector instead of destroying what is already working. Another aspect that has not been mentioned much is the likelihood of an exodus of many of our doctors abroad once their earning potential nosedives following the introduction of any compulsory NHI scheme. So my message to the Prime Minister is this. Forget what the consultants' report says, go walkabout and speak to people on the street. Very quickly you will establish that few people want compulsory NHI and most certainly not in the near future. You have already gone against the express wishes of Bahamians on the gambling referendum, it would be an act of utmost folly for you to do so again.
TalRussell 9 years, 1 month ago
My fellow Comrade Tribune Bloogers who are against a National Health Insurance plan laughed at me when I sat down 3 days ago to post, that unless you pay a $221 in upfront fees, you will not be admitted to the "Pubic Wards" at Princess Margaret Hospital. They will turn you away.
Well_mudda_take_sic 9 years, 1 month ago
SANIGEST INTERNACIONAL is a surreptitious agent of U.S. foreign policy (much like the IMF, World Bank, WTO etc.) charged by the U.S. Dept of State to help destabilize countries in our region of the world. The destabilization effort is designed to result in the national assets and natural resources of countries like the Bahamas being acquired at bargain basement prices by private sector interests in the highly developed countries that our closely connected with their governments. Typically key politicians and other government officials in lesser developed countries targeted for destabilization are handsomely compensated (bribed) for the role they greedily play in helping to sell out the interests of the very people they were elected to serve. VAT and all of the other recent taxation initiatives (e.g. proposed increases in national insurance contributions, national health insurance taxes, etc., etc.) are being pushed on the Bahamian people by Christie and his merry band of bandits in a very deliberate way to rapidly destabilize our economy thereby paving the way for our national assets and natural resources to be acquired by foreign interests for pennies on the dollar of their true value. You can expect to see many non-transparent deals cut by our government whereby foreigners and a select handful of key politicians and their local business cronies end up acquiring our national assets and natural resources whether they be utility enterprises, waste management systems, oil and other mineral exploration rights, airports, tourist industries (hotels, shipping, etc.), communications enterprises (mobile, internet, TV, etc.) and so on and so on. In a well-governed Bahamas all of these assets and resources would have significantly more value and accordingly would not be ripe for the pickings by foreign interests in various partnerships with a small select group of greedy corrupt politicians and their local cronies. WAKE UP BAHAMIANS...ALL THAT YOUR COUNTRY HOLDS FOR YOU AND YOUR FELLOW BAHAMIANS IS BEING STOLEN RIGHT FROM UNDER YOUR VERY EYES IN NON-TRANSPARENT CORRUPT AND FRAUDULENT DEAL-MAKING OF THE WORST KIND....DESIGNED TO LEAVE JUST ABOUT ALL BAHAMIANS BEREFT OF EVERYTHING THEY HOLD SO DEAR IN LIFE.
Reality_Check 9 years, 1 month ago
I think you mean "RIGHT IN FRONT OF YOUR VERY EYES" or "RIGHT UNDER YOUR VERY NOSES". No matter though, your point is well taken and basically describes the standard game plan the highly developed countries have indeed been using for decades now in exploiting for their own benefit the 'national assets and natural resources' of the lesser developed countries. Of course, in order for the game plan to have its intended consequences, the targeted lesser developed countries must have greedy corrupt political leaders and other key government officials who are willing to betray the trust of their people in exchange for their own personal self-gain obtained by fraudulent activities of one kind or other.
duppyVAT 9 years, 1 month ago
Just out of curiosity ............. how does our healthcare statistics compare to Costa Rica ???
TalRussell 9 years, 1 month ago
Obviously for political reasons, there's no shortage of Comrade critics at the red ready questioning either the quality of the report or the fact they are Costa Rican based, all the while ignoring how tough the consultants criticisms are of the inefficiencies, wastes and political interferences at PMH.
Taking into considered that they were hired by the government, their report is much more unbiased than one would expected it to have been.
Excellent straight no BS report. But doubtful there will be meaniful action taken by government to address serious concerns.
ohdrap4 9 years, 1 month ago
the inmates have to pay for MRI's . Boo hoo.
So do I, and i pray I do not need one because no one is paying for me.
I dropped health insurance because the monthly premiums were one half of my rent.
The_Oracle 9 years, 1 month ago
This whole concept of "free" is such a blatant lie and illusion. There is nothing free in life. Will doctors work for free? nurses? Will equipment suppliers "give" us free equipment? Free healthcare is a complete and total lie. We will all pay, via taxes, and with the Government involved, a government that cannot guarantee anything at all. we will all pay dearly, some with their lives. Nothing the Government touches, promises, or is responsible for works as it could and should. This great "social experiment" will be a complete failure, but we will suffer the consequences and keep paying long after the collapse.
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