The Tribune

By NEIL HARTNELL

Tribune Business Editor

nhartnell@tribunemedia.net

The Bahamas Insurance Association (BIA) yesterday unveiled its own Obamacare-style alternative to the proposed National Health Insurance (NHI) plan, arguing that requiring all legal residents to have insurance will be “less disruptive” to the economy.

The BIA said its proposal, which has been submitted to the Christie administration, would achieve the same universal healthcare objectives as NHI via the provision of government subsidies to ensure those who cannot private health insurance are able to do so.

Emmanuel Komolafe, the BIA’s chairman, said the industry’s proposal would preserve consumer choice, and could be implemented “more quickly and seamlessly” than the proposed NHI scheme.

The BIA’s proposal has four key requirements for health sector and insurance reform: They are:

• All legal residents buy health insurance

• Government subsidies to help those who would not otherwise be able to afford health insurance

• A requirement for health insurers to cover all legal residents without age or pre-existing condition limitations under the NHI plan

• A governance structure that regulates the cost of healthcare and insurance premiums for the government-mandated benefits package

“Our proposal can be implemented more quickly, in a seamless ‎manner, and with minimal disruption to the economy,” Mr Komolafe said. “But this can only be achieved through collaboration with the insurance industry, the Medical Association and other stakeholders to finalise a viable plan.”

He added that the BIA felt there was an urgent need for comprehensive healthcare reform in the Bahamas, a position backed by other private sector stakeholders.

The BIA’s proposal is similar to what many private sector stakeholders believe was contained in a report submitted to the Government by the PricewaterhouseCoopers (PwC) accounting firm.

It, too, is thought to have advocated a completely different approach to healthcare reform and adopt an ObamaCare-style plan for the Bahamas, rather than the proposed NHI model.

Tribune Business contacts suggested that PwC recommended that the Christie administration subsidise health insurance coverage for those Bahamians who cannot afford it, rather than go with an all-encompassing NHI model.

A doctor, who has been closely associated with the Medical Association of the Bahamas (MAB) response to the proposed NHI scheme, said he understood PwC had recommended the “complete opposite” to proposals by the Government’s main consultants, Sanigest Internacional.

“They’re trying to recommend we go with an ObamacCare kind of thing with mandatory insurance,” the doctor, speaking on condition of anonymity, said of the PwC report.

“Coverage would be offered through private insurers, with subsidies for those who can’t afford the premiums.”

That was also confirmed by Mr Komolafe, who previously told Tribune Business that he, too, understood PwC had recommended an ObamaCare-style approach to Bahamian healthcare reform.

“That’s what we heard as well,” he confirmed. “I don’t think it’s far from the truth. I think it’s accurate, but no one has the report.”

Tribune Business understands the report was compiled by PwC’s Bahamian arm with assistance from a US consultant, which may have contributed to the ObamaCare-type proposal.

The Patient Protection and Affordable Care Act (ACA), otherwise known as ObamaCare, facilitates the sale of private insurance to US citizens and offers subsidies to persons who cannot afford their own health insurance coverage.

Such a model would likely impose a smaller cost burden on the economy and Bahamian taxpayer, as it would only finance health insurance for those that cannot afford it - rather than the all-encompassing NHI proposal, which would finance health insurance for 100 per cent of residents.

‎The BIA yesterday said it agreed with Prime Minister Perry Christie that the introduction of NHI services should be done in parallel with the Bahamas’ ability to pay for those services, and that economic growth is critical was vital to fund universal healthcare.

“The emphasis recently has been on determining the actual costs of, and funding mechanism for, NHI. What does not get enough attention is the equally important fact that the model and approach adopted to implement NHI will drive the cost,” said Mr Komolafe.

“In other words, how we choose to achieve universal healthcare will determine the cost to taxpayers, which will then raise fundamental questions about how we will pay for the programme.”

The BIA said it had analysed several other countries in developing its alternative, and suggested that its model was more suited to the Bahamian economy and geographical layout.

It added that its proposal will be more affordable than the Government’s existing plans, and will allow individuals and businesses greater flexibility to choose the plan that best meets their needs.