The Tribune

By NEIL HARTNELL

Tribune Business Editor

nhartnell@tribunemedia.net

A well-known physician yesterday expressed hope that the Prime Minister had “some remaining reason” to ensure that political objectives were overridden, and a National Health Insurance (NHI) “catastrophe” avoided.

Dr Duane Sands, the former FNM Senator, told Tribune Business that if the Government chose to proceed with the scheme as is, it would do so against “overwhelming evidence” in the PricewaterhouseCoopers (PwC) that there was a nine-figure funding gap inhibiting its plans.

“I certainly don’t believe it was a very supportive document of the costing analysis and pricing of the various plans as suggested by Sanigest,” Dr Sands told Tribune Business of the PwC report.

“So if the Government is minded to proceed, they would clearly be doing so in the face of overwhelming evidence that there’s a huge funding gap no matter what revenue sources are used to pay for this proposal.”

The PwC report, which the Government has yet to release publicly, estimated that the NHI proposal faced between a $110.5-$134.3 million ‘funding gap’ based on the initial $362.6 million costing for the Vital Benefits Package.

The accounting firm said the ‘gap’ was the difference between the latter figure and the $228.3 million and $252.1 million in existing public health spending to NHI that PwC believes can be re-allocated to finance the scheme.

However, given that both the Government and Sanigest subsequently increased the Vital Benefits Package ‘price tag’ to $400 million, Tribune Business estimated on Monday that the so-called ‘funding gap’ had risen by another $37.4 million based on the PwC findings - to $147.9-$171.7 million.

Dr Sands suggested that the Christie administration had effectively shelved, and ignored, the contents of the PwC report because it was desperate to have ‘an achievement’ it could use as part of its re-election campaign.

When asked why the Government seemed determined to forge ahead, he replied: “Because it is the only possible chance to salvage - to be frank, I don’t think there is much that can be salvaged - but politically this is the only thing that can be salvaged to maintain credibility for this administration.

“They have no choice; they have to put something on the table. Damn the torpedoes, ignore the naysayers; this is full of inconsistencies but we’re going to do this anyway.”

Dr Sands warned that the Government was going to make itself “hugely unpopular” among members of the security forces, teachers and other public sector workers if it went ahead with Sanigest’s proposal to switch them all from private health insurance to NHI.

This, he added, was likely to eliminate some of the benefits and health services coverage they currently enjoyed via private insurance.

“When you read the PwC report and you listen to the plan for NHI, it seems as if they’re looking at the dumbing down of the benefits of a significant section of the population in the interests of this nebulous, not well thought-out, not well-planed, grandiose NHI scheme,” Dr Sands told Tribune Business.

Apart from PwC, he added that the Christie administration was also ignoring the Medical Association of the Bahamas (MAB), Bahamas Insurance Association (BIA), private sector organisations and individual businesses, who were all warning it to “put the brakes on and let’s talk about this”.

Dr Sands said the Government’s rush to NHI meant it was missing an opportunity to involve healthcare industry players in developing a careful, well-planned reform scheme that could “do something wonderful for Bahamians:”.

He added: “I think this is going to be another missed opportunity, a squandered opportunity, in large part because of the way they have approached it.

“It is so inconsistent with what people think is wrong with the health system in the Bahamas, and we’re trying to bite off more than we can chew, more than we can digest.”

Dr Sands said PwC had used “pretty strong” language in warning that the proposed NHI scheme could “destabilise” both the Bahamian healthcare system and economy.

“I am hoping that the Prime Minister has some remaining reason in his administrative mind, and he does not do something detrimental and catastrophic for the country,” he told Tribune Business.

“It is my hope they put something on the table called NHI, but is not more than a figurehead programme.”