By NEIL HARTNELL
Tribune Business Editor
nhartnell@tribunemedia.net
The Bahamian healthcare industry reacted with fury this weekend after a key architect of the Government’s National Health Insurance (NHI) scheme branded its stakeholders as “morons and money-grubbing asses”.
The Facebook posting by Etoile Pinder, a member of the Sanigest Internacional team that devised the current NHI model, drew a vehement response from Bahamian private health industry players, who suggested the could no longer work with the Costa Rican-based consultants.
Ms Pinder’s comments, posted on her own page and reproduced here, read: “I give up. My country prefers morons and money-grubbing asses to intelligent, evidence-based decision-making. Peace out. I’m off to help countries that actually value my contributions. Good luck ya’ll.”
Although the remarks are not directed at any individuals or companies specifically, there is little doubt that Ms Pinder was referring to the private sector opponents of the Government’s - and her - NHI model.
They reflect her, and likely Sanigest’s, frustration, that the likes of the Medical Association of the Bahamas (MAB), the Bahamas Insurance Association (BIA), the Bahamas Chamber of Commerce and Employers Confederation (BCCEC) and other private sector groups have remained steadfast in their NHI concerns and have yet to fully embrace the scheme.
And that was before the report by the accounting firm, PricewaterhouseCoopers (PwC), was made public. That document effectively torpedoed the case for the current NHI model, and its January 1, 2016, implementation, while creating holes in much of the work, analysis and data employed by Sanigest.
Ms Pinder’s comments are likely, though, to further inflame divisions between the Government/Sanigest and the private sector over NHI, and create the foundation for what the Prime Minister feared would be a ‘confusing debate’ between the two sides over the scheme.
Based on the reaction to Ms Pinder’s comments by health industry stakeholders, the Prime Minister’s worst fears appear about to be realised.
Smarting from Ms Pinder branding the healthcare industry as ignorant, and a bunch of ‘money grabbers’ motivated by their own financial self-interest, one doctor told Tribune Business: “This is what Sanigest thinks of us. Please write an article on this matter. This is unacceptable.”
Another told Tribune Business: “I can’t believe she posted that. This is who the Government trust to work with us. They value her opinions.”
The Tribune Business contact who supplied this newspaper with the ‘screen shot’ of Ms Pinder’s posting said they were “110 per cent certain she did it; no questions”.
Ms Pinder, a Bahamian, has spent more than a decade on the NHI project. She, together with health economist Dr Stanley Lalta, led the technical team on the subject during the first Christie 200-2007 administration.
She represents the link between that effort and Sanigest, which is headed by her husband, James Cercone.
Meanwhile, Branville McCartney, the Democratic National Alliance’s (DNA) leader, warned that it would be “extremely dangerous” for the Government to ignore the PwC report’s conclusions.
“It will be to the Bahamian people’s detriment to ignore what was said in that report,” Mr McCartney told Tribune Business. “It will most definitely cause it, if they ignore it, to be one of many failures by the PLP.”
The PwC report bluntly warned that the Bahamian public and private healthcare sectors were “not ready” for NHI, and would face a major challenge in coping with “an initial surge in demand” for services.
PwC, in its May 2015 report on key NHI plan elements, warned that no one seemed to have accounted for a likely increase in health services use by a newly-insured population.
This, PwC warned, was likely to “compound” the Bahamas’ challenge in controlling healthcare cost growth - a problem being experienced by many other countries.
It added that the demand-driven rise in healthcare costs will impose “significant pressure” on the Christie administration to either increase taxes, or re-allocate spending away from other high priority public services, to finance NHI.
Mr McCartney said NHI had been “high on the agenda” of Prime Minister Perry Christie since 2002, when the scheme formed a major element of the PLP’s successful general election campaign.
“He wants this [NHI[ to be part of his legacy, and I can understand him wanting something to be part of his legacy, but not to the detriment of the Bahamian people and the Bahamas as a whole,” the DNA added.
Mr McCartney said NHI would likely be sold to the Bahamian people as ‘free healthcare’, even though it was not and “nothing is free”. This, in turn, would enable the scheme to again be used as a plank of the PLP and government’s 2017 re-election bid.
Mr McCartney added that it would be impossible for the Government to implement NHI because it was “not of one accord” with key stakeholders, such as the Medical Association of the Bahamas (MAB) and Bahamas Insurance Association (BIA), who were essential to the scheme’s successful implementation.
“That’s significant,” he told Tribune Business. “How are you going to implement this when you don’t have the relevant persons that need to be on board speaking with one voice.”
Comments
ThisIsOurs 8 years, 5 months ago
Aah...ok so they tried to implement a plan that they needed three other parties, health insurance insurers, medical providers and the public to participate in, but they neglected to bring those parties in at the start. Recipe for disaster, even if you talking sense.
sheeprunner12 8 years, 5 months ago
She is not totally incorrect in her assessment .............. this country is FULL of morons and money grabbing asses ......... in every sector of the economy ......... what is new????? Healthcare is controlled by a select few, construction is controlled by a select few, Wholesale is controlled by a select few, and so is insurance, petroleum, etc ............ DUHHHHHH
asiseeit 8 years, 5 months ago
This NHI is being rushed and has all the makings of a disaster. They have no idea how much it will cost and who or how it will be paid for. Just take one look at the PMH and tell me you have confidence the government, any Bahamian government will get NHI right. Actually tell me any government of the Bahamas scheme that has been devoid of corruption, theft, and failure. The government of The Bahamas is the biggest threat to The Bahamas there is period!
Honestman 8 years, 5 months ago
"I’m off to help countries that actually value my contributions. Good luck ya’ll.”
Mind and close the door!
realfreethinker 8 years, 5 months ago
Dont let the door hit you in the ass while you closing it LOL
B_I_D___ 8 years, 5 months ago
Whoooops!!
Economist 8 years, 5 months ago
Guess she missed the $100,000,000.00 spend that was wasted.
Doubt she has ever run a business. Sure can't be running one now.
GrassRoot 8 years, 5 months ago
the mere fact that she is married to Mr. Cercone, disqualifies her from continuing to be paid with government dollars. So I wonder whether she was married by Mr. Cercone before or after she started working for the NHI projects for the government in 2000. Sounds like in the middle ages, power and influence through marriage.
EnoughIsEnough 8 years, 5 months ago
she met and married him long after she began working on those projects.
newcitizen 8 years, 5 months ago
But they were married when the government decided to throw millions of our tax dollars over to her husbands company who it's pretty clear will just go along with what she had been pushing this whole time. This is why there are such things as conflicts of interest.
newcitizen 8 years, 5 months ago
Honestly, what the hell? They hire the company that is run and owned by this woman's husband! This has got to be a joke. Was this an open tender? Who else applied for this consulting job, or was it just handed to one person that would do nothing more than go along with all of the work his wife had previously done.
This is so typical of this government. Corruption and graft, non stop and right in front of us. These people are thieves, they are stealing from us every single day.
Turns out Etoile and her husband are the real money grubbing asses.
This place is almost not even worth saving.
sheeprunner12 8 years, 5 months ago
But ................... what is so wrong with her assessment????????????? Are we satisfied with the present quality/cost of healthcare that we have now??? take time to study our dismal health statistics and then make a sensible suggestion on how to improve our public health system
sealice 8 years, 5 months ago
takes one to know one lady......
The_Oracle 8 years, 5 months ago
Sheeprunner, do not forget the Government is controlled by a select few also........
TalRussell 8 years, 5 months ago
Comrades if the PM hired me as his chief political strategist, I would tell him there is no better enemy needed than insurance companies. They can be turned into the jewel of all enemies.Voters will help you eat them up.
Economist 8 years, 5 months ago
Let's focus here. Government Official ADMITS to $100,000,000.00 or 25% to 30% of governments annual budget is for healthcare is wasted.
We can afford this NHI but not unless we put PHA etc. in order first.
We have to clean out the corruption and the usual public corporation slackness and political interference now BEFORE we start NHI.
If we don't we will just be pouring money into a broken system and get nothing out.
TalRussell 8 years, 5 months ago
Comrade Economist I see the official's admission of waste as there is even more of a $100 million urgent reason to rush to introduce "Universal" Healthcare. The $100 million is on the conservative side the ledger.
Economist 8 years, 5 months ago
Tal, we would surely then be giving more money to be wasted or am I missing something here? I am not sure that I understand the point you are making.
TalRussell 8 years, 5 months ago
Comrade pure money alone thrown into anything by civilians has never had positive results - so it is foolish to think a government can make it work . I have never heard or read of a single word from the PM, Minnis or even Bran, that directly addresses poverty. Have you? Seriously doubt they even bothered to mention "poverty" anywhere in either of the PLP, FNM or DNA's 2012 election manifestos?
newcitizen 8 years, 5 months ago
Tal, the money was wasted by useless officials who don't know what they are doing and never will, but your solution is to give them more money.
Do you believe any of what you type here or are you just being contrary every chance you get?
EnoughIsEnough 8 years, 5 months ago
good for you Etoile!! i don't blame you. and i think most intelligent, informed Bahamians completely understand your frustration (although maybe not the execution :). I am sure you know that you are not alone and many of the productive, middle class Bahamians who have been fighting to build this country have just had enough - of the crime, the corruption and the apathetic attitude of Bahamians and so they are simply leaving. It's sad that we are in this position but there does not seem to be a light at the end of the tunnel. the commenters above who disagree with your position and who continue to defend the PLP and previous governments are the people who ultimately the problem in this country.
newcitizen 8 years, 5 months ago
Her position is in line with the PLP, not against it. She heads a PLP project. She is part of the problem and the fact that she managed to get her husbands company involved shows you exactly why this country is falling apart. Wake up!
Stapedius 8 years, 5 months ago
Again we have a serious national discussion which has descended into personalities. It doesn't really concern me what one individual thinks. We as Bahamians should be asking the question as to how we address the lack of access to healthcare in this country. A lot of resource is spent without proper direction and this is across the board in the public sector. The medical community should be leading this charge in my opinion not resistant to it. Physicians are often times frustrated with the quality and pace of things in the current system. But still they sit in it and complain. Healthcare requires a lot of human resource and collaboration. Bahamians need to work together to start solving our country's problems. Not every issue has to be so contentious and argumentative. Healthcare is a big deal. I wouldn't want politics and personal issues to cloud this discussion. But alas we make everything a blood sport here.
JohnDoe 8 years, 5 months ago
It is certainly not helpful and some may say unprofessional when a consultant begins using dehumanizing rhetoric to describe the "stakeholders" of a project she has been leading. Indeed, in my view, it probably says more about her than the stakeholders. If she is as intelligent, as it appears she believes, and the NHI scheme "is all that" as she also appears to believe, then it would seem a small issue to eviscerate the small minded questions from these "morons" with reasoned and compelling arguments supporting the strength and efficacy of her NHI scheme. The fact is that serious questions have been put forward about this proposed NHI scheme and they deserve serious answers not name calling. Granted some of the answers are political but answers are needed all the same. In my view the stakeholders and all of us should be concerned about this NHI scheme which is scheduled to be implemented in a few months but no one can explain how much it will costs, how it will be funded and by whom nor what it would look like. Further, the analysis and projections, in my view are inherently faulty and shallow. They underestimated the trade-offs and the free rider, moral hazard and systemic corruption factors already inherent in the fabric of our society. It also pays little attention to the supply side dynamics and infrastructural factors once we have exploded the demand for medical services as it is intended to do and if you ask five people which economic or societal problem this NHI scheme is intended to solve you would get five different answers. Maybe healthcare is a fundamental human right, but let's have a real debate about exactly what that means, what societal or economic problem we are trying to solve, how much will it costs, how will it be funded and who is going to pay for it, what are the trade-offs and consequences for society of using scarce resources for healthcare instead of some other societal issue and most importantly how will the design of the health care program influence the incentives for stakeholders and beneficiaries to behave in this or that way.
B_I_D___ 8 years, 5 months ago
If you are going to dance with the devil...as in...work hand in hand with the government (PLP/FNM/DNA or other) then you need to have the political prowess to deal with the varying levels of stupidity. It's only going to get worse as they try to figure out as many ways as humanly possible to get their fingers into the pie.
sheeprunner12 8 years, 5 months ago
But ............ I am still waiting for someone to refute her description of those who control the health/life/medical insurance industry in The Bahamas ...................... and all other sectors where there is a special interest group that wants to protect their wealth or control
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