The Tribune

IN his budget address in the House of Assembly on May 27 this year, Prime Minister Christie announced that his government planned to introduce its National Health Insurance plan on January 1, 2016.

Only three months away, yet all the private sector knows is that there will be no extra taxes in the first year. To add more taxes so soon after the controversial VAT tax would be more than this government would dare do if it hoped for another five-year term in office. In this balancing act, Mr Christie is twirling a wobbly balloon that could burst in his face. He knows that among the poorer sections of the voting population free medical care would be an election winner. However, if the full plan were rolled out now, and the inevitable taxes announced before the election, such a revelation would be the death knell of the PLP as a government. So it would appear that we are heading for an election blindfolded on the cost of government’s future NHI programme.

“The implementation of NHI must be phased in a way that is most practical and affordable hence, the government would not impose additional taxation or contribution to fund NHI at this time but rather, the introduction of services will be done in parallel with our ability to pay for those services,” Mr Christie said in his Budget address.

Mr Christie also recognises that the continued growth of our economy is not only critical to the overall success of the Bahamas, but “also to our ability to fund universal healthcare in the future”.

And this is our present stumbling block. On Tuesday, Chamber of Commerce CEO Edison Sumner told Tribune Business that while government and its NHI consultants had promised no taxes would be required to fund the scheme in its first year the medium and long term “unknown” was making it impossible for companies to plan.

In a dissertation done in 1990 on the failure of President Roosevelt’s New Deal it was pointed out that “when firms cannot form long-term expectations of profitability, investment in fixed capital assets becomes more risky. Therefore, the government faces a serious constraint on the policies it can undertake without inducing an investment slump: insofar as business people view these policies as illegitimate, investment may stagnate”.

This is what is happening at the moment, business people are backing off and the unemployment lines are growing. So whoever said recently that the job market looked bright was obviously out to fool voters. Today, however, even the most ignorant Bahamian who lives in the various communities can no longer be fooled — they daily see the desperation of the unemployed and hear the crack of illegal guns at night. They no long believe their politicians, because they – not the politician — live the reality of what life is truly like in today’s Bahamas.

Dr Perry Gomez after the NHI announcement in May explained that NHI is a “contributory scheme and the level of employment is very important because the more unemployed there are the greater will be the burden on the government to finance it.” The truth of that statement is that it will be a greater — even an unbearable burden – for the taxpayer to finance.

The National Health Service was introduced in England in 1948 — 67 years ago and the country is groaning under its weight.

On Tuesday, The Times of London published a piece by Ross Clark in his Thunderer column under the heading: “Stop the NHS runaway train before it is too late.”

Mr Ross reported that the British health service is on course to consume the country’s entire wealth by 2100. His article dealt mainly with prescription drugs, particularly the generic version.

“We know about the chronic over-prescription of antibiotics,” he wrote, “because it has caused serious problems in bacterial resistance. If they are still being over-prescribed when doctors have been warned endlessly about the problem, then how much more extensive must be the over-prescription of socially more benign drugs?

“Prescribing drugs is far too built in to the culture of the NHS. It has become a way of keeping GPs‘ consultations short and to the point. It is as if doctors are saying: ‘Look, how about I write this for you and then you go away and I can get on with the next patient?”

“It isn’t just the price of drugs that we are going to have to contend with if we are going to contain the NHS’s ever-expanding budget. We are going to have to ask ourselves: how did we get to the situation where 50 per cent of women and 43 per cent of men are on regular prescriptions —and how much of these are really necessary?”

And a Sussex doctor writing a letter in the same newspaper was commenting that the resignation of the chief executive of Addenbrooke’s hospital, which was “put in special measures,” was further proof that the funding basis of the NHS is corrupt.

“As with other ‘failed’ health trusts,” the doctor wrote, “it has proved impossible to balance the books while maintaining clinical services at the level expected — it is predicted that more than 80 per cent of acute trusts will show a deficit this year. Thus financial deficit is the norm. If this was a real market, more than 80 per cent of our hospitals would be placed in receivership, or a substantial number would have to close, or both. Such a scenario is unthinkable, so the only alternative is to accept that the NHS cannot be run on market lines, we should stop kidding ourselves that new initiatives represent ‘investment’ (they are ‘spending’); we must change the criteria for failure; and we should start making ruthless decisions about what the NHS will no longer offer rather than force the disappearance of loyal senior employees who are castigated when they cannot square circles.”

If Britain can’t get it right after 67 years of struggle what are we – who don’t seem to be able to get the simplest things right – doing dabbling in something for which we still have no reliable information.

Our money would be better spent in raising the standard of government’s present medical services rather than adding on a heavier burden, which will drag our present low standards even lower.

Government should delay its present plans until the day that it can come to the Bahamian people with a coherent business proposition that is affordable and from which the indigent will truly benefit.