The Tribune

By NEIL HARTNELL

Tribune Business Editor

nhartnell@tribunemedia.net

Private sector stakeholders believe an accounting firm has advised the Government to take a completely different approach to healthcare reform and adopt an ObamaCare-style plan for the Bahamas, rather than the proposed National Health Insurance (NHI) model.

Tribune Business contacts have suggested that PricewaterhouseCoopers (PwC) has 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.”

The doctor’s assessment was yesterday backed by Emmanuel Komolafe, the Bahamas Insurance Association’s (BIA) chairman, who 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.”

No one, that is, apart from the Government, which has yet to release the first PwC report despite Prime Minister Perry Christie promising the BIA that it will do so.

The administration’s reluctance to release the document could thus easily be interpreted as a sign of its continued secrecy, and hesitance to make public an inconvenient truth. In the meantime, stakeholders and the Bahamian people can only speculate on the PwC report’s contents.

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.

Mr Komolafe, meanwhile, said the BIA had made little progress in resolving the impasse with the Government over the second PwC study on NHI.

As previously reported, the accounting firm has been recalled to assess the NHI cost estimates provided by both the Bahamian insurance industry and Sanigest, given that they are hundreds of millions of dollars apart.

The BIA, though, is resisting the Government’s efforts to cover the process in secrecy, and prevent the findings from being revealed to the Bahamian public.

“There are two main outstanding issues,” Mr Komolafe said, confirming that resolution was some distance away. “Having given our data, we’re insistent that we get a copy of the final report.”

Describing this as “standard practice” and the norm globally, although apparently not for the Bahamian government, Mr Komolafe added: “The second issue is that when we get the report, there’s no gag order. We should be able to speak to it.”

The BIA chairman said he was going to e-mail the Prime Minister yesterday in a bid to set up another NHI meeting between the Government and the insurance industry, adding that the latter “want to help as much as we can” with the healthcare reform efforts.

“We’ve been open and candid in our views, and are trying to work with the Government,” Mr Komolafe said, adding that the Government “can end up with a product” that works if it incorporates the ideas of all stakeholders.

The Prime Minister used the BIA’s 40th anniversary banquet on Saturday night to hit out at what he described as the organisation’s, and Mr Komolafe’s, “public relations exercise” on NHI.

Emphasising that he did not want to fight the insurance industry over an initiative he described as being in the Bahamian national interest, Mr Christie said the BIA would get what it was seeking by talking to, “not beating on”, him.

Mr Komolafe and the BIA yesterday avoided responding directly to Mr Christie’s comments, but said they had an “obligation” to contribute to the national debate on an initiative described by the Prime Minister himself as the ‘single biggest development’ post-independence.

“The position of the Bahamas Insurance Association (BIA) has always been that we are committed to working with the Government to implement universal health coverage (UHC) in the Bahamas in a manner that is affordable, sustainable and least disruptive to the industry and economy at large. Other stakeholders have expressed similar sentiments,” the BIA said in a written statement.

“The significance and importance of universal healthcare to the Bahamas cannot be overemphasised. The Prime Minister had indicated that NHI will be the ‘single biggest development’ in the Bahamas, post-independence.”

Striking a conciliatory tone, the BIA added: “We do not want to fight with the Government on a progressive social initiative that is designed to serve the best interest of the Bahamian people; after all, we all support the principle of universal healthcare.

“We agree that such a fight is unnecessary, especially seeing that we do not disagree on the fundamental need for universal health coverage in the Bahamas.”