The Tribune

By SANCHESKA BROWN

Tribune Staff Reporter

sbrown@tribunemedia.net

NATIONAL Health Insurance Project Manager Dr Delon Brennen said access to the government’s $25m catastrophic fund will not be determined by a committee, but based on objective criteria.

The special fund is expected to be launched with NHI’s primary care phase in April, for patients with catastrophic diseases.

Dr Brennen told The Tribune that “taking the decision out of the hands of people” will eliminate the perception that someone was added to or moved up the list because of “who they know.”

In January, Prime Minister Perry Christie said the government would put aside $25m to create the catastrophic fund. Leading physician Dr Duane Sands later warned that without legislation governing this fund, it opened it to potential abuse and accusations that some patients could receive preferential treatment.

He also questioned how one patient would qualify for assistance from the NHI catastrophic fund while another did not.

“There will be objective criteria, so it does not matter what your name is or where you came from,” Dr Brennen said.

“What matters is what is your illness. How likely are you to recover and what the cost of that care will be? That will put you in an algorithm that says this person qualifies to access this fund. So we will be able to address those needs but just because you may not have access to the $25m because you don’t meet the objective criteria, does not mean you do not get care. What it means is, if you do not have the ability to pay for it out of pocket or have health insurance, you will then be entered into the public sector to be able to address your needs that way.

“We are trying to take it out of the hand of having a group of people making the decisions, so it wouldn’t matter who you are or who you know, it will always be criteria based.”

The government initially said NHI’s primary healthcare phase would be introduced in April.

Last week Tuesday, Minister of Health Dr Perry Gomez said a delay in NHI’s roll out was “likely”. However when asked about this the next day, Prime Minister Perry Christie did not want to speak to a timeline, but stressed that his administration was focused on getting it right.

Dr Brennen has since said the NHI Secretariat is working on the premise that the scheme would not be delayed, but added that anything is possible.