By NEIL HARTNELL
Tribune Business Editor
nhartnell@tribunemedia.net
The Bahamas has “zero margin for error” in bringing order to the Government’s finances, the Insurance Association’s (BIA) chairman warning that this needed to be balanced with initiatives such as healthcare reform.
Emmanuel Komolafe told Tribune Business that while healthcare reform was “desperately needed”, addressing the Government’s fiscal woes ranked equally as a policy priority.
Pointing out how “fragile” the Bahamian economy is, the BIA chairman said in e-mailed responses to Tribune Business questions that this nation could not afford for any reform efforts to impede job-creating investments by the private sector.
“We have a fragile economy that requires us to handle [it] with much care and implement appropriate remedies,” Mr Komolafe said.
“We literally have a zero margin for error in getting our fiscal house in order. Our policies should aim to grow the economy rather than shrink it, and create jobs instead of lose them.”
He added: “I believe it is clear that while we desperately need comprehensive healthcare reform, there is also an urgent need to address the fiscal challenges we face as a nation.
“What we have seen over the past few years is a convergence of thought on the importance of stimulating the economy and providing incentives to the private sector to invest, while creating sustainable jobs.
“The Government, private sector, international organisations (such as the IMF) and rating agencies (such as Moody’s and S&P) seem to be on the same page on the need to exercise fiscal prudence. This will require prioritising programs and finding innovative ways, in conjunction with the private sector, to implement important initiatives such as universal healthcare (UHC).”
Mr Komolafe said the roll-out of UHC’s primary healthcare phase was expected to begin in the 2017 first quarter, based on information presented to-date to industry stakeholders.
He said that while the UHC Stakeholder Advisory Council had been created, following advice from both the KPMG and PricewaterhouseCoopers (PwC) accounting firms, to formalise consultation between the Government and healthcare industry, “only time will tell” if this actually happens.
“Only time will tell whether the Council will be used as a resource centre to shape the UHC programme and system, rather than an information dissemination centre with information flowing in one direction only,” Mr Komolafe said.
“It is important that we do not miss the opportunity to leverage the skills and expertise of a diverse group of professionals from the private sector that currently sit on the Council.”
He added that the UHC Advisory Council had only just finished “an orientation process” where information was provided to its members, and said: “It is yet to be seen if and how the Council will be able to contribute to this [UHC] process, seeing that the agenda seems to have been fixed and ambitious timelines have been established.
“There are also concerns about the new governance structure and the composition of the UHC executive steering committee, to which the Council is expected to report.”
Mr Komolafe said the UHC executive steering committee is made up almost entirely of civil servants and/or representatives from the public sector.
“We must not forget that UHC is more of a marathon more than it is a sprint event,” he added. “It is a journey rather than a destination.
“This allows us to pace ourselves as a nation to roll out the various phases of UHC based on our ability to afford them. It also presents us with an opportunity to address systemic issues and inefficiencies in the interim as part of a comprehensive healthcare reform agenda.
“A number of these reforms do not necessarily require government spending or significant investments at taxpayers’ expense, [but] the realignment of systems and redeployment of resources may have to be done.”
Asked whether Moody’s recent threat to downgrade the Bahamas to ‘junk’ status had vindicated previous calls for the Government to proceed cautiously with UHC-style reforms, Mr Komolafe said healthcare industry stakeholders “never had any doubt in our minds” that their concerns were “valid”.
“As to whether the Moody’s issue vindicated stakeholder arguments that we ought to proceed with caution, that is not our focal point as the facts speak for themselves,” he added.
“Our focus and ultimate objective is to ensure that we expand the UHC system the right way, in a pragmatic and proper manner using the talents of Bahamians in myriad industries.”
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