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Insurers Claim Nhi’S Secretariat Is Likely Acting 'Illegally'

By KHRISNA VIRGIL

Deputy Chief Reporter

kvirgil@tribunemedia.net

THE Bahamas Insurance Association yesterday said it supports measures by the Minnis administration to stop, review and get right all aspects of National Health Insurance, adding that it is likely NHI’s Secretariat is “illegally” acting as an insurance company.

In a press statement yesterday, the BIA said it is “concerned” breaches of the NHI Act are continuing and have not been addressed to date.

The association pointed to the NHI Act’s anticipation of regulated health administrators (RHA), which would be responsible for the management and administration of NHI benefits.

However, the BIA said to its understanding no RHA has been contracted to administer NHI benefits.

Under Section 25(2) of the NHI Act, a RHA should be among other things, a company carrying on long-term insurance business and registered with the Insurance Commission to carry on long-term insurance business for sickness or health insurance in accordance with the Insurance Act.

It should also be certified by the Insurance Commission as an administrator in accordance with the provisions of the Insurance Act, enter into an agreement with the authority in accordance with the provisions of the NHI Act; and satisfy such other requirements as may be determined by the NHI Authority.

“It is our understanding that no RHA has been contracted to administer the NHI benefits. Instead, the NHI Secretariat presumably under the guise of purporting to act as the NHI Authority has taken on the functions of an RHA as defined in Section 26 of the NHI Act,” the BIA’s statement said yesterday.

“It is noteworthy to state that the functions of the NHI Authority are clearly stated in Section 6 of the NHI Act and do not overlap with those of an RHA.

“The BIA contends that the NHI Secretariat acting on the premise that it can function as the NHI Authority, which has not been formally constituted, may have illegally taken on among other things the following functions of an RHA as defined in Section 26 of the NHI Act: providing beneficiaries with access to benefits, paying providers for benefits, processing beneficiary claims, case management, monitoring the provision of health care benefits.”

This would violate the NHI Act and as the NHI Secretariat would be carrying on insurance business, is also a violation of the Insurance Act, the BIA said.

The statement continued: “The recently reported complaints regarding non-payment of medical providers seems to illustrate one of the practical consequences of violating the law. Had an insurance company failed to make payment, a complaint could have been filed with the Insurance Commission who has the legal power to investigate the complaint and to direct the company to resolve it.

“The insurer in question could also have been sued for breach of contract. Under these circumstances where the payments themselves violate law, the affected medical providers may not have any legal redress available to them.

“We submit that it is highly improper for the NHI scheme to be violating the very law that brought it into being. We recommend that the government take steps to rectify this apparent disregard for the provisions of the NHI Act and Insurance Act. Additionally, the NHI Authority Board when formally constituted, must take immediate steps to rectify the aforementioned breaches and ensure that the authority complies with the NHI Act and other applicable legislation.

“The government should ensure that a dangerous precedent is not set vis-à-vis disregard for applicable law. The Bahamas has to act in accordance with the rule of law and public officials cannot knowingly violate duly passed law.

“The BIA reiterates its agreement with the concept of universal health care and is committed to working with the Minister of Health (Dr Duane Sands) and the NHI Authority (when formally constituted) to ensure that a sustainable NHI plan is implemented and administered successfully for the Bahamas.

“We wholeheartedly agree with the minister that this is the time to stop, review and get it right.”

On Monday, Dr Sands admitted doctors’ complaints about not being paid by NHI are “unlikely to be the last” revelation concerning the scheme’s woes.

Dr Sands told Tribune Business private doctors who had signed-up to provide services to NHI’s 25,000-plus beneficiaries were “another potential casualty” of the Christie administration’s haste to roll-out the scheme as a pre-election “vote grabbing” tool.

Promising to speak with the NHI Secretariat about the alleged non-payment, Dr Sands reiterated that the failure to fully implement the NHI Act and its governance structure - especially the NHI Authority and its board - meant the scheme lacked a lawful basis to make any payments whatsoever.

Comments

DDK 2 years, 8 months ago

"Dr Sands told Tribune Business private doctors who had signed-up to provide services to NHI’s 25,000-plus beneficiaries were “another potential casualty” of the Christie administration’s haste to roll-out the scheme as a pre-election “vote grabbing” tool."

Here's hoping the 25,000-plus will not also be casualties!

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birdiestrachan 2 years, 8 months ago

It is the peoples time. The FNM Government never supported NHI The Bahamian people voted for the FNM Government in large numbers. So the Bahamian people did not want NHI what ever the FNM Government does. as far as I am concerned is great, wonderful

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MonkeeDoo 2 years, 8 months ago

Yes Birdie but the PLP Cabinet members should he held personally responsible for wasting so much of the peoples money. This is fiduciary misconduct on a very grand scale. Every damned one of them should go to jail for this and have to make good on whatever money they wasted. PERSONALLY !!!

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Honestman 2 years, 8 months ago

Put a stop to NHI NOW! It is going nowhere and is simply a big unnecessary distraction for the government. The FNM should concentrate on improving what facilities we already have and let private health insurers get on with helping those who can afford cover. NHI was only ever a carrot in a desperate attempt by the PLP to win over those who could not see through the scam.

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Reality_Check 2 years, 8 months ago

Repost: Most people fail to understand that paying health insurance for one's healthcare is just legalized gambling where:

The insured is the gambler; The element of chance (the cards dealt or dice rolled) is the probability of the gambler remaining healthy; The casino is the insurer; The casino or house rules are the insurance policy; The bet or wager made by the insured is the insurance premium paid to the insurer; The gaming board or commission providing minimal regulatory oversight is the Insurance Commissioner at the Registrar of Insurance Companies; The betting odds are set to favour the insurer by the insured's actuary who determines the likely outcome of the bet based on the element of chance within the entire risk pool of gamblers (insured individuals).

Why should the doors of the health insurance casino only be open to those of us who can afford to place high cost bets (pay astronomical premiums)? Why should everyone else be denied affordable quality healthcare when they need it? Why should insurers have the privilege of only insuring wealthier people who can afford to gamble in their casinos while the government is made to foot the healthcare bill for everyone else? Why should private hospitals exist for only those who can afford to gamble while the government has to fund the costs of public hospitals and public health clinics for everyone else?

Bottomline: Access to affordable quality healthcare should not be reserved for the wealthier among us, with everyone else left to depend on the government (taxpayers) for their healthcare needs. The unnecessary costly intermediary casinos (the private health insurers) serve no purpose other than take away resources that would otherwise be available to all under a single payer universal healthcare system. No civilized society should permit any kind of profit motivated gambling (by private healthcare insurers) on the healthcare needs of its members. Access to quality healthcare when needed should be regarded as a fundamental right and entitlement for each and every member of a civilized society and we must recognize this within our own society notwithstanding that the profit motivated private health insurers would have us believe that their existence is vital to our country's healthcare needs. Tha'st just self serving baloney on their part!

The existing NHI Act should be repealed in its entirety and the new Minnis-led government should move posthaste towards putting in place a single payer universal healthcare system with incentive programs that reward individuals for their own personal effort in maintaining good health.

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