The Tribune

By NEIL HARTNELL

Tribune Business Editor

nhartnell@tribunemedia.net

The Medical Association of the Bahamas (MAB) president yesterday expressed "surprise" that the Minnis administration had yet to meet with doctors over its plans to reform National Health Insurance (NHI).

Dr Sy Pierre indicated he had been taken aback by the Government's meeting last week with the Bahamas Insurance Association (BIA), given that the MAB's efforts to arrange a similar encounter had yet to receive a response.

He also expressed concerns to Tribune Business about the Minnis administration's plans to expand NHI to secondary and tertiary care, given the unknowns and concerns over the NHI model left by the Christie administration - especially its costs.

Dr Pierre also warned that suggestions by Dr Duane Sands, minister of health, could "destroy" the medical insurance industry if the Government forced it to provide coverage to women with certain gene mutations.

"I was actually very surprised, when I saw it in the paper, that the Minister and the Government saw fit to meet with the commercial insurers," the MAB president told Tribune Business.

Believing that the Consultant Physicians Staff Association (CPSA) and other bodies representing doctors also had yet to meet the new administration over NHI, Dr Pierre said his efforts to-date to reach-out had proven fruitless.

"I reached out, I called, I texted, but I've heard nothing yet about the route they're going, what the plan is," he added. "They met with the insurers and I was like: 'Wow, they saw fit to do that and not meet with the MAB. We have heard absolutely nothing as the MAB.

"It would surprise me that they had a meeting with the insurers and not the physicians, even though I spoke, texted and e-mailed."

Dr Pierre emphasised that it was "crucial" for doctors, and the wider healthcare industry, to be briefed - and give input to - the Government's NHI reform plans as soon as possible.

Private sector buy-in remains vital to NHI's success, and Dr Pierre said agreeing a "fee schedule" for doctor compensation was one of many issues that had to be agreed.

"There's the whole mechanism of this thing," he explained. "It was difficult with primary care, but with secondary and tertiary care added in you're looking at an even more complex system."

Dr Pierre told Tribune Business that based on what the Minnis administration had disclosed to-date, he was concerned about plans to broaden it beyond the $100 million primary care phase initiated by its predecessor.

"Prior to the election everyone was saying NHI was too expensive, that they couldn't do it, we don't know what it will cost, and all of a sudden they're going to expand it to include tertiary care," he said.

"With this NHI thing it seems like they're going to spend more money. I don't know where it's coming from. They haven't asked us for anything. We had a plan put together by the stakeholders that involved no large increases in spending."

Dr Pierre also criticised the $10 million spent on foreign consultants by the former Christie administration, including Sanigest Internacional and the KPMG and PricewaterhouseCoopers (PwC) accounting firms.

Suggesting that the Bahamas had received little in return, he added: "Those consultants have gone away, been well paid, and the Bahamian people are still suffering and nothing has happened."

He also questioned Dr Sands' suggestion that the Government might legislate to force insurers to cover women with the BRCA 1 and BRCA 2 gene mutations, given that the Journal of the American Medical Association (JAMA) found women with the former had on average a 72 per cent risk of developing breast cancer by the age of 80.

"Are you going to force insurers to insure those people," Dr Pierre asked. "That will destroy the insurance industry."

He added that the MAB wanted to give the new government "a chance", and planned to write another letter requesting a meeting over NHI.