The Tribune

By NATARIO McKENZIE

Tribune Business Reporter

nmckenzie@ribunemedia.net

The Government has yet to publish the regulations that will govern the National Health Insurance (NHI) scheme, with Bahamian insurers yesterday said to be “watching the landscape” ahead of the planned $100 million primary care phase roll-out.

Emmanuel Komolafe, the Bahamas Insurance Association (BIA) chairman, speaking with Tribune Business at the Grand Bahama Business Outlook conference, said: “We are still awaiting the accompanying regulations for NHI, which give the details on any legislation that is passed.

“Another important component will be the co-ordination of benefits. The NHI Act specifies that in the event that the person has private insurance, and they enroll for NHI, if they have to make a claim the primary payer will be the private insurer.

“What that means is if I enroll for NHI, I have to first exhaust my benefits under my private health plan before NHI kicks in, at least in so far as it relates to the benefits covered under NHI,” he added.

“Some persons are asking whether, once they exhaust their benefits under their private insurer, how would it work. Let’s say the insurer can only pay 80 per cent; will the other 20 per cent be picked up by the NHI Authority?”

Mr Komolafe continued: “For the industry right now, it’s just watching to see how it plays out and the sign-up by the health care providers, for instance.

“One thing is certain: Whatever is agreed between the health care providers and the NHI Authority, eventually you will begin to see a convergence in terms of what private health insurers pay and what the Government pays to physicians. You’re not going to have that huge gap.

“If you have a physician signed up for NHI, and he or she is charging $30 for their service, you would not have a private health insurance industry that pays $150. If $150 is the price, you will have customers asking how come when they use the NHI card they are charged $30,” he added.

“This is something that we are watching closely as well. What drives the cost of health insurance most times is the cost of health care.”