The Tribune

By DENISE MAYCOCK

Tribune Freeport Reporter

dmaycock@tribunemedia.net

THE proposed amendment to the National Health Insurance programme is expected to be enacted between April and July 2019, with employers making employee mandated contributions by January 2020, according to NHI Authority chairman Dr Robin Roberts.

To date, 43,000 persons across the country have enrolled under the initial National Health Insurance (NHI) primary care package and some 80 plus providers are providing services, according to Dr Roberts.

He reported that so far, the quality of care delivered has been very satisfactory according to those already enrolled – an indication that the NHI programme “seems to be going in the right direction”.

Over 3,000 of those already enrolled participated in a recent survey conducted by the NHI Authority, and Dr Roberts said that they were very pleased with the response received.

“Ninety-five percent are very satisfied with the care given and, more importantly, we need to emphasise that 80 to 90 of the providers are in the private sector,” he revealed.

Dr Roberts and his team are in Grand Bahama over the next two days, meeting with private sector stakeholders to present the latest plans for the implementation of NHI and to get feedback and recommendation on the proposed amendment to the initiative.

On Monday, they met with various sectors of the business community at the Grand Bahama Chamber of Commerce in Freeport. They will also speak with residents at town hall meetings in Eight Mile Rock and Freeport.

According to Dr Roberts, the NHI plan is one of shared responsibility providing sustainable and affordable health care services to all.

Due to limitations of the public health system, he said: “We want to establish a public-private partnership in which the private sector in the health care services can increase capacity of the health care system.

“We look at primary care as a shining example of this because what package of benefit they deliver we get at the most affordable price, and it appears so far the quality of care they are delivering seems to be going in the right direction.”

Building on the primary care programme initially started under the Christie administration, Dr Roberts said the NHI Authority has worked over the past year to draft a framework of the way forward for NHI to proceed.

He noted that those already enrolled under the initial programme, can start to enroll in the new NHI scheme.

The new proposed expanded package of benefits in the primary care programme will not only include physician visits, but also expanded health education, health prevention, health promotion, and wellness programmes, as well as expanding diagnostic and imaging tests.

In the proposed expansion in the programme for high-cost care, all common cancers in women and men will be covered.

Dr Roberts said that cervical cancer and breast cancer in women, prostate cancer in men, and colon and rectal cancers in both men and women will be covered under the package.

“It was also expanded to include the common coronary artery disease conditions which leads to heart attacks and includes having pacemakers available for those individuals who have potentially fatal rhythms of the heart,” he explained.

It also covers dialysis for patients with chronic kidney failure, he said, adding that officials look forward to adding kidney transplants as well.

“We realise we cannot afford to cover everything in the beginning, so this is a phased approach,” he explained.

The government will be responsible to provide insurance coverage for those who are unemployed, and the unemployable, such as senior citizens, children, pensioners, and those who are indigent.

With regards to the current private insurance that persons have, Dr Roberts explained that it will not affect the status quo presently.

“So whatever arrangement exists in your private insurance coverage by your employer with regards to him paying all of it, or part of it, what the employee mandate says is that if you are held responsible to pay a portion, the maximum you must pay will be no more than $42 per month if your salary is $25,000 or more,” he said.

Those earning less than or minimum wage will pay $8 maximum, depending on what their coverage will be.

“We will enact this and start the programme between April and July 2019,” Dr Roberts said. “In terms of employee mandated contributions, employers will not have to start making contributions until January 2020.”

To ease the burden on employers, Dr Roberts said those business owners with less than 100 workers will not make full a contribution from payroll deductions, but a request will be made for them in the first year to pay 25 percent of the standard benefit package cost, amounting to $25 per month for an employee to be enrolled in NHI.

“We also stipulated that those individuals whose income declared on their business licence that is less than $100,000, that they too will not be required to take salary deductions, so they can enroll in NHI without any cost,” he said.

“We are looking to the fact that everyone will be covered,” he said, adding that no one will be excluded either due to pre-existing conditions.

“If you are known to have breast cancer before, they cannot say now that you cannot have coverage or that the premium will go up because the basic benefit of the package will be the same cost for everyone,” Dr Roberts noted.

Because sustainability and affordability of the package of benefits are important, Dr Robert said the pooling of the premium is necessary so those who can pay will provide support for those least able to pay.

Secondly, he said the government health care system will be fundamental to delivering the services for the package of benefits as it allows for greater flexibility and strength in terms of controlling the cost of health care.

“We feel we are looking at advancing and improving the health benefits available. We feel we have done so in a way that is realistic, and more importantly we feel we have done so in a way that is more sustainable,” he said.

Mick Holding, president of the Grand Bahama Chamber of Commerce, said that the groups supports the implementation of NHI.

“I think that everyone would agree that something needs to be done in terms of health coverage in the country because a lot of people are disadvantaged and cannot afford health care. Something needs to be done about that, and I support that initiative,” he said.

He thanked Dr Roberts and his team for coming to the island to hold sessions with the business community and with general public at town hall sessions.

A town meeting was held at Mt Caravel Baptist Church at 6pm in Eight Mile Rock last night and another is scheduled for 6 o’clock tonight at the Church of the Ascension on Ardent Forest Road, Freeport.

Last month, the NHIA proposed a contributory scheme in which the salaries of every employed Bahamian would be subject to a deduction of about two percent each month as a means to pay for universal healthcare coverage.

The group also revealed a proposal to tax sugary drinks and potentially other unhealthy products be implemented July 2019 to fund health education and outreach programmes.

However, government officials have said the proposals have not been decided upon, adding there will be public consultation before anything is formalised.