Fee Rises Targeted Again To Make Up $40m Pha Deficit

HEALTH Minister Dr Duane Sands.

HEALTH Minister Dr Duane Sands.


Tribune Business Editor


A Cabinet minister yesterday confirmed that the Princess Margaret Hospital (PMH) is still targeting fee increases to make up a $40m funding shortfall in time for the upcoming fiscal year.

Dr Duane Sands, minister of health, told Tribune Business that while the Public Hospitals Authority (PHA) had already decided to raise fees, which ones - and the extent of any increase - had yet to be determined with the Ministry of Finance and Cabinet.

He added that PMH was also still working on the necessary infrastructure to properly code and bill patients/insurance companies for services rendered, with the new business office and staff recruitment both still in process.

Reiterating that “the insatiable demand for healthcare services” among Bahamians was “not matched by a willingness to pay” for them, Dr Sands said raising the necessary extra revenues on top of the PHA’s annual $217m Budget allocation was not as easy as initially thought.

He added, though, that the necessary investment had to be found if The Bahamas was to “stay abreast of new developments and healthcare technology” while meeting the demands of an expectant publication.

Asked how far PMH and the PHA had progressed on efforts to implement up to 500 new and increased fees, as previously suggested, Dr Sands told Tribune Business: “We are still working out these proposals.

“At the end of the day, it’s really going to come down in its entirety to what happens with the budget’s allocation towards health and what we’re going to propose to do in terms of shoring up revenue. We know what it costs to do the things people need and want. The question is: How are we going to pay for it?

“We are definitely walking down that road where we have agreed to adjust the fee schedule. To what extent, and the specific fees, remains a work in progress. We’d like to be able to synergise or harmonise those with the budget. We’d like to be able to know in the fiscal year 2019-2020 how we are going to be able to meet the mandate required or requested by the public.”

With the PHA’s costs and spending levels already known, Dr Sands added that the next step was to work out “how do we get the revenue to pay for it” given that annual budget allocations were now unable to cover the necessary expenditure.

“It’s a very real challenge,” he told Tribune Business. “There’s a nearly insatiable demand for healthcare services, but the demand for healthcare services is not met by a comparable willingness to pay for these services.

“There’s not a whole lot of elasticity or flexibility in the financing of these services. Cat scans, MRIs, neurosurgeons, cardiologists, gastroenterologists...these things have specific costs. Infrastructure maintenance and capital investment, these things have certain costs.

“All these things we can price, budget and work out to a specific dollar amount. It’s more than the $217m allocation to the PHA in the 2018-2019 budget.

“New technology has costs, and if we are going to keep abreast of new developments, new healthcare technologies, it means we have to invest. Training of doctors, allied healthcare staff, has specific costs associated with it.”

Dr Sands said “one of the simplest things we may have to do is enforce the existing laws”, pointing to multiple fees that had been “gazzetted” and placed into law years ago but never enforced.

While public health matters such as HIV treatment, heart disease and dialysis treatment were likely to be financed from the Government’s consolidated fund via the Budget, Dr Sands said obtaining revenue from civil servants and other public servants on whose behalf it paid health insurance premiums had been complicated by existing trade union agreements and policy.

“We also need the capacity to code, collect and bill that revenue,” he told Tribune Business. “The business office is being built as we speak, individuals are being recruited as we speak. But it does not exist as of this date.”


DDK 11 months ago

Have we not been listening to this drivel for two years? IT'S THE PEOPLES' TIME!


realfreethinker 11 months ago

I guess you are part of the "free" healthcare for all crew.


momoyama 11 months ago

No, he is part of the that's-what-taxes-are-for crew!. How on earth can it be "free" when it is EXACTLY the kind of thing we pay taxes for. When you call the police to report an armed robbery, do you expect them to charge you a "fee"? NO. Because governments use tax revenues to pay for things that are necessities. Have you been fully indoctrinated, zombie-style by these FNM clowns at the helm? Or do you honestly not realize that government gleefully indulges corporations and wealthy people (income) tax free status, only claim that there is not enough revenues and they need to put fees on poor people. It is called welfare for the rich and it makes no sense, economic or otherwise.

Think about things critically, rather than just repeating hogwash from the useless, right-wing FNM.


Dawes 11 months ago

Then taxes need to go up plenty to pay for health care if it is meant to be free. In reality the taxes are there to subsidise the cost of it, not make it 100% free.


bogart 11 months ago

WHERE ....DA ....VAT ....GONE.....???????????


bogart 11 months ago

LAST ...RESULTS INCREASED VAT .....9 MONTH LAST CHECKED PERIOD......EXTRA 100 MILLION DOLLAR........Pore people increasing ..soup lines longer.....more beggars on da streets......minimum wage $210...weekly.....govt wages up....Bahamas air gets new jet for bigtimers subsidized.....free schooling for all da rich housekeepers...gardiners...handyman....renewed work permits like 20 years...year after year....producing children...grandchildren.....free schooling from work permits.....Pore people regressive VAT taxes subventions to electricity...even though power off.......Rich makes 1000 week an VAT PAID ON CONSUMPTION.....SAME.even few eating more getting fatter......... AS PORE $210 WEEK MINIMUM WAGE EARNER......Soooooooo.....why majority pore VAT going to have surplus paid efficiently....AND ....still all of a sudden....Hospital fees .increases...( pore people needon hav second thoughts if dis sudden changes period by experts)..sticking to pore people......!!!!!!!!!!!!...WHAT DA BEJESUS.....ALL PMH MONIES AINT BIN COLLECTED FROM INSURANCES..?????.....MONEY AINT COLLECTED FTOM PLENTY COMPUTER ...BUT NO COMPUTER PAYMENTS PLATFORM..??????........is dem same staff still employed...?????....IS DIS NOW MEDICAL CARE.....NATIONAL PUBLIC HOSPITAL.....ONLY FOR DA RICH PAYING ....??????............AND DA PORE BACK AN CONTINUING...BEGGING PUBLIC....MEDICAL CARE COOK OUTS.....in front all dem cruise ships....


Economist 11 months ago

YOU DON"T NEED TO RAISE FEES. Plug the $100 million dollar a year leak and have $60 million more for the people.
Make people in the PHA accountable for the expenditures. Stop making Bahamians pay for a poorly run Health system.
Do your job as a Minister and clean up the system. We all know that something needs to be done about the way the Civil Service operates. You will get lots of support if you clean it up.


Well_mudda_take_sic 10 months, 4 weeks ago

Minnis and Turnquest have kept Sands hamstrung by not giving our public health system the funding it needs. It's frightening how quickly Minnis and Turnquest were able to decide the corrupt numbers bosses should get a very generous and unnecessary $25 million tax break while our public healthcare system remains gravely starved of funds, no doubt contributing to the loss of many lives. There's something very wrong going on here, especially when you consider that Minnis himself is 'supposedly' a medical doctor with first hand knowledge of the serious financial needs of our public heathcare system. Just imagine what $25 million could have done for our financially starved public healthcare system!


Sign in to comment