By MORGAN ADDERLEY
Tribune Staff Reporter
HEALTH Minister Dr Duane Sands forecast "increased collection of gazetted fees” to meet healthcare demands but insisted no one is going to be denied care in its facilities — particularly the destitute.
He underscored those who can pay should do so as he addressed the financial boost his ministry is set to receive in the 2019/2020 budget on the sidelines of the “World No Tobacco Day 2019” press conference.
The Minnis Administration is planning to earmark $301,973,034 for the Ministry of Health, a little over $8m more than the $293,915,388 it got in 2018/2019.
When asked about the projected revenue increase for public health fees, Dr Sands replied: “Well, first of all, I think the Ministry of Health is pleased that we actually got an increase in allocation in this upcoming budget year.
“When we compare the allocation, however, to the anticipated demand for services, we recognize that there is still going to need to be something to fill the gap. So even as we cut waste and improve efficiency, it is likely that we are going to have to increase collection of gazetted fees.
“We have tried to account for that in a very small way and we’ll see what we’re able to do in terms of actual collections over the upcoming fiscal year. Certainly the position of the Ministry of Health remains the same: that if somebody us unable, for those who are destitute, for those who are struggling in order to make ends meet, nobody is going to be denied care in our facilities.
“However, there are a number of persons who are indeed able to pay the gazetted fees, which are legally mandated. The same way that people are mandated to pay stamp tax, the same way they’re mandated to pay real property tax, et cetera, the law stipulates that you should pay for certain healthcare services.”
When asked if the ministry would be going after people who do not pay their bills, Dr Sands underscored it’s important to treat this matter sensitively, particularly for those who cannot afford to pay.
“It’s very different people who do not pay or will not pay. And if the law says that you should pay, that you should continue, then why not?”
“We believe that if the law says that you should pay, and you can pay, then it is perfectly reasonable for us to insist that you pay.”
Dr Sands also discussed the status of National Health Insurance on Friday.
“We continue to grow the primary care services and we will determine the appropriate time for expansion of the catastrophic component as promised,” he said.
Proposed NHI financing mechanisms include VAT levied on health insurance premiums; a reallocation from the existing Public Hospitals Authority (PHA) budget; and a so-called “sin tax” on sugary drinks.
Tribune Business revealed last month that NHI’s true cost was closer to a range between $200m to $236m, with the much-touted $100m-$130m price tag only covering “the government’s exposure” to the scheme.
Healthcare for the 206,000 persons covered by the employer mandate will be financed through their annual $1,000 Standard Health Benefit (SHB) premium, NHI’s minimum level of care, which is to come from a combination of 1.5 percent of their annual gross salary and employer contributions.
When asked about this 1.5 per cent, Dr Sands said while proposals are being made, he underscored the deputy prime minister’s promise that there will be “no new taxes any time soon” — and certainly not this budget year.
Regarding whether there is a timeline for the implementation of the expanded proposal for NHI, Dr Sands said: “We now have almost 55,000 people who receive NHI benefits. We will continue to grow NHI. What we have said is we would wish to expand NHI services to include a menu of services, kidney failure services…so on and so forth, certain cancer or high-cost care services.
“In order to do that, you have to know how to pay for it. And we have not backed away from that commitment. We have been attempting to manage many different things simultaneously. And so I believe that we will get this accomplished. If we don’t get it accomplished this year, then perhaps next year.”
“There will be a significant effort to improve infrastructure across the public health system in order to prepare for the rollout of national health insurance, as well as squeezing more efficiency out of the health system,” he continued. “But, the Bahamian people have only a limited capacity for expenditure.”
When asked if the National Health Insurance Authority’s proposal for funding NHI is off the table, Dr Sands said no.
“No, I don’t think so. I think it’s a matter of determining when is the appropriate time. Timing is everything.”