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Dr Sands: Increased Collection Of Fees Likely For Healthcare Demands

HEALTH Minister Dr Duane Sands.

HEALTH Minister Dr Duane Sands.

By MORGAN ADDERLEY

Tribune Staff Reporter

madderley@tribunemedia.net

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.”

Comments

Well_mudda_take_sic 1 year ago

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.

".....no one is going to be denied care"

Now that's a loud whistle to the millions of Haitians in Haiti who are destitute and in need of healthcare they cannot get in their own country, notwithstanding that our public healthcare system is already financially crippled by illegal aliens.

So even as we cut waste and improve efficiency, it is likely that we are going to have to increase collection of gazetted fees.

Sands and the senior bureaucrats running our public healthcare system have no real managerial experience and therefore don't have the slightest clue as to how they can and should go about cutting out the waste and inefficiencies throughout the system.

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Well_mudda_take_sic 1 year ago

There is no incentive for Minnis and his cabinet members to address our public healthcare crisis. After all, if any one of them or their family members becomes seriously ill, they can simply count on being able to go to a hospital anywhere in the U.S. (by air ambulance if necessary) to receive appropriate required treatment. And they can do this because the vast majority of us, who don't enjoy the same privilege, are taxed to death to pay for all of their overly generous health and retirement benefits.

If Sands himself developed a serious illness, you can be rest assured he would high tail it out of the Bahamas to the U.S. to receive medical treatment. Both Minnis and Sands as medical doctors with intimate knowledge of our failed healthcare system, know full-well that having to receive treatment for a serious illness at PMH today is pretty much a death sentence. And to think Minnis as a medical doctor promised us it would be the people's time if he were fortunate enough to become PM. What a joke!

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DDK 1 year ago

A SICK joke at that, Mudda.

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ThisIsOurs 1 year ago

Actually there's some nuances in there. Because there are some exceptionally good doctors at PMH. But to the average citizen the quacks and the good doctors all look the same in their white coat, and don't let them have curly hair, then they really qualified.

Think how many persons have been operated on by Dr Sands himself "at PMH" and he's an A-class doctor.

Dr Sands could safely go to PMH because he knows which doctors to let operate on him and which to get a protective order against. and the nurses wouldn't dare leave him unattended for hours. He's relatively safe. It's the rest of us who are picking a quack out of a hat.

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Well_mudda_take_sic 1 year ago

Where do you think Sands made sure his father was treated and cared for during the final stages of his life?

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ThisIsOurs 1 year ago

I don't know but I assume you're going to tell me in the US? I've personally had several unfortunate experiences at PMH with relatives and friends so I get the point. I still say if you know which doctors to select your experience is better. While some of them are ill trained, and some could care less there are some excellent doctors there.

AND don't for a minute believe that they don't have quacks in the US. Doctors and even hospitals seem to be very reluctant to rat out other doctors who are a danger to patients.

I can't say one bad word about Dr Sands. Some say he's arrogant...who knows...may be he's just not good at social graces. But if I have a relative who's been shot...call Dr Sands. I do think he could use an intelligent non-sycophantic political strategist/advisor to navigate this space.

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ThisIsOurs 1 year ago

Oh I have no idea. I assumed that was the implication.

But my point was there are some great doctors at PMH and some bad doctors at PMH. if you know who the good doctors are you can get good care. If you get a bad doctor...Well .... Dr Sands knows just who the bullskaters are. He's be quite safe being treated at PMH

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bahamianson 1 year ago

if you are inferring that he had treatment in the states, incorrect.

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bogart 1 year ago

Doc Sands....sayin da ting on collecting fees....saying da ting on no one being denied health care......PROBLEM is dat news will lightning action....be in Haiti to send its sick troubled stateless illegal citizens to hop on boats ........to over extend calculated logistics at PMH............ CANNOT EVER RECENT NATION PUTTING FOOT DOWN AN TELLING HAITI GUBBERMINT TO STOP ......!!!!!!!!....THE WELL KNOWN DECADES OLD LACK OF POSITIVELY...FORCEFULLY...WITH GREAT PATRIOTIC FIGHTING LOVE WE BAHAMIAN SOVEREIGNTY......ENLIST FORCEFUL.ACTION ........TO STOP.....DETER....ONE SENTENCE.....TO STOP..... DERE PEOPLE RISKING DERE LIVES TO ILLEGALLY....KEEP BREECHING......OUR BORDERS......DA BUCK STOPS AT THE HAITIAN REGISTERED GOVERNMENT....!!!!!!!!!!!......CONTINUED BURDENS ON OUR STATE HAS TAKEN ........DECADES OF BAHAMIAN RESOURCES....BOATS BOUGHT....HUGE WORKERS EMPLOYED AT IMMIGRATION.....RESOURCES....DETENTION....APPREHENSION...STRETCHED PAST THIN.........schooling...restaveks....medical facilities....erry conceivable Bahamian .....including wishy washy visits to Haiti.....decades of hundreds of millions of Bahamian dollars redirected towards Haiti sending illegals......hundreds of millions of Bahamian dollars....sum total decades.....BILLIONS OF DOLLARS DIVERTED ......action and inaction to stemming illegal migrants.....pathetic failure....BILLIONS DOLLARS ESSENTIALLY TAKEN FROM GROWING THE BAHAMIAN NATION CONTINUOUSLY OVER THE DECADES....if for last 50 years $20 million per year.... on average spent on illegals ..defence force...salaries...boats...fuel...police...staffing to deal eith paperwork..stopping...apprehending..shanties...illegal no taxed activities.....trips...must use services...looking conservatively....$1Billion ...?? ..compounded...invested..reinvested....today....??..

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bogart 1 year ago

IS DA DR. SANDS.....HAVE A MUST ...THAT ERRY......PERSON...WORK PERMIT WORKER...ON A WORK PERMIT.....HAVE TO HAVE A MANDATORY....HEALTH INSURANCE............????????....is there some 25,000 WORK PERMIT WORKERS.......getting health checkups annually ....an other illnesses have Medical Insurance....????????........

......an likely Financial Work Permit.....Technical Computer Work Permit....Senior technical Work Permit have MEDICAL INSURANCE........so why isnt Employers of thousands of all other WORK PERMIT employees wid bringing family...SHOULD NOT.....have VALID Medical Insurance.....PREREQUISITE FER WORK PERMIT........??????????

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John 1 year ago

REMEMBER when they tried to put pay toilets in Airports, Gas stations, Train and bus stations? And the end result was other passengers would walk to the public areas of these facilities and end up walking in a pile of poop or finding the areas so dirty and nasty they refuse to use the facilities. Persons were urinating in dark and empty corners. And it was not only because travellers did not want to pay or could not afford to pay to use the toilet, but many didn't like that fact that they were being caught with their pants down. And so it is with the public hospital. No one planned on getting sick or going to the emergency room and here they are, bleeding from the neck or chest and you trying to tax them. So with the airports and bus stations and etc, they introduced a user fee so rather than charge you when you needed to "GO" they charged you before you "CAME". The fees were added on to the cost of your ticket and in a sufficient way that the airports didn't have to sit and have you show your ticket to use the toilets or to sit and watch television. And so it may have to be with the hospital. The $300 plus million given to the Health Ministry is already taxpayers money. So plan accordingly that when persons use the health care facilities, only minimum fees will be collected. Dammit, its time Bahamians feel that they are entitled and are getting something free in this country..after tax after tax after tax! So plan a budget that will recognise that Bahamians don't want to pay when they are sick or injured or dying and need to use the public hospital.

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