Thursday, February 11, 2010

Dr. Duane Sands: I support National Health Insurance (NHI)

By Candia Dames ~ Guardian News Editor ~ candia@nasguard.com:




In 2006 when the debate over National Health Insurance (NHI) was raging, Dr. Duane Sands emerged as a key opposition voice to the plan as presented by the Christie administration.

Today, as the Free National Movement's candidate in the approaching by-election, Sands is making headlines for other reasons, but his opponents are quick to remind voters that four years ago he fought the battle against the highly touted program.

"My impression was he did not support National Health Insurance," said Dr. Bernard Nottage, who was minister of health in 2006 and is now the Progressive Liberal Party's coordinator for its Elizabeth by-election campaign.

"Indeed, my impression was he did not support universal health insurance. Dr. Sands is an influential physician who has worked in our system in both the private and public [sectors] for many years. And he knows the weaknesses and the faults of the system. He knows that there are people in this country who when they fall ill are denied care because they do not have the money to pay."

Sands on the other hand suggested that because he has worked in the system for such a long time, he has a good idea of what is realistic and what is not. And what the PLP was proposing in 2006, he said, was just not realistic.

"It's interesting that much of what is being said about me now is that I opposed National Health Insurance (NHI)," Sands said yesterday. "There's nothing further from the truth. I did not oppose National Health Insurance. I didn't then and I don't oppose it now.

"What I did oppose was something that was poorly conceived and likely to be poorly executed, and I thought that we were trying to sell the Bahamian public a bill of goods for political mileage. I say that without fear of contradiction. At the time, when I was a technical person in the Ministry [of Health], I said this cannot work, this will not accomplish what it is setting out to do."

In 2006, Sands was part of the National Coalition for Health Care Reform.

Back then he said, "I have absolutely no problem with a National Health Insurance Plan.

"I think it should happen now. I think we need to make dramatic changes in the way health care is delivered. We need to improve access for our Bahamian people, but I've gone on record, and I go on record today, as saying this plan as currently touted will not do what it's intended to do, and more importantly, I believe that we're not terribly far off from the proponents of the current [proposed] National Health Insurance Plan.

"I believe that there's enough talent in this country that if we sit down together and hash out the differences we can all develop a National Health Insurance Plan which we can be proud of, which would be sustainable and which would achieve the noble goals set out by the Blue Ribbon Commission [on National Health Insurance]. We're not terribly far off."

When the National Health Insurance Bill came to Parliament in 2006, Free National Movement members supported it, although they repeatedly pointed to what they called flaws in the Christie government's NHI plan.

In his contribution to the debate on December 6, 2002, then leader of the opposition Hubert Ingraham pointed out that the bill would not have created NHI.

"If, according to them (the PLP) people are dying because there is no National Health Insurance, then people will continue to die because this bill is most certainly not delivering National Health Insurance," Ingraham said.

The bill was passed, but had a short shelf life as it came mere months before the Christie administration's one term in government ended. Under the Ingraham administration, talk of NHI has taken on new form.

The government has said its national drug prescription plan is the first step to NHI and that there will be other steps in its planned phased approach, although no timelines have been given.

But Nottage is doubtful that any meaningful National Health Insurance Scheme will ever develop under the current administration.

"If poor people can't afford it now, how are they going to be able afford it in the future unless there is a national system which we were trying to implement, a system by the way which requires every person who is employed to make a contribution toward health care in the country, pooling the resources so that everybody pays and when one of us becomes ill [we] would not have to worry about having the cash to pay," he said yesterday.

The former health minister said some members of the medical profession are ambivalent about National Health Insurance.

"They want people to have good health care but they don't want to make the sacrifices that are required for them to have good care," he said. "And some of those sacrifices include having to forgo many of the benefits that health professionals have, and so I think it is that ambivalence that has created this opposition."

Sands said in 2006 that he is prepared to work with anyone to come up with a plan that will be sustainable and realistic.

Yesterday he said, "Let's not offer people something that it isn't. National Health Insurance, universal health care, health care reform are emotionally charged buzz words because health care is so critical in a personal way and in a national way. You've got to be very careful that you don't take people's emotions and run with them in a way that you hold out something that is not real. That's lying to people.

"What you need to be able to do is say 'here's where we are, here's where we'd like to go and we think this is where we can get to'. You've got to be honest. I think people understand and appreciate honesty."


February 11, 2010


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