A New National Health Insurance - NHI Bill Laid in The Bahamas House of Assembly

The new Bill will lay the foundation for the launch of Catastrophic Care coverage, which is a priority for The Bahamas Government, according to The Minister of Health and Wellness, the Hon. Dr. Michael Darville

The best prescription to address the country’s complex health challenges is an affordable and robust primary health system that can mitigate many of our health challenges brought on by the impacts of poorly managed non-communicable diseases like hypertension, diabetes and cancers undiagnosed in the earlier stages of clinical presentation, said Dr. Darville.

NASSAU, The Bahamas -- The Minister of Health and Wellness the Hon. Dr. Michael Darville laid for the first time in the House on Wednesday,  October 26, a new National Health Insurance (NHI) Bill, 2022, which aims to repeal and replace the existing 2016 legislation that proved instrumental in the initial launch of quality, affordable primary care coverage and services in 2017. 

Dr. Darville explained that the current legislation is no longer sufficient to meet the evolving needs of NHI and the increasingly complex financial landscape presently in the country. 

“Over the past few years, with the ongoing COVID-19 pandemic, we have witnessed first-hand the importance of maintaining accessible primary care and the impacts of primary healthcare coverage on the overall health and well-being of our people. 

“We have also seen the staggering financial impacts of acute care and the tremendous burden at our hospitals brought on by patients suffering from chronic non-communicable diseases.” 

He said the best prescription to address the country’s complex health challenges is an affordable and robust primary health system that can mitigate many of our health challenges brought on by the impacts of poorly managed non-communicable diseases like hypertension, diabetes and cancers undiagnosed in the earlier stages of clinical presentation. 

Dr. Darville said this universal challenge was brought to the forefront by the Pan American Health Organization 30^th Sanitary Conference in Washington D.C . a few weeks ago, and confirmed at the recent Cuban Health Conference.

“For this reason, I am introducing the National Health Insurance Bill, 2022 which will modernize the NHIA’s legislation to meet the current realities of the Bahamian health system.”

He said, “This bold move will certainly bring together both public and private clinical practices under a common financing structure that rewards performance quality and service excellence.” 

Dr. Darville said the new NHI Bill will lay the legal framework to roll out a suite of services known as the Standard Health Benefit, that all NHI beneficiaries will receive what is available now and much more.  These services include: 

• Primary Health Care Services 

• Health Education and Promotion 

• Early Detection and Preventative Care 

• Diagnostic Imaging 

• Pediatric and Maternity Care 

• Screening Programs for Cancer and Other Specified Conditions 

He explained that the new Bill will lay the foundation for the launch of Catastrophic Care coverage, which is a priority for the administration.

The Health Minister said this piece of legislation will prove to be a critical step for the expansion of primary healthcare benefits along with robust health and wellness programs across the country as the government pushes toward universal health coverage.

He said through this proposed Bill, all private insurers that offer health insurance plans in the country will be required to offer the newly purposed Standard Health Benefit package as a minimum standard of coverage. 

Dr. Darville said in this sense, NHIA will assume the role of the insurer of last resort and will protect the poorest and most under-served communities. 

He also noted that in addition to introducing the Standard Health Benefit as the minimum standard for all health insurance plans in the country, this legislation will expand the network of providers to deliver services. 

Dr. Darville said, “But let me reassure the general public that these providers will need to meet the Authority’s high-quality standards and they will not be a part of this entire process unless they prove to be in good standing with our medical licensing agencies.”

Source

The High Cost Reality of National Health Insurance (NHI) in The Bahamas

NHI roll-out ‘could take years’

ROYSTON JONES JR.
Guardian Staff Reporter
royston@nasguard.com



While the government has said it will implement National Health Insurance in January 2016, Minister of Labour and National Insurance Shane Gibson suggested yesterday it could take several years to fully implement that plan.

Gibson, who has ministerial responsibility for the National Insurance Board, said it is “impossible” to roll out the entire plan in just over a year, but the government will introduce it in phases.

“National Health Insurance is not something that you can implement wholly on one day,” he said following a press conference to announce Public Service Week.

“You can begin the process of implementation and you would generally have to implement it in phases.

“We have some countries where it took them as much as 10 years to fully implement.

“We are looking at implementing it on January 2016, [but] it is impossible to have it implemented 100 percent on a particular day over this short period of time.”

NHI is intended to provide universal access to affordable healthcare for all Bahamians.

The first Christie administration had pegged the cost of NHI at around $235 million annually, but the government has said it will cost a lot more.

Before the May 2012 general election, now Health Minister Dr. Perry Gomez pledged NHI would be implemented within the first year of a new Progressive Liberal Party term.

Gibson said the roll-out could be similar to that of the National Prescription Drug Plan, which was introduced in phases.

Sanigest Internacional, a Costa Rican-based firm contracted by the government to advise on NHI costing, has said it is “plausible” in some scenarios for NHI to cost more than $500 million.

Asked about that figure and the status of Sanigest’s costing report, Gibson said he plans to meet with officials this week to discuss the plan.

The consultants submitted a draft report in August.

October 21, 2014

thenassauguardian

The government is moving ahead with a National Health Insurance (NHI) plan / universal health scheme

Gibson: Gov’t Will Meet NHI 2016 Deadline

By Korvell Pyfrom
The Bahama Journal


Despite tough scrutiny from the Opposition over its ability to implement the much touted National Health Insurance (NHI) plan, Labour and National Insurance Minister Shane Gibson yesterday assured that the government is moving ahead with establishing the universal health scheme.

However, Mr. Gibson who has repeatedly been quizzed by the press about how much the government is paying a Costa Rican based firm contracted to consult the government on the plan’s implementation, was still unable to provide any figures.

“We’re not operating in a vacuum as soon as we have all the information and we are ready to release the information we will release it,” Mr. Gibson said to reporters outside of Cabinet Tuesday. “It makes no sense to me personally, to release information bits and pieces at a time.

“As soon as we are ready to release the appropriate information through the appropriate means then we will do so, but at this time we are not going to be releasing information every time the committee meets.”

The administration has announced January 2016 as the deadline for its rollout of NHI, but earlier this week Mr. Gibson announced that elements of the plan will be implemented ahead of that date.

Free National Movement (FNM) Deputy Chairman Dr. Duane Sands is among those skeptical of the plan ever coming to fruition and recently he said that the government’s track record on meeting its deadline makes it highly unlikely that NHI will ever come to reality.

But Mr. Gibson dismissed these assertions and suggested Dr. Sands is a man desperate to be elected.

“It is very difficult for me to keep responding to an always rejected man who wants to be a politician. He is at his best when he is criticising and I’m not going to endorse or authenticate what he says by responding to it,” he said.

“As soon as he is able to be elected in parliament and the people say that we want you, I will speak to him.”

The government contracted Costa Rican based Sanigest Internacional healthcare and management consultancy firm in March to provide a costing, benefits package and payment modalities report within three months.

Health Minister Dr. Perry Gomez has announced that the report is expected to be completed in early July.

May 14, 2014

Jones Bahamas

Implementing both value-added tax (VAT) and a contributory National Health Insurance (NHI) scheme cannot co-exist

NHI ‘too much too fast’ given VAT

Head of Coalition for Healthcare Reform says ‘only so much’ private sector can bear, as NHI steering committee moves ahead

By ALISON LOWE
Guardian Business Editor
alison@nasguard.com

As a government-appointed steering committee on National Health Insurance (NHI) ramps up its activity surrounding the potential implementation of the healthcare initiative, a former chamber of commerce president has warned that implementing both value-added tax (VAT) and a contributory NHI scheme cannot co-exist.

Winston Rolle, former chamber of commerce president, and a former head of the Coalition for Healthcare Reform, a private sector group formed to highlight concerns surrounding the possible implementation of NHI prior to the end of the last Christie administration in 2007, said there is a limit to how much the private sector can bear in the form of taxation.

“There were seven or eight guiding principles we’d said we need to look at before we can talk about modernizing our health system and I don’t see where that position would’ve changed.  It still boils down to one, cost, and two, who’s going to pay for it?

“Obviously with the changes that would’ve taken place in this fiscal year, with the business license fee and now with talk of the implementation of value-added tax (VAT), and another scheduled national insurance increase coming up as well now, you are talking about yet another expense that has to be borne by the citizenry and the business community.  There’s just only so much that they can take.  I think it may be a case of trying to do too much too fast,” said Rolle.

Arguing that “putting in place a system that can’t meet the objectives would be just as bad as what you have now”, Rolle suggested that the government has to take into consideration “not only VAT but the whole taxation system” and ensure that those who are required to “pay for this cost have the ability to pay”.

His comments come as Guardian Business understands the government’s steering committee on NHI has begun to meet every two weeks as it attempts to move the NHI agenda forward.

In October, Minister of Health Dr. Perry Gomez said that implementing NHI remains a priority for the Christie administration.  He suggested that an updated costing of the roll out of the initiative would be completed by the end of the month.

Meanwhile, the government is forging ahead with controversial plans to implement VAT at a rate of 15 percent by July 2014, in an effort to address a spiraling debt situation and respond to calls from the World Trade Organization (WTO) to phase out high import tariffs, a key source of government revenue.

Yesterday, sources close to the government’s steering committee on NHI revealed that the group, which was appointed in July of this year, has begun to meet once every two weeks and has already provided a document outlining the terms of reference for NHI to Gomez.

Gomez himself, described as a “passionate advocate for equity in access to healthcare” by sources close to the committee, is said to be keen to see the initiative move forward, addressing the rising cost and inaccessibility of healthcare to many Bahamians.

While the minister had earlier suggested that the updated costing for NHI – how much the government would need to cover the launch and maintenance of an expanded publicly-funded healthcare program – would be complete by last month, Guardian Business understands that this element of preparation is yet to take place.

Guardian Business understands that among those on the steering committee, who include Edison Sumner, president of the Bahamas Chamber of Commerce and Employers Confederation (BCCEC), and John Pinder, president of the National Congress of Trade Unions of The Bahamas (NCTUB) and the Bahamas Public Service Union (BPSU), there are some reservations about the feasibility of implementing NHI given government’s intentions to move ahead with VAT in particular.

It is believed that among the suggestions emanating from the committee are the possibility for the government to implement NHI in phases, with an appreciation for the fact that such a staged implementation – rather than the immediate launch of a comprehensive national health system ­– would more closely approximate what has happened in other countries.

Meanwhile, it has been suggested by sources close to the process that based on the current progress with respect to NHI, the full costing of the initiative may not be completed until next April.

Rolle said he has not been personally informed of any specific advancements in the NHI agenda, but suggested that the government must ensure it seeks the input of the private sector as it moves forward.

“The same parties who were involved in 2007 would want to have sight of and have input into anything that comes up,” he said.

December 03, 2013

thenassauguardian

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