Let’s get real on redeeming the National Insurance Board (NIB) fund, Minister Myles LaRoda

Let’s get real with National Insurance, Minister Myles LaRoda 

By Dennis Dames

Minister of State in the Office of the Prime Minister with responsibility for the National Insurance Board (NIB), Myles LaRoda, has been talking a lot lately about increasing contributions of employers and employees in order to stabilize the NIB fund.

That is an impractical proposition by itself in my view as the NIB fund is already in a very critical state, and employers and employees are presently paying a combined 9.8 percent!

How much higher does any sensible government thinks that that rate can realistically and practically increase without serious financial ramifications for the employer and employee?

The minister stated that the government is in no position to assist NIB financially.  What nonsense!

NIB’s problem has always been poor governance and a lack of prudent vision from its inception, in my humble opinion.

Too much political interference and sweetheart jobs over the decades have contributed significantly to the deplorable state of the NIB fund today.

Add the issue of inept management, over-staffing and political crony jobs, and we get an even grimmer picture of the depressing and ongoing disgraceful state of the rapid erosion of the NIB fund.

The government must find a way to become a partner in the rescue of the NIB fund, Minister LaRoda.  Let’s start with reducing the government’s travel budget, for example.

We live in the 21st Century and technological age where we can show some international leadership, and encourage and persuade our respective global counterparts to have more conferences online.  We can use the savings from the elimination of unnecessary state, political and sweetheart travelling to enhance the NIB investment fund.

Let’s stop acting brand new and talking fool like we just realize that more and more of us are living longer, and are thus putting a strain on the NIB fund by collecting our well deserved monthly pension checks.

Let’s get real on redeeming the NIB fund, Minister LaRoda.

Now is the time for the government of The Bahamas to show real political and executive leadership in the salvation of the NIB fund by letting the people know what the government’s financial contribution is going to be until the NIB fund is put in to a healthy position once and for all - for the future posterity.

The National Insurance Board (NIB) and the growth and development of the modern Bahamas

In its 40 Years, NIB has Fueled National Growth

By Gena Gibbs:


NASSAU, The Bahamas – In his address of the National Insurance Board’s 40^th Anniversary Church Service at Evangelistic Temple on Sunday, Minister of Labour, National Insurance and the Public Service, the Hon. Shane Gibson illustrated the significant role NIB has played in the overall growth and development of The Bahamas.

He expounded saying, “we’ve not only assisted with the benefits paid to contributors, we’ve assisted in building dozens of clinics all over The Bahamas.  We’ve assisted in constructing many Government facilities.  We’ve assisted with unemployment benefits.  And we are now on the way to introducing a National Health Insurance scheme, which would mean universal healthcare for all Bahamians, throughout the length and breadth of The Bahamas.”

Acknowledging the significant milestone of 40 years, Minister Gibson said: “We pause to reflect on and access the National Insurance Board as an Institution, as a movement, and as a foundation pillar of our modern Bahamas.”

NIB was created to administer the country’s social security programe, and first opened its doors on October 7, 1974.   Minister Gibson outlined its history and development since then, noting that Prime Minister the Rt. Hon. Perry Christie, also present at the service, was the third Minister of National Insurance, and among the first Ministers appointed to National Insurance during the period of 1977 to 1982, just three years after the program was introduced.

Mr. Gibson stated: “In the historical context of The Bahamas, this was the immediate post Independence period when expectations in the social, economic and political context were very high.  It was a time when the Government of the Bahamas had to be seen to be delivering on the promises and aspirations that drove the movement to Independence.

“But as history has proven, time and again, political freedom gained from a struggle is not an end in itself, but rather a means to an end.  In The Bahamas, we dreamt of and aspired to education for all of our people, access to basic healthcare, non-discrimination in employment opportunities, and social mechanisms that would allow and give us some measure of dignity when things become rough, and a normal means to earn an income uninterrupted.”

Minister Gibson said that to its credit, the Bahamas Government had seen the need for a comprehensive system of social security, and a small group of persons in The Bahamas was charged with developing a social security scheme that would provide some acceptable form of income replacement for workers of the country, and their dependents, from the cradle to the grave.

“And this work was completed with the passage of the National Insurance legislation in 1972.  I think the point of then and now would best illustrate the phenomenal growth of the scheme.  At the start of the various programs under the National Insurance, short-term benefits were paid at a maximum rate of $54 per week, long-term benefits were paid at a rate of $26 per month, and funeral benefits, one-time payment, was $200,” said Minister Gibson.

“Old age, non-contributory pension, which was paid when insufficient or no contributions had been made, was $26 per month.  At the end of its first three years, National Insurance had collected some $58 Million in contributions; had paid out over $6 Million, as Benefits assistance; and had a reserve fund of some $52 Million.

Minister Gibson said that no one at the time could imagine how significant NIB would grow to become over the years.

“Today, in contrast to its humble, but ambitious beginnings, NIB at the end of its last financial year 2013 had accumulated reserves of some $1.6 billion.  Its contribution income for the same year was reported at $229 million.  While its benefits expenditure for 2013 was some $222 million,” said Minister Gibson.

“It also realized an investment of some $86.3 million during the period.  Additionally, maximum monthly long-term benefits and weekly short-term benefits payments have increased on average of 63-fold and seven-fold respectively, since 1972.” 

For its achievements, Minister Gibson congratulated the employees of NIB, “in particular those long serving employees who would have made a significant contribution over the years.  And even though persons may say they were well rewarded, I can tell you they have made many sacrifices in making sure that you get the quality service that you do get from NIB.  And so we thank them and we congratulate them.”

Minister Gibson then introduced Prime Minister Christie as one of the most socially conscious Prime Ministers in the Commonwealth of The Bahamas over the last 40 years, who has been there from the beginning and like NIB, is also celebrating 40 years serving the Bahamian people.

Senior Pastor, Rev. Dr. Vaughan Cash welcomed NIB Board members, executive management, honourees, and staff attending the service to launch National Insurance Week.

October 07, 2014

Bahamas.gov.bs

Audit Report: The National Insurance Board (NIB) Salaries and Bonuses were Unauthorised

Report: NIB Salaries and Bonuses Unauthorised

By Ianthia Smith
Jines Bahamas




The National Insurance Board (NIB) audit report noted that former Chairman of the NIB Board of Directors Patrick Ward increased suspended Director Algernon Cargill’s base salary from $140,000 to $171,225.50 from October 20, 2008 to October 19, 2011 without the proper approval.

According to the controversial and scathing report the increases were given without the approval of former Prime Minister and NIB Minister Hubert Ingraham, NIB board of directors and human resources.

The auditors from Grant Thornton sought advice from Thomas Evans QC, senior partner at Evans and Co. Attorneys at Law to determine whether the authorisation and payments of executive salaries and bonuses by Mr. Ward without the knowledge of the proper authorities were in accordance with the NIB act.

But in his opinion, the attorney indicated that Mr. Ward, in approving these payments without the full knowledge of the NIB board and the human resources committee.

That such actions were ultra vires, or beyond the powers of both the board and human resources and consequently are void and of no effect.

Additionally, Mr. Evans said in the report that Mr. Cargill and Human Resources Vice President Richenda King in submitting the proposal for salary increases to Chairman Ward for authiorisation may lead to an inference that they were complicit in the ultra vires conduct of the chairman.

Also from the scathing report Grant Thornton outlined the findings of an interview the company did with Mr. Ward and is reported as saying, “I believe that I did not do anything illegal or unethical and I would certainly react very strongly if someone tried to tarnish my reputation.”

The interview also said Grant Thornton asked Mr. Ward why the Board was not informed about Mr. Cargill’s increases.

According to the report, he replied, “We did not discuss details of the executive remuneration at the full Board meetings. The minister does not approve annual increases. The minister approves the initial contract/terms of the contract,” he continued.

“You cannot run to the minister every time for salary increases. The previous minister didn’t and as far as I’m aware, it has never been done.”

The report also noted that Mr. Cargill took home more than $915,000 from 2011 to early 2013 acting as an NIB representative on the Commonwealth Brewery Limited, Cable Bahamas Limited and Bank of The Bahamas Limited boards.

May 08, 2013

The Bahama Journal

Caribbean Blog International 

We want the truth, the whole truth and nothing but the truth concerning the disposition of the people’s money at the National Insurance Board (NIB)

Come Clean on NIB

The Bahama Journal Editorial



That matter concerning who did what, who decided who should get what and that matter which concerns money in the care of the National Insurance Board is one that should be decided now.

The Hon. Shane Gibson is himself clear enough in his mind as to what should be done. Like us he seems to be on the side of those Bahamians who know that whatever is to be done should be executed now rather than later. As one news report suggests: – “…National Insurance Minister Shane Gibson said he is already satisfied [in his mind] “what course of action we should take” based on the findings of the audit into the National Insurance Board.

Decisions made by NIB board members “based on the information (they) had when they were first appointed, seem to be justified…it went way beyond where we thought it would go and so we don’t want to make any rushed judgment or decision; we want to think about it carefully.

But I can guarantee you one thing, at the end of the day – it will be made public and it’s just a matter of when…” Just a matter of when is not good enough. Whatever is to be done should be done now. We need to know all that the Minister and whomever else already knows the whodunit questions and the corresponding answers.

In his statement of the obvious, Minister Gibson says that, “…As soon as we make a decision based on the recommendations of the AG’s Office, then one of two things will happen:- “He will either return to work or he won’t return to work.” We all must wait to hear, see and understand what the Attorney-General’s Office has to say on the matter concerning the stewardship of the people’s money.

The time is now for demanding that the Hon. Shane Gibson show and tell the Bahamian people all that he knows concerning whatever it is that has come to light in the aftermath of that forensic audit into the affairs of the National Insurance Board ordered and/or sanctioned by his colleagues in the Cabinet. And let it be known that we shall have none of that good old fudge that some among us are prepared to feast on when there is information in hand that might hurt this or that favored character of ours’.

The chips – as they say – should be allowed to fly where ever they may. Very many other right-thinking Bahamians want to know about what really did go down at National Insurance to cause all the furor and innuendo that now engulf a number of current and former employees of that star-crossed government owned entity.

Not only do we want to know what happened, we want to know if anyone is going to be charged with any wrong-doing. And most of all, we take this opportunity to let this administration know that the Bahamian people want them to come clean and let the chips fall where they may. And lest there be some other mistake concerning the extent of the people’s justified anger about what they have heard concerning the National Insurance issue, these people are also angry because things are tough for them. They are therefore in no mood to turn a blind eye on this scandal.

The hurt for many continues, so too does the gravy train hum for some others who are mired in games now being played out in other sectors of this or that state-owned entity. Enough remains enough! In addition, as we look in on scandal’s NIB face, we are reminded of the fact that this nation now reels not only at the hammer blows inflicted by a world-economy over which it has little to no real control, but that the so-called man in the street now cowers in the cold shadow of poverty on the hoof.

An ever expectant people now demand transparency, accountability and responsibility from all who lead and all who would lead. But above all else, the Bahamian people demand action, results and transparency from those elected to serve them. In addition, they are now demanding the same from all those nameless, faceless bureaucrats who work with, for and under the command of politicians. We too need to know whether the National Insurance Fund has been pillaged and somehow or the other been diverted from their proper use.

Put simply:-We want the truth, the whole truth and nothing but the truth concerning the disposition of the people’s money.

April 17, 2013

Jones Bahamas

Caribbean Blog International

...while undeniably entertaining, the public spat between the National Insurance Board (NIB) director Algernon Cargill and the newly appointed chairman Gregory Moss has some actual value beyond its qualities as political soap opera

Nib: The Real Lesson

By PACO NUNEZ

Tribune News Editor

AMID all the sound and fury of the ongoing the National Insurance Board saga, one voice rang true last week – that of former BEC chairman Fred Gottlieb.

He reminded us that while undeniably entertaining, the public spat between NIB director Algernon Cargill and the newly appointed chairman Gregory Moss has some actual value beyond its qualities as political soap opera.

In response to claims by Mr Moss that he ran up more than $240,000 in charges on his corporate credit card over three years, Mr Cargill denies any wrongdoing and points out that a review found the card was not misused.

He in turn, alleges the existence of several unexplained charges on Mr Moss' own NIB card, including some for "large amounts of alcohol and food" at the Hilton Hotel, despite the chairman being provided with a $125 allowance whenever he is in Nassau.

But, asks Mr Gottlieb, regardless of who is telling the truth, why does either man – or any other member of the board of directors for that matter – need a government issued credit card in the first place?

"I served as chairman of several public corporations and, as such, did not approve credit cards being given to any board member (including myself) as I deemed it to be unnecessary and undesirable," he said.

According to the hefty affidavit filed by Mr Cargill last week, the card was approved for use in "business development and conduct of board business; as well as to execute purchases where credit card payment is required; and to mitigate against the inherent risk present when in possession of cash; and for use as and when required as is customary in today's business environment."

But would it not make more sense, in order to avoid allegations of misuse of public funds, both valid and false, that such individuals simply charge work expenses to their own credit cards, with reimbursement coming after proof they were engaged in legitimate company business?

Surely, we aren't expected to believe such luminaries of commerce and industry as Greg Moss and Algernon Cargill can't get a local bank to extend them credit.

How many other public service chairmen, directors, board members are currently packing government-issued plastic? At what rate is this privilege abused with impunity?

"But this is how things are done in the business world nowadays," some who are more accustomed to the corporate culture, may say. Well this isn't the business world, it's the Bahamas – which suffers at the moment from double digit unemployment and severe revenue shortfalls. We are in no position to let public funds slip away unaccounted for.

The credit card issue is, in fact, only one of several "undesirable" tendencies brought to light by the Moss-Cargill blame game.

Take for example, NIB's contract for property insurance with Bahamas First. Mr Cargill's affidavit alleges that during the application process for a replacement firm, Mr Moss ordered him to award the contract to one of the bidders, Star General Insurance, despite the fact that this would have been "improper" because the other contender had yet to issue a proposal.

Mr Cargill claims the Superintendent of Insurance confirmed "management's concerns to be material".

But how can the scenario alleged even enter the realms of possibility? Why is the process for selecting a company for a government contract not enshrined in law?

In the interest of transparency and anti-corruption, why is it not explicitly illegal for any public servant, right up to the prime minister, to arbitrarily choose the beneficiary of such a contract?

There is also the matter of Kenuth's Electric, which it is claimed received around $8 million worth of contracts from NIB.

Mr Cargill denies he is a friend and former colleague of the owner and asserts he was "not involved" in the decision-making process.

But questions of nepotism aside, why, under any circumstances, should it be possible for one company to benefit to such a great extent from a government department, to the virtual exclusion of the rest of the industry?

Mr Cargill's affidavit notes that during the renovation of NIB Headquarters beginning in 2009, the project manager recommended that "due to the specificity of electrical work required, NIB not engage a variety of electricians for various projects so as not to compromise the environment and to be able to determine which company was at fault" should anything go wrong.

All well and good, but in such extraordinary circumstances, the Minister for National Insurance should be required to bring the matter before the Cabinet – or better yet Parliament, so the public can know how its money is being spent.

The construction of the Fresh Creek Clinic furnishes a similar example.

Mr Cargill's affidavit alleges Mr Moss accused the director of intervening in a contract to award it to his cousin.

Saying the discussion to award the contract to HEW Construction came from the quality surveyor, not him, Mr Cargill claims the contractor being replaced was thought to lack the requisite building experience, was said to have asked other contractors to share NIB jobs so he could "receive a portion of the contract proceeds" and had been accused of requesting "kickbacks".

The affidavit also claims Mr Moss ordered that the notice dismissing the first contractor "be rescinded".

The immediate question that springs to mind is, if a contractor is suspected of illegal behaviour while on a government job, why is it not public service policy to report it to the police for investigation?

Such decisions could then be made on the basis of evidence instead of hearsay, and would be much more resistant to outside interference of the kind alleged.

Frequent interference is the essence of Mr Cargill's complaints against his new chairman.

For example, he claims Mr Moss directed him to surrender his full authority, including control of human resources, to newly appointed senior vice president Cecile Bethel.

Mr Cargill notes that "due to the sensitivity of HR matters" it is established corporate practice "to ensure that the executives who have legated authority for HR matters continue to exercise those functions while the CEO is out of office, to avoid anyone seeking to advance separate causes with the temporary authority held."

He asserts that Mr Moss attempted to direct him "in an operational area with respect to the management of NIB, without any support for the National Insurance Act or regulations and with total disregard for my position as director and CEO of the National Insurance Board."

He adds that Mr Moss "sought to control personally the day-to-day operations of NIB."

But, he points out, "My role as director and CEO of NIB, pursuant to Section 40 (1) of the National Insurance Act, provides that I shall be the chief executive officer of the board."

It does indeed, but the Act obviously needs amending so as to be more specific about what this means.

Better yet, the distinct roles of all CEOs and chairmen across the public service should be clearly defined and delineated in law, to avoid any future confusion.

In particular, because they tend to be political appointees, board members and chairmen should be barred from assuming any functional role, confining themselves to oversight and broad policy formation.

This would perhaps bring an end to the "we reach" attitude that seems to crop up on these boards whenever the government changes hands. Mr Cargill goes on to accuse Mr Moss of:

• Ordering that they switch offices and advising a staff member to "contract an interior decorator to ensure the former director's office, now occupied by the chairman, is decorated at a standard befitting of a minister."

• Seeking to have a $42,000 energy study of NIB's properties conducted by a newly formed Grand Bahama company of his choice, when a recent study of the same kind has cost the Board only $3,000.

• Pushing NIB to invest $10 million in a private venture, against the advice of management, by saying Cabinet ministers Ryan Pinder, Khaalis Rolle, Michael Halkitis and Prime Minister Perry Christie himself wanted it approved.

Whether valid or not in the particular case of Mr Moss, do these allegations not epitomise the behaviour of far too many whose positions see them straddle the line between politics and the public service in this country?

"Constant experience shows us that every man invested with power is apt to abuse it, and to carry his authority as far as it will go," Montesquieu wrote.

Whether or not anyone at the top of NIB fits this model is now for a court to decide. But the real lesson of Cargill vs Moss is precisely the existence of a grey area at the top which facilitates favouritism and corruption, and encourages all manner of overreaching and self importance.

If anything productive is to come of this argument, it will be a greater understanding not only that vague laws and lax regulations

have nourished a continuous squabble for power and influence at the top of our public institutions, but also that at the end of the day, the average citizen is the only real victim of this state of a affairs.

On the off chance Prime Minister Christie might be inclined to address the situation in a meaningful way, a fun place to start would be a public review of all cars, drivers, credit cards, expense accounts and other perks and privileges enjoyed by chairmen, directors and general managers in the government's employ.

What do you think?

Email questions or comments to pnunez@tribunemedia.net, or join the conversation at www.tribune242.com/opinion/insight

December 10, 2012

Tribune242 

Caribbean Blog International

...monthly National Insurance Board (NIB) contribution rates increase proposed: ...from 9.8 per cent to 10.8 per cent... ...It is unclear whether this will be split 50/50 between employer and employee

NIB 1% RATE RISE IS PROPOSED


By NEIL HARTNELL
Tribune Business Editor
and NATARIO McKENZIE
Tribune Business Reporter
nmckenzie@tribunemedia.net


A RECOMMENDATION to increase the National Insurance Board (NIB) contribution rate by one percentage point to 10.8 per cent has been lodged with the Government, its director yesterday saying it was "lobbying" private health insurers for reduced premiums.

Algernon Cargill brought a stunned silence, and some gasps of disapproval, to the Bahamas Business Outlook conference yesterday when he confirmed the recommended contribution increase, arguing that it was necessary to fund an expanded National Prescription Drug Plan.

In truth the contribution increase had been flagged some time ago, so it should not come as a total shock to Bahamian employers and employees. The former, though, will again be looking at their financial position with concern, and wondering just how much of a chunk it will take out of cash flow and profits.

Meanwhile, Mr Cargill's assertion that NIB was pushing private health insurance underwriters, such as Colina, Atlantic Medical, Generali and BahamaHealth (Family Guardian), to reduce premiums and provide extra benefits, could stoke concerns in some quarters over a revival/continued move to a National Health Insurance Plan.

This is especially so given that Mr Cargill suggested NIB wanted to be the "first payer of private carriers".

Under the initial envisaged expansion of NIB's drug plan, Mr Cargill said it would cover illnesses/diseases such as epilepsy, sickle cell anemia, thyroid, BPH (Benign Prostatic Hyperplasia) and strokes.

"We envision the plan to cover all employees and self-employed persons, and voluntary insured persons," Mr Cargill told the Business Outlook. "We have recommended that the extra programmes by funded by an additional 1 per cent."

That will increase monthly NIB contribution rates from 9.8 per cent to 10.8 per cent. It is unclear whether this will be split 50/50 between employer and employee.
Confirming that NIB had been talking to private health insurers over its plans, Mr Cargill said plan participants would incur only a small co-payment.

He added: "We are lobbying for reduced premiums or additional benefits from your private insurance companies." Claims reimbursements were also said to be on the table.
"We aim for the day when no Bahamian has to choose between paying rent, paying for food or paying for medicine," Mr Cargill said.

Meanwhile, the National Insurance Board (NIB) saw contribution income increase to about $190 million last year.

Mr Cargill said NIB had recorded "remarkable" contribution income despite the economic recession. "In 2008, NIB's contribution income was $155.2 million. In 2009, toughest year so far of the recession, we saw growth of almost $5 million for a total contribution income of $160 million," he added.

"In 2010, we increased contribution income by a further $7.9 million, and in 2011 NIB's contribution income will increase to approximately $190 million. These advances can certainly be accounted as remarkable given the recessionary times we are in today.

Mr Cargill credited the increases to well planned strategies taken by NIB to encourage and facilitate contributions, as well as enhance the collection process.

According to Mr Cargill, administrative expenses for 2011 amounted to $40.5 million, and that as a percentage of contribution income, these have averaged around 21 per cent. He pledged that NIB would reduce this percentage "significantly" in the future, having "done a good job" in containing them in recent years.

On the benefit expenditure side, NIB is forecast to have paid out $182 million in 2011, a slight increase from $176 million in 2010. That represents a $30 million increase from the $152 million payments in 2008, with much of the rise coming from the unemployment benefit.

Regarding the unemployment benefit made available through NIB, Mr Cargill said: "As of January 3, 2012, 24,635 have received unemployment awards. We have also paid out approximately $35 million in unemployment benefits.

"From the time the benefit was instituted there have been steady and significant decreases in the number of claims. In 2009, awards totalled 14,071 out of almost 16,00 claims totalling $20.8 million. In 2011, we paid out only 4,500 claims awards out of almost 5,700 claims, totalling $6 million."

NIB generated $75 million in investment income in 2011, and Mr Cargill said its reserve fund had ended the year at $1.6 billion, up from $1.57 billion in 2010 and $1.5 billion in 2008.

Mr Cargill added that the National Prescription Drug plan launched in 2010 now has a membership of more than 70,000 persons, and provides prescription drugs to almost 14,500 active beneficiaries.

According to Mr Cargill, to date the drug plan has paid out more than 170,000 claims and over $3.3 million to participating private pharmacies.

January 13, 2012

tribune242

Caribbean Blog International

National Drug Prescription Plan in Dispute

Drug plan in dispute
By CANDIA DAMES ~ Guardian News Editor ~ candia@nasguard.com


The National Insurance Board and the Bahamas Pharmaceutical Association have failed to reach agreement on the government's National Drug Prescription Plan, with a major disagreement erupting over markups for the drugs that will be a part of the scheme.

"You can't ask business owners to sign their own death certificates," said Dr. Marvin Smith, who heads the association.

The government plans to implement the national plan through NIB in August to increase access to cost-effective drugs for certain conditions. During the initial phase of the plan, patients who qualify will be able to fill prescriptions at no cost to them from participating private and government pharmacies.

Thousands of Bahamians who qualify for the plan are waiting for it to start. The plan is a key campaign promise of the Ingraham administration, which has touted it as a crucial initial element of a national health insurance program. The drug scheme's beneficial schedule will include prescription drugs and specific medical supplies deemed necessary by an attending physician for treating a chronic condition of a plan participant.

But NIB has so far failed in its efforts to get the Pharmaceutical Association onboard.

Smith said the nearly 50 pharmacies that are members of the grouping still have concerns about the markups that would be allowed under the plan, and will not participate under the current proposal.

He told The Nassau Guardian that NIB is proposing a 45 percent markup for drugs that cost at under $5; a 35 percent markup on drugs that cost between $5 and $25 and a markup of 25 percent on drugs that cost over $25. Added to the costs of the products would be a $3 dispensing fee per drug.

"There is no way that pharmacies can support, in this first phase, any markup that they're proposing," Smith said.

He said the pharmacies would not be able to survive under that proposal because they have numerous overhead costs that must be taken into consideration.

The association is proposing a 45 percent markup on pharmaceuticals that cost under $20; 40 percent on drugs that cost between $20 and $40 and a markup of 35 percent on drugs over $40. Under the association's plan, the dispensing fee would range from $3 to $5.

"We're not asking for excessive markups," Smith said. "We're saying let's get it to where people can survive, get it to where businesses could be steady and stable. That's all we want."

NIB Director Algernon Cargill said the plan will go forward even if an arrangement cannot be worked out with the Bahamas Pharmaceutical Association.

"We've negotiated markups based on a scientific review of similar plans throughout the region," Cargill said. "While our markup is at the highest level of all the similar plans that already exist in the region, we believe that markup allows for a fair and reasonable return based on the anticipated 35,000 new clients in the first phase and 100,000 in the final phase of the National Drug Prescription Plan.

"In our view, the markups that approximate 50 percent allow for a reasonable return and also allow for the pharmacies to provide for a high level of service to clients that ordinarily would not have visited their pharmacies because they primarily now go mostly to public pharmacies to receive their prescription drugs."

He noted that several pharmacies have already embraced the plan. Cargill said these include Walk-In Medical Clinic pharmacies; Betande Pharmacy; Lowe's Pharmacy; People's Pharmacy and Centerville Pharmacy. He said Wilmac's Pharmacy is also signing on.

According to Cargill, the contracts are flexible and pharmacies that sign them can opt out at any time without penalties.

"We are happy that we have a representative group of pharmacies in order to move the plan forward," Cargill said.

While Cargill admitted that no Family Island pharmacy has signed on as yet, he said the prescription drugs for Family Island locations will be available at public clinics.

He also said the biggest challenge with launching the plan right now is identifying the wholesalers who will provide the drugs to the participating pharmacies.

Cargill stressed, "The National Insurance Board is not insisting that all of the pharmacies sign on to the plan. We want the pharmacies that want to work in partnership in providing better health care services to Bahamians in The Bahamas and can do so with a reasonable profit."

But Smith told The Guardian, "Do you really want a plan that says only the giants who can afford to operate at a loss maybe a bit longer than other people are going to be involved? All that would do is deplete the sector of small businesses and if you only leave the giants then the government puts itself at risk because they would be the only ones who can actually pull a power play on the government. You need the small business persons."

He said, "We want to partner with the government in this initiative. We want this plan to work."

The initial phase of the plan will include NIB pensioners; people receiving invalidity benefits; minors 17 and younger and all full-time students up to 25.

During the later stages of the plan, a new addition to NIB contributions will be initiated to cover the plan.

April 29, 2010

thenassauguardian

Bahamas Blog International