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Timeline for NHI rollout unclear

Guardian Staff Reporter

Published: Jan 09, 2017

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While the government said primary care services under National Health Insurance (NHI) would be rolled out this month, the overall timeline for the universal healthcare scheme has become vague, with key phases of NHI hinged on several outstanding components.

In a recent interview, Deputy Chief Medical Officer Dr. Delon Brennen was asked to confirm the January rollout of primary care services under NHI.

He said, “January rollout, but not of primary care.

“Obviously, we have to get to enrollment for that to happen in early 2017.

“What we said was, we are meeting our providers and in order to start enrollment we have to wait until we have our providers on board.

“So, we’ll meet with them and have discussions with them related to the primary care benefit package and them signing up with NHI.

“So, as soon as we have our providers signed up for NHI, then we would be able to roll out the enrollment phase.”

Asked to provide the timeline for enrollment, Brennen said, “Once it starts, it goes on forever; as new people are born; as new people become eligible or they move to The Bahamas and become permanent residents or they become eligible for benefits, then they would enroll.”

Primary care services, phase three of NHI, was set to begin in April 2016.

It was budgeted to cost $25 million per fiscal year.

But days before the rollout, Minister of Health Dr. Perry Gomez said it would be delayed by six months.

The government then planned to roll out the primary care phase this month.

Gomez announced recently that there is likely to be another “slight delay” in the rollout of NHI, but provided no specifics.

Asked whether it is unlikely for primary care services under NHI to be rolled out this month, Brennen said, “I think it all depends on as we get our primary care providers involved the system.”

Pressed for a timeline for a workable NHI program with a base number of beneficiaries receiving basic services under the scheme, Brennen said, “That depends on the starting of the primary care providers being involved in the system, rather than actually the numbers of people who choose to be a part of system.”

At the suggestion that the proposed schedule for NHI appears confusing, he responded, “I can understand that. I think we are all trying to work with all of the dependencies in order to make sure the timelines are maintained.”

The process of establishing a public insurer is ongoing.

Regulations to flesh out the details of NHI have not been finalized, though Brennen said stakeholders are in possession of a draft, which could receive Cabinet sign off at any time.

Registration for the NIB smart card was considered phase one of NHI.

Phase two, enrollment, involves people selecting a healthcare provider.

But as pointed out by Brennen, this process is also ongoing, though there has been some buy-in.

Free National Movement candidate for Elizabeth Dr. Duane Sands said recently that with so many key elements outstanding, it is “inconceivable” that the Christie administration will roll out the primary care phase of the scheme before the next general election.

Primary care is a basic level of healthcare that includes programs directed at the promotion of health, early diagnosis of disease and prevention of disease.

It also covers laboratory work; diagnostic services such as X-rays, mammograms and prostate exams; and the medications required from primary care.

It is a subset of the vital benefits package.

It does not include catastrophic illnesses such as cancer and heart attacks.

According to the government, primary care services under NHI will initially be administered without cost.


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