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BIA questions NHI legality

  • The Christie administration rolled out the primary care phase of NHI on May 1.

Guardian Senior Reporter

Published: Jul 17, 2017

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Pointing to the “haste” in which the Christie administration implemented National Health Insurance (NHI) weeks ahead of the May election, the Bahamas Insurance Association (BIA) has raised concern over what it has deemed key elements lacking from the scheme and its legal framework.

The Christie administration rolled out the primary care phase of NHI on May 1.

It did so with no public insurer and no means of funding the program.

The BIA said it understands the board of the NHI Authority has also not been appointed.

It said the absence of the board calls into question the acts undertaken by the NHI Authority in an effort to implement the plan.

“We also note that the NHI Act anticipated that regulated health administrators manage and administer NHI benefits under the NHI Act,” the BIA said in a statement.

“Such administrators are required by the NHI Act to be companies duly licensed under the Insurance Act.

“It appears that no such company was contracted with to administer NHI benefits and that the government via the NHI Secretariat has taken on these responsibilities.”

The Guardian understands that the members of the board have recently been selected, but the names have yet to be gazetted, meaning much of what has been implemented regarding NHI so far was done without legal authority.

The BIA said extensive advertisements, including endorsements from physicians who signed up to provide services under NHI, all encouraged Bahamians to enroll.

The association said it believes the board of the NHI Authority, when formally constituted, may be challenged considering the advancement of the scheme in its absence to date.

At last report, around 25,000 people have enrolled for NHI, the BIA noted.

During the 2017/2018 budget debate, Deputy Prime Minister Peter Turnquest was critical of NHI, saying when governments put forward “bright, brilliant programs” but do not “bother to work out the details” the country is placed on a disastrous path.

According to the budget, the government will provide $40 million to the NHI Authority in the current fiscal year, another $40 million in 2018/2019 and a further $40 million in 2019/2020.

Minister of Health Dr. Duane Sands previously said the government foreshadows apportioning approximately $10 million of the $40 million allocation on staff and administration, $15 million on primary care services and another $15 million on catastrophic care.

Sands said the public expects value in terms of health and is now looking to the Minnis administration to provide a program that will stop the need to have cookouts to raise funds for healthcare services.

He asserted that NHI is still not ready to help the average Bahamian and said the opposition will accuse the government of stop, review and cancel.

“I’ll own that up,” Sands said.

“Let’s stop, review and make it right for Bahamians.”

The BIA said it welcomes the opportunity to restructure the universal healthcare scheme to ensure the best outcome for the nation, and looks forward to being engaged in the process.

“The BIA reiterates its agreement with the concept of universal healthcare and is committed to working with the minister of health and the NHI Authority — when formally constituted — to ensure that a sustainable NHI plan is implemented and administered successfully for The Bahamas,” read the statement.

“We wholeheartedly agree with the minister that this is the time to stop, review and get it right.”

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