Just over five months following the introduction of value-added tax (VAT), Bahamas Christian Council (BCC) President Dr. Ranford Patterson said VAT is "killing Bahamians" and suggested that the implementation of any tax associated with National Health Insurance (NHI) would be the final nail in the coffin. While Patterson said he fully supports the implementation of NHI and encouraged all Bahamians to do the same, he added that the government needs to find ways to fund the scheme without taxing Bahamians further.

"Everyone should support a National Health Insurance," he said this week in an interview with The Guardian.

"The challenge I have is how do we pay for it? Can we find another way to pay for it other than putting taxes on the backs of Bahamians again at this time? I believe that with all of the concessions that we are giving to the hotel and other [investors] coming in they should be made to pay to assist with this National Health Insurance.

"How do we get our monies back that we give every year to these investors who come into our country. They should be made to pay for it."

Patterson added, "People are hurting. People can not afford more taxes. It's killing us. The cost of living has gone up by more than 7.5 percent. It's killing us. People are hurting more than I've ever seen in my life."

VAT was implemented in January at a rate of 7.5 percent. Chief Medical Officer Dr. Glen Beneby said recently the government is considering a payroll tax of no more than three percent to help fund NHI. However, he added that the administration's goal is to introduce NHI in January 2016 without that tax in place. It is unclear how the government would initially fund the program without implementing a tax.

Patterson said he doesn't know how The Bahamas would look if the government were to implement a second tax.  Asked if the government should consider delaying NHI, he said an emphatic 'no'.

"We need NHI," he said. "There are old people in our country who need medical insurance. I'm saying we must find another way. We must not close our eyes to other avenues to make this thing a reality. That's all I'm saying."

Patterson said the BCC met with officials from the Ministry of Health to discuss its concerns.

"That's all we can do," he said. "We can just tell them what the people on the ground, that we deal with every day [are saying]. The difference between, I believe, the politicians and the preachers is that we see these people every week. And we are in their face every week. Politicians basically see them once every five years.

"They think they know the pulse of the people, but they don't. The church knows the pulse of the people. The church knows what the people are going through. The church knows how many people that we feed every day. The church knows how many light bills we pay every day. We have to do it."

Patterson said more and more people are looking to the church for help.

"Right before I came into this boardroom today I got a call... people are looking to us," he said. "So even the church is stretched."

He said his church, Cousin McPhee Cathedral, spends thousands of dollars monthly "to ensure that people have food."

"We spend more money helping the poor people than we ever did before," he added.

Costa Rican consultants Sanigest Internacional concluded NHI would cost between $362 million on the low end and $633 million on the high end annually. The report proposes three revenue scenarios to pay for the scheme, each with varying taxes. The Bahamas Insurance Association (BIA) has predicted that NHI could require close to $1 billion to implement.

The BIA supports the concept of universal health coverage, but not the NHI proposal as it currently stands. One significant reason is the financing, with BIA suggesting that the Sanigest cost estimate was about $300 million short. After failing to implement NHI during his first term in office, Christie has listed NHI as a priority matter this term. While observers have said January 1, 2016 is too ambitious, the government insists that it must not fail this time around to implement NHI.

Click here to read more at The Nassau Guardian