There was nothing "new and significant" learned from the first UHC (universal healthcare) Stakeholder Advisory Council Meeting late last week, said one stakeholder, who added that it is "too early to tell" whether the administration intends to fully collaborate with stakeholders. Meanwhile, the government's lead consultant touted the meeting as "very productive".

According to actuary Derek Osborne, the NHI Committee chairman in the Bahamas Chamber of Commerce and Employers' Confederation (BCCEC), the point of the meeting was to set the terms of reference (TOR) with the National Health Insurance (NHI) Secretariat, the chamber, members of the United Healthcare Reform Alliance (UHRA), KPMG - the Christie administration's new NHI consultants - and other stakeholders present.

"This meeting was really to establish the TOR for the UHC Stakeholder Advisory Council, so it is too early to tell whether there will be full collaboration among all stakeholders. We did not learn anything new and significant about the proposed design and structure of the path to UHC or NHI. We expect to learn more in the coming weeks," he said.

The NHI Secretariat announced the formation of the advisory body with great fanfare, and its formation was welcomed officially by the UHRA. The UHRA is an alliance of more than a dozen health professional bodies and more than 2,000 members who have decided to move forward collectively in the NHI consultation. The group has rejected the version of NHI designed and promulgated by Costa Rican consultants Sanigest Internacional, and vowed to present the government with an alternative proposal for universal healthcare in The Bahamas.

The Sanigest model was in the process of being implemented by the administration when Prime Minister Perry Christie brought in KPMG to - as the prime minister told Guardian Business - "just to be sure we are doing the right thing". It is said to be at KPMG's instigation that the implementation delay many had urged was finally adopted by the administration.

Osborne spoke to what KPMG brings to the table.

"Certainly, the KPMG team appears to include persons with a vast amount of international experience and so they would have seen the "good, bad and ugly" in other countries' attempt to implement UHC. While The Bahamas and our healthcare system have its own dynamics, achieving improved and affordable healthcare for a population is more similar than it is different across countries. There is a role for external consultants and there are roles for local experts and stakeholders," he said.

On the question of timelines on this initiative, particularly given how many of them have been missed, Osborne suggested that every goal or initiative that one hopes to achieve must have a timeline.

"For this new initiative, there should be a documented plan with milestones and timelines. These timelines should be realistic, given the need for dialogue, submission of recommendations by the various committees within the new governance structure and ultimate decision making by the policy makers," he said.

According to Osborne, it is critical that the public know and understand that "the government seems committed to proceeding with the first phase of a phased approach to full UHC with this first phase being primary care only".

"The government now appears willing to formally include stakeholders in the dialogue. Time will tell whether the UHC Stakeholder Advisory Group is able to influence the implementation of UHC in The Bahamas," he added.

Productive
Nonetheless, the government touted the meeting.

Dr. Mark Britnell, chairman and partner, Global Health Practice, KPMG, facilitated the discussion...

K. Quincy Parker, Guardian Business Editor

Click here to read more at The Nassau Guardian