September 12, 2014
A prominent businessman has thrown his support behind changes to the current healthcare system, arguing that too much is being spent and too many are "dying by the roadside" for lack of access to healthcare.
Dionisio D'Aguilar commented after Guardian Business revealed that total spending on healthcare in The Bahamas ballooned from $380 million to $800 million between 2001 and 2013, even as health indicators stagnated.
The figures were revealed in a presentation by government consultants on National Health Insurance (NHI), Sanigest Internacional (SI), to local healthcare providers on September 2. SI claims that The Bahamas is getting a "low return on its healthcare investment" and pointed to ways in which the introduction of a NHI system could improve matters, in part through being combined with steps to reduce "high wastage" in the current system, both private and public.
Dionisio D'Aguilar, president of Superwash and a former Bahamas Chamber of Commerce president, told Guardian Business of the government's proposal to implement NHI in 2016: "It's a tough one. I think the government is right to look at this. I generally go against the trend here with my private sector friends. I think we are spending far too much on our healthcare, and for what we are spending a lot of people are dying by the roadside because they can't afford to get decent healthcare. And it's a duty of a government to provide healthcare to their citizens and I think we need some mechanism that does that..."
"How it works and comes about I'm not in a position to say, I just know that what is there now is not working," he said.
In its presentation, SI also showed that there are major issues as it relates to equity of access to healthcare in The Bahamas, with over 100,000 people having no access to a health "safety net" in the form of insurance, and those considered to be in the lowest
25 percent for socioeconomic status 76 percent less likely to have private health insurance than those in the top quartile.
The Bahamas also ranked poorly for access among the population to high tech medical treatments, such as MRIs and CT scans.
Meanwhile, SI showed that of the $270 million spent on private health insurance in 2013, as much as $60 million of it left the country to pay for medical treatments abroad, and $66.7 million went to cover non-health related costs such as broker's fees.
Bahamas Chamber of Commerce and Employers Confederation Chairman Robert Myers told Guardian Business that the local medical profession "needs to improve" if it wishes to see more of the dollars spent by Bahamians on healthcare remain in The Bahamas.
Myers said that he does not see the amount being spent by Bahamians on healthcare outside of the country reduced through the implementation of national health insurance (NHI).
"I don't think NHI is going to minimize the number of people who go away for treatment," he said.
"I think people who can afford to go away will go away. The quality of care, surgery, is better there. I think a lot of people are concerned about the fact that there are very few malpractice suits in The Bahamas and it's a boys' club.
"People are just concerned about malpractice. The medical profession needs to improve. It's not just about cost improvements, it's about improvements in quality of care."
Commenting on the growth in spending on healthcare in The Bahamas, Myers said that more information is needed comparing The Bahamas' spending on healthcare with other countries relative to its size.
"Those statistics don't mean anything to me, because I don't know what the comparisons are. That's the whole point of having a company like Sanigest (Internacional) and being transparent in the process.
"We need to look at the cost per person of procedures here, versus other countries and in the U.S."
Myers said that the Chamber has yet to be allowed to see the contents of SI's full report, now confirmed as having been issued to the government, on NHI.
Myers confirmed that the BCCEC is still seeking to get the government to agree that its involvement in any committees on NHI would not come at the cost of having to sign a non-disclosure agreement (NDA).
"Next week we are going to decide where we are going to draw the line in the sand. We'll try to be as cooperative as possible but these are fundamental issues."
"We can't be out there fighting for a Freedom of Information Act and signing non-disclosure agreements, that's just hypocritical."
He noted that the Chamber of Commerce is a "consensus driven body that is not just the CEO or the chairman, but consists of a board of directors".
"The purpose is to have input from a wide array of sectors," he said.
"That's the point of building a wide board. If we can't talk to those people there's no point having us there.
"We shouldn't be embarrassed about what the report says. We should be looking at it constructively and saying 'How do we do it better? How do we create more efficiencies and lower costs?'"
Asked what happens if the government denies them the opportunity to be involved in the NHI consultation process without being bound by an NDA, Myers said the government would be "missing a significant opportunity to collaborate with the private sector".
"We have to mature as a nation and be more transparent. It's absolutely ridiculous, as if we are operating in some archaic country. We're not going to grow and prosper in this way."
Click here to read more at The Nassau Guardian