June 03, 2015
"After consultation with the private sector insurance companies, put in place a system of National Health Insurance so that every Bahamian will have insurance coverage for major surgery and other medical services."
- 2002 PLP platform
In the lead-up to the 2002 general election, I joined a delegation led by Perry Christie on a visit to Moore's Island, Abaco. During our walkabout, we met a young man who was extremely challenged, both mentally and physically. I was moved by the interest and attention Christie showed him. I realized then that Perry Christie was fully committed to the implementation of a comprehensive range of health services for all Bahamians.
The first system of universal health care was established in Norway in 1912. Since then, Norway has been joined by 32 of the most developed nations on the planet, with the United States establishing in 2014 comprehensive health insurance coverage for all United States residents. The time has now come for The Bahamas to join the community of nations relative to universal health care.
Universal health care does not necessarily imply a government-only scheme. Many countries, in implementing universal health care, continue to include both public and private insurance and medical providers. I congratulate those who are sufficiently fortunate to afford medical insurance plans that fully meet their health needs. However, those persons whose health is impaired and cannot afford insurance coverage, should receive health care that is financially supported by the state. The absence of such arrangements could condemn them to a lifetime of poverty and lost opportunities that could result from debilitating or life-threatening health problems that are not adequately addressed.
If health insurance and many other privileges are taken for granted by those who can afford access to health care services, then surely our relatively affluent society, which enjoys the highest per capita income of any Caribbean nation, can find an optimal formula to demonstrate to the poor, the needy, the aged and the infirm that we care enough for them and every family in The Bahamas to provide them with quality health care.
We deceive ourselves if we believe that we can truly have a high level of prosperity without a healthy and just society. If we recognize this fact, we will support National Health Insurance (NHI). We can and should do everything in our power to make a difference in this noble effort.
There are two primary arguments that have been advanced against NHI. The first concerns funding, often with the refrain that "we can't afford it," and that "there should be no additional taxes" to finance this endeavor. While I accept the argument about taxes "at this time", I believe that we must find the means to afford a January 2016 rollout without any new taxes. One might well ask, how is this possible? I believe that if we muster the resolve, we can find a way.
The government could find many millions of dollars by reducing the size of government (particularly the Cabinet) and reducing the expenditure of many government ministries and departments, reducing the subvention to Bahamasair and the Broadcasting Corporation, eliminating unnecessary travel and minimizing the use of foreign consultants.
The latter expenditure can be significantly reduced by engaging the local talent and skills of professionals who have the ability to compete with many foreign consultants. I readily accept that exceptions in the reduction of expenditures should apply in the areas of health, education, public safety, social services, investment in infrastructure and tourism and foreign investment promotion.
Insurance companies and other corporate citizens should be invited to fully participate in the national discourse and assess how they can contribute to the NHI fund, in the spirit of our increased focus on public private partnerships. Those who suggest that we cannot afford the cost of universal health care should seriously compute the considerable cost of not doing so.
The second argument that has been advanced is that "National Health Insurance could risk our way of life". If "our way of life" means ignoring the conditions of the poor, the infirm, the elderly, the chronically ill and the unemployed, then all right-thinking persons should not only risk that way of life, but publicly condemn it to the dung heap.
The private sector should be encouraged to join the government in promoting significant economic growth. This can be successfully achieved by enterprising Bahamians who can be empowered through the prudent use of Crown Land, so that by expanding the economy, such entrepreneurs can contribute to the goal of a healthy and vibrant nation. We must find an effective way to enlist the bright minds that have been educated over the years and who have proven that they can successfully manage large businesses.
We should also ensure that the public debate on this important national issue is not relegated to the kind of political bickering that would suffocate an objective, honest and beneficial dialogue. Every effort must be taken to transcend partisan political differences to develop a scheme that is generally acceptable to most Bahamians so that successive governments will not radically alter the program which we finally decide on, much like we have done with our National Insurance Program.
Above all, as we transition to a National Health Insurance scheme, we should guarantee that those persons who are selected to manage this program are beyond reproach and are answerable to their mandate, while maintaining cordial relationship with the government of the day.
Bahamians have an inalienable right to enjoy a better life in a better land - a land where our people are healthy, educated and prosperous, enjoying an improved quality of life in safe and secure communities.
There is a guiding star in The Bahamas' firmament that points the way to that better land.
o George A. Smith served as a member of Parliament for 29 years and a Cabinet minister for 11 years. He was a member of the delegation at the London talks on Bahamian Independence.
Click here to read more at The Nassau Guardian