The Bahamas Insurance Association (BIA) has charged that despite reports that the government had engaged a new consultant to advise on the implementation of the National Health Insurance (NHI) scheme, that engagement "has not yet been confirmed". This and other matters of concern to the BIA remain "unresolved". The association made the claim in a press statement issued over the weekend after having met with the NHI Secretariat on Thursday. Attempts by Guardian Business to contact secretariat members were unsuccessful up to press time.
Said the BIA, "Despite media reports that the government had engaged a new consultant to advise on NHI implementation, the BIA learned that the engagement has not yet been confirmed. Nonetheless, the BIA expressed its interest in learning what is the consultant's mandate and indicated our willingness to meet with the consultant at the appropriate time."
Guardian Business reported that the Consultant Physicians Staff Association (CPSA) and the Medical Association of The Bahamas (MAB) met recently with Prime Minister Perry Christie, who revealed that he had asked international firm KPMG to provide yet another layer of outside consultation on the National Health Insurance (NHI) scheme. Other news agencies identified the supposedly contracted consultant as Dr. Mark Britnell, chairman of the accounting firm's 4,000-strong global health practice, as the latest NHI consultant.
Some weeks ago, on the sidelines of the 25th annual Bahamas Business Outlook, Christie told Guardian Business that, despite having had the advice of PricewaterhouseCoopers (PwC) and the government's internal advisors - and of course the scheme's progenitor, Sanigest Internacional - he was going to bring in yet another outside consultant "just to be sure" his administration was "doing the right thing". Christie did not at the time identify who that consultant would be, and has kept the information close to his chest even up to now. No public notice has been given that KPMG has been brought in.
According to the BIA statement issued on Saturday, KPMG's contract - whether for Britnell or someone else - has yet to be confirmed. According to the BIA, the Thursday meeting was the first such meeting between the parties in more than two months, aside from a meeting hosted by the Bahamas Chamber of Commerce and Employers' Confederation. Both association and secretariat sources had expressed hopefulness heading into that meeting; according to the statement, the BIA is "hopeful that tangible progress will ultimately come out of the resumed engagement".
The statement, however, asserted that despite the meeting, the BIA is "still hoping for a meeting of the minds".
"While the matters of concern to the BIA remain unresolved, the BIA is hopeful that tangible progress will ultimately come out of the resumed engagement," the association said.
Public insurer
For instance, the association reiterated that the NHI Secretariat has indicated that under NHI, Bahamians can choose their preferred registered and certified insurance provider and doctor.
"The BIA expressed its anticipation that the NHI Secretariat will hold discussions to specify the nature of such health insurer involvement so that insurers can prepare themselves to successfully partner with NHI. We note that as NHI services are said to commence in April, such discussions should begin shortly.
"As we learned the reasons that led to the government believing that there is merit in creating a public insurer in December, the BIA wishes to be afforded an opportunity to demonstrate how the government's concerns can be met through alternative approaches, sparing the country the waste of creating another state-owned corporation which will inevitably provide poor service at great expense to taxpayers," the BIA added.
The association reported that the NHI Secretariat had advised that the ultimate decision on the establishment of a public insurer lies with the policy makers and the secretariat expressed optimism that recent overtures by the BIA will encourage the government to engage in meaningful discussions with the BIA on the best approach to the administration of NHI, which will minimize any potential disruption to the insurance industry.
The association reasserted that despite its misgivings about the current design of NHI, it remains supportive of the secretariat's objectives.
"We believe that the skills and capabilities of private health insurers must be leveraged in order for NHI to be a success and we would expect that, despite disagreements, the NHI Secretariat ought not to have long lulls between meetings and exchanges of information with the BIA," the association said.
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