The Bahamas Insurance Association (BIA) has decried the reported eight-business-day turnaround the Christie administration has allowed for the association and other stakeholders to review a draft National Health Insurance (NHI) Bill as "simply insufficient". In fact, the association said it is "very unlikely" that its comprehensive review will be complete by the March 2, 2016 deadline.

Yesterday, BIA Chairman Emmanuel Komolafe issued a statement welcoming the opportunity to review the draft legislation for NHI, indicating right off the bat that the BIA has problems with the administration's proposed consultation timelines.

"We look forward to examining the draft legislation more closely in the coming weeks with a view to providing the NHI Secretariat with tangible and constructive feedback that will strengthen the bill and eventually result in legislation and regulations that effectively achieve our common objective of a robust universal healthcare system in The Bahamas," Komolafe said.

"We are in the process of commencing a comprehensive review of the draft NHI Bill and will be providing our comments and/or recommendations to the NHI Secretariat once this is complete. It is very unlikely that our review will be complete by March 2, 2016."

He said the reports of the March 2 deadline were cause for concern, because that timeframe is "inconsistent with best practices" for such consultation as it is "unreasonable to allow the public and private sector stakeholders only eight business days to review and provide feedback on the draft legislation". He said it was general practice that consultation periods range from six to 12 weeks, depending on the level of familiarity with the proposed legislation or policy document and the significance of the proposed initiative.

According to Komolafe, implementation of NHI is "a monumental and progressive social initiative that requires the broadest consultation and meaningful feedback from all stakeholders". "Hence, one would have expected that the standard 12-week consultation period would have been adopted to enable stakeholders to conduct proper and in-depth reviews prior to providing their comments.

Stakeholders may need to consult legal counsel or other experts and have extensive discussions with their constituents before compiling their responses. An eight-business-day consultation period is simply insufficient to obtain useful input and the timeframe should be reconsidered by the NHI Secretariat; we are hopeful that this was just a case of misunderstanding or misreporting," he said.

However, the NHI Bahamas website (www.nhibahamas.gov.bs) confirms that "comments, suggestions and advice on the bill should be forwarded in writing, by hand or via email no later than March 2, 2016".

Komolafe noted the appearance of disparity between what has been said about the consultative process and what is being put out as fact with regard to that process.

"The abbreviated consultation period on the draft bill is surprising as it is inconsistent with recent comments made by the prime minister. We concur with the prime minister that the government's focus should be on 'getting it right' and we propose that this can only be achieved by engaging stakeholders in meaningful discussions," he said.

Regulations
Much as the 2006 National Health Insurance Act was promulgated without regulations, the draft NHI Bill 2016 has also been floated without regulations. This is another point with which Komolafe took issue. He called it "challenging" to review the draft NHI Bill "in isolation" - that is, without the details typically contained in regulation.

"It would have been ideal to have the draft regulations released at the same time as the draft NHI Bill, as the important practical details are often contained in the regulations. However, we are constrained to consider the draft legislation at this time as that is all we have.

"The NHI Secretariat had advised the BIA that they would solicit our assistance and input in the drafting of the regulations, so we are waiting to hear from them. It is unclear, however, how this will work, seeing that there are still discussions and reservations about the proposed model after which the legislation has been crafted. This is further complicated by the announcement that a new consultant may be engaged to review the proposed framework and provide recommendations. We will have to wait and see how this unfolds in the coming days and weeks," Komolafe said.

Prime Minister Perry Christie has indicated that the government intends to bring in KPMG to review what has been done so far and to "make recommendations" about the implementation going forward. That appointment has yet to be confirmed.

By K. Quinicy Parker - NG Editor

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