Bahamas Insurance Association (BIA) Chairman Emmanuel Komolafe yesterday questioned why private insurers and other stakeholders were not included to form a new consultative body to advance National Health Insurance (NHI) and said he hopes this was not a deliberate exclusion.
Acknowledging the "fragmentation and disagreement" on how the project has been managed, KPMG's Global Health Practice Chairman Dr. Mark Britnell revealed on Tuesday that the government has decided to form a new consultative body comprised of the "medical profession, the [Bahamas] Chamber of Commerce, the Christian faiths and the trade unions" to develop NHI and bring about "active participation". It is expected to be established in a matter of weeks, Britnell said.
The BIA has decried the government's strategy for the rollout of NHI, namely the lack of "full participation".
Komolafe said he could not agree more that inclusion of all stakeholders is pivotal for the success of universal healthcare. He expressed concern about the apparent omission of major stakeholders.
"An obvious omission from the list is the insurance industry, which is a major stakeholder (as indicated by the prime minister and permanent secretary) in the journey to full universal healthcare, and an industry that has much expertise, experience and value to contribute to the process," Komolafe said in a statement.
"I was advised that physician organizations such as the Medical Association of The Bahamas (MAB), [and the] Consultant Physician Staff Association (CPSA) will not be represented on the program board, but rather physicians and service providers will likely be represented by retired practitioners.
"It is imperative to state that the defunct NHI Advisory Committee and the recently constituted NHI ConsultativeCommittee had representatives from the MAB, BIA and BIBA (Bahamas Insurance Brokers Association) in addition to the proposed membership of the program board.
"We are hopeful that this was an oversight or error and not a deliberate exclusion of major stakeholders from the program board.
"As the NHI Secretariat and KPMG have committed to being more inclusive going forward, we will be reaching out to them to address this matter."
During Tuesday's press conference, Britnell also revealed that the rollout of the primary care services phase of NHI "will take a bit more time". This phase was scheduled to begin in April. Britnell said the establishment of primary care services under NHI is dependent on the establishment of a public insurer, an entity he said must be in place to have "sustainable" universal healthcare.
The NHI Secretariat said government accepted KPMG's recommendation to issue a global tender for a third party private company to manage the public insurer. It is unclear when the tender will be issued.
On the delay, Komolafe said the NHI Secretariat and the implementation team are in the best position to determine the level of preparedness for the rollout of the various phases.
"I presume that the decision to delay implementation was made following a detailed assessment of the progress made to date in system strengthening, discussions with stakeholders, achieved milestones and outstanding matters," Komolafe said.
He said universal healthcare is a continuous journey and steps being taken to enhance the existing healthcare system are an important part of the process that should continue as "we continue to address outstanding matters in the days ahead".
Doctors and insurance companies have not yet come on-board with NHI.
The secretariat formally released the NHI Bill just over a month ago. The bill has not yet been brought to Parliament.
While the government has said primary care services would cost $25 million per fiscal quarter, it remains unclear how much the total scheme will cost.
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