President of the Medical Association of the Bahamas (MAB) and member of the United Healthcare Reform Alliance (UHRA) Dr. Sy Coolidge Pierre yesterday asserted that the country's major healthcare providers and stakeholders have "in no way or form" signed on with any independent provider association (IPA). Pierre added that the MAB - as the largest and officially recognized physician association - "has no intention of signing onto any agreement that may potentially marginalize Bahamian physicians, and more importantly not be in the best interest of the citizens and legal residents of The Bahamas".
Pierre was responding to the release last week of a statement from the National Congress of Trade Unions, although the statement as sent mistakenly said the Trade Union Congress, and a so-called Bahamas Independent Provider Association (BIPA), which Guardian Business understands includes Drs. Conville Brown and Robin Roberts, among others. The release from BIPA was a staunch statement in support of the Christie administration's National Health Insurance (NHI) initiative.
In a statement disavowing the IPA, Pierre reasserted the support of the majority of Bahamian healthcare providers and stakeholders for a National Health Insurance-funded universal healthcare (UHC) plan.
"The Medical Association of The Bahamas has been lobbying for a proper universal healthcare plan for more than 30 years. What the providers want is a plan that will provide a properly managed NHI-funded UHC plan for The Bahamas; do so with minimal to no upheaval of the present system; fully utilize the present infrastructure; will not require any massive increases in government expenditure; provide a mechanism whereby benefits can be easily added if fiscally sustainable, and will not only retain our most valuable healthcare resource - our providers - but will provide a healthcare system that our future Bahamian providers will be proud of and want to fully participate in. This is especially important, as 'brain drain' is catastrophic for any country," he said.

Deceptive
Pierre noted that while all parties will never agree on all aspects of any plan, the healthcare providers and stakeholders "have been and will continue to work closely with the NHI Secretariat to craft an NHI-funded UHC that is in the best interest of all Bahamians and legal residents."
The MAB spoke to the BIPA; Pierre said that if a group of physicians and providers decides that the formation of an IPA is in their best interests, then they should be free to do so. However, he said, an IPA is not necessary to properly manage an NHI-funded UHC plan.
"The recent BIPA statement is both distasteful and deceptive, seeing that certain members of the organization recently met with the major healthcare providers and were given a clear and unequivocal "no" answer to their proposal. BIPA's public statement that the "major physician provider groups... signaled their commitment and agreement" with the BIPA is an outright untruth.
"I have personally spoken with the major provider/stakeholder groups and they have gone on record as saying that they have not agreed to sign on to any IPA agreement, including BIPA's. Some members of a few of the groups had agreed to look into the viability of an IPA but that is as far as it went," Pierre said.
He said the groups he contacted as president of the MAB include the Consultant Physicians Staff Association, the consultant physician group of Princess Margaret Hospital; The Bahamas Association of Primary Care Physicians; The Bahamas Doctors Union, the junior doctors group of the public health service; The Bahamas Dental Association; The Bahamas Physiotherapy Association; The Bahamas Medical Technologists Association; The Bahamas Insurance Association; The Bahamas Pharmaceutical Association; The Bahamas Psychological Association, and The Bahamas Chiropractic Association.

Questions
Pierre contended that if the BIPA has major provider and stakeholder groups definitely signed onto an agreement they should make it public, as he failed to see where the "2,000" providers are located.
"Maybe they are located outside of The Bahamas," Pierre said.
And should the BIPA plan to be seen as a credible organization - especially if their leadership is composed of members of organizations that have definitively said they will not join the BIPA - Pierre said the groups should say, among other things, who its executives are, and what its organizational structure is, whether it is a non-profit, and what fees are paid to the organization and by whom.

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