The Bahamas Association of Physiotherapists (BAPT) said the minister responsible for National Health Insurance (NHI) would have "near unlimited" power to invest NHI dollars without accountability and responsibility, and that NHI funds are vulnerable to abuse.
The association was referring to section 16(1)(b) of the NHI draft legislation, which stated that the National Health Insurance Authority (NHIA) may invest monies from the reserve fund and any other monies from the fund, which include securities issued by the government and other securities, real estate, financial contracts, agreements and investments authorized by the minister in collaboration with the authority.
BAPT said that in the absence of regulation that includes guidelines, restrictions and definition of risk profiles for investment of NHI funds, the minister would have near unlimited power over NHI dollars.
However, the government responded that the authority will control and manage the NHI fund, and that no adjustment had been made to that section of the draft bill.
The NHI fund would be established for financing the objectives outlined in the NHI legislation.
Parallel to comments from other stakeholder advisory council members, the BAPT expressed its concerns over the constitution of the board and powers of the NHIA.
The first schedule of the bill underscores the constitution and procedures of the board.
Section 1(a) of the first schedule states the board shall consists of 12 persons, seven of whom shall be appointed by the minister from among those categories of persons who would be regarded as representative of the views of beneficiaries, the medical and nursing profession, and the religious, commercial and labor sectors.
BAPT said the appointment process is too minister-heavy.
And while the government said the constitution of the board would be revisited, no changes were made to this section in the NHI Bill 2016.
BAPT also recommended that ex-officio members should be allowed to vote, which was the opposite of what was stated in the bill.
The government said there would be no changes to the voting powers of the ex-officio members.
In section 7 (1)(e) of the bill, it states that the powers of the authority are to appoint officers and such other employees or agents, as the authority considers necessary and section.
BAPT said that the basis for such appointments is not clearly defined, therefore transparency is not possible. "Any system of universal healthcare (UHC) requires strong leadership and good governance to successfully deliver healthcare and to improve health outcomes. Transparency is the cornerstone of success for any UHC model."
The government's response was, "All powers and functions of the authority will be governed by the NHI board."

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