The model for National Health Insurance (NHI) should not be a one-size-fits-all model, Minister of Health Dr. Duane Sands said yesterday, adding that the debate on what NHI should become has "missed the mark".
Sands compared healthcare to the varying classes on an airplane, suggesting that those with the means to afford the creature comforts of the most expensive kinds of health services (first class) should be on a separate tier than those who may have to choose business class or coach.
"This is the model of healthcare we need to deliver - if you can afford creature comforts, if you can afford amenities, there is no reason you should not get it," he said.
Sands explained the principle of universal health coverage like this: "Ensuring that all people have access to needed promotive, preventative, curative and rehabilitative health services of sufficient quality to be effective, while also ensuring that people do not suffer financial hardship and pain for these services, is the
definition of universal health coverage."
He insisted that a healthy population is essential for sustainable development and said data shows an extra year of life expectancy can lead to growth in gross domestic product (GDP).
Sands said given The Bahamas' unique health profile, in which chronic non-communicable disease is a big factor in the morbidity of Bahamians, a "Bahamian solution" to NHI has to be found that will be the most effective system to service the needs of locals. He said Bahamians have for too long used research and data from other countries to make decisions about our own.
"We have not adequately invested in healthcare research and development to answer uniquely Bahamian questions," Sands said. "We have relied on extrapolating data from the first world."
Besides this, the physical plant of the public health care system has not been updated and upgraded in a lot of instances, and Sands said the country has done away with its "retrogressive approach to rating high risk, or older persons, or people with pre-existing conditions".
"We have not dealt effectively with inefficiency, waste and abuse in our public healthcare system," he said.
"We have ignored calls to manage and account for the hospital and public health accounts of most individuals.
"We have not equipped or supplied our facilities with the support services and materials needed in a modern healthcare environment. Our record keeping is outmoded, our information management systems are obsolete, and we have refused to tap legal means of funding to build local capacity.
"We have refused to deal with those people who have at best not provided value to our healthcare system and, at worst, are guilty of extorting limited funds from the national coffers by inadequate productivity or unreasonable charges."
Sands said the private sector will have to partner with the government to produce the new iteration of NHI.

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