In fact, some people have called the proposed compulsory deductions to fund the plan “a poorly disguised tax on income.”
Dr. Sidney Sweeting, a member of the Bahamas Dental Association, charges that the government is rushing the National Health Plan into being “with an election in mind,” and that the so-called consultations ongoing are in fact nothing of the sort.
“(Health Minister Dr. Bernard Nottage) is implying that he is consulting with people. He meets with them, yes, but thatﾒs not consultation,” he told the Journal on Thursday.
“Unless they sit down and seriously consider (the opposed bodiesﾒ) proposals and their views, thatﾒs not consultation, thatﾒs just telling people what youﾒre planning to do. Itﾒs just too much of a rush into this ﾖ letﾒs get it right before we even implement it.”
Taking a more diplomatic line, Executive Director of the Bahamas Chamber of Commerce Philip Simon said it was premature to say the plan was being rushed into being.
He pointed out that Dr. Nottage has voiced an intention to bring proposed legislation for the National Health Plan by the end of the year, which would clear the way for implementation of the plan.
“If that is happening in the absence of informed debate and dialogue, then the answer to that question (of whether implementation of the plan is being rushed) will be yes,” Mr. Simon said, “but at this particular point in time, hopefully the consultative process fulfills its true potential.”
Dr. Nottage said last month at an appreciation lunch for the Blue Ribbon Commission and the Steering Committee on National Health Insurance that he intended to have all elements of the scheme handed over to the government by the end of the year so Parliamentarians can debate the scheme.
Prime Minister Perry Christie said, at the same luncheon, that “it is an incredible requirement to meet the expectations of our people when it comes to health careﾅWith the health plan persons on the Family Islands will have access to the same level of care as those persons who reside in New Providence.”
Mr. Simon on Thursday reiterated the Chamberﾒs support of the concept of the plan, but noted that rushing to implement the plan would be doing the country a disservice.
He said the question has always been what the true cost impact of this proposed plan to businesses as the Bahamian people would be, and how it would be administered.
“And again,” Mr. Simon continued, “there needs to be clarity and full disclosure on all points and data and information related to this proposal so that there is transparency and clarity, and so the feedback that is given is given from an informed position.”
He added ,”obviously there is more consultation ﾖ quote, unquote ﾖ to be done and the feedback that is given has to be considered in a serious manner, otherwise that puts the system and the proposal in some type of jeopardy going forward because there would not have been full buy-in and transparency in the entire process.”
In the absence of informed dialogue, Mr. Simon said, “we may just be spinning wheels, just having meetings that are not realizing their full potential.”
The Nassau Institute has apparently presented a report to the government on the proposed plan prepared by Nadeem Esmail, who the institute said has studied health plans around the world.
Dr. Sweeting told the Journal that Mr. Esmail goes through the proposed plan step by step, and points out the flaws in the proposed plan and makes a number of suggestions that, according to Dr. Sweeting, the government has not considered.
He argued that it is irresponsible of the government not to consider these suggestions, and charged that the new round of meetings on the plan is not “legitimate” consultations.
“They meet with people, but they donﾒt actually discuss. (A number of organizations) do have ideas that could go into this plan, and one of the main things is that we would like to see government involved in this, but only to the extent of working with the private insurance people,” Dr. Sweeting said.
“I resent it, and every businessperson Iﾒve spoken to resents the idea that they are putting a mandatory premium which is going to force the majority of businesses to forego their private insurance. And the employees donﾒt want it and the businesspeople donﾒt want it.”
Dr. Nottage said last month that “consultative groups” were being organized “to ensure that all key stakeholders have an opportunity to inform the design on the NHI scheme.”
“The objectives are to share information, to secure feedback on operational implications of specific proposals for each group and to establish lines of communication so that key information is transmitted,” he said.
Dr. Sweeting pointed out on Thursday that plans in Quebec and the UK similar to the NHI scheme are creating problems, citing a recent report that shows 23 percent of the specialists in Quebec are planning to leave that province because of the strictures of a plan very similar to the one the Christie administration plans to introduce in The Bahamas.
“Itﾒs putting doctors under restrictions that are just not going to sit well with people, and itﾒs not only the doctors, itﾒs the patients (who) are going to end up in long lines. Itﾒs happened in Canada, itﾒs happened in Britain, and I donﾒt see why ﾖ if weﾒre working basically under the Canadian plan ﾖ why they think it will not happen to us,” he said.
Dr. Sweeting insisted that people expect more when they are paying for something, which may lead to long waiting lists for procedures such as CAT scans and MRIs ﾖ the length of the wait for these services may put Bahamian lives at risk, he said.
“I feel that the government is just rushing into this, and my feeling is (it is) because an election is coming, and (if the government considered) stepping back and consulting seriously with the (Bahamas) Medical Association and these other people, and this report that Mr. Esmail has put out, it would make it a lot more palatable than it is now,” he said.
Leader of the Bahamian National Party Dr. Dexter Johnson has also released a statement sharply criticizing what he sees at “the imminent flip-flop of the Christie administration,” pointing out that the prime minister made a “no new tax” promise during the budget debate.
“Yet all the utterances of Health Minister Dr. Bernard Nottage point to the impending imposition of a legislated compulsory deduction from income to fund the so-called National Health Insurance,” Dr. Johnson said.
“This compulsory deduction is nothing but a poorly disguised tax on income and as such would be a gross betrayal of (Prime Minister Christieﾒs) promise.”
Dr. Johnson, after a tirade criticizing the government for proposing these deductions in the midst of increasing prices on gas, groceries and a host of other necessities, wondered what assurances exist that the National Health Insurance money would be better handled than National Insurance Board funds.
“We all know that National Insurance is not operated in an efficient manner,” Dr. Johnson said.
“What is to guarantee that this health tax money will be handled any better? After all, it will be handled by the same policy persons who are in charge of National Insurance.”
Dr. Johnson added, “A tax by any name is still a tax, and a promise not to impose any new tax ought to be binding when it is stated in the halls of Parliament.”
Dr. Nottage pegged the cost of the scheme at $235 million, of which employers are expected to cover a portion, as will employees and the government.
Former Chamber of Commerce executive Rick Lowe said recently that in his limited experience in “consulting with government as a representative of the Chamber of Commerce or the Coalition of Private Sector Employers is that the government is simply out to inform the stakeholders about what they intend to do.”
“This has been the case with the so called Labour Bills, Financial Service Legislation and the Consumer Protection Legislation,” according to Mr. Lowe.
The major benefits proposed in the health insurance package include NHI paying for visits to doctors at government and private hospitals and clinics, coverage for medication prescribed by doctors, lab tests and surgical operations coverage.
By: Quincy Parker, The Bahama Journal
