Universal health care was the focus of discussions at the recent Grand Bahama Health Service’s (GBHS) World Health Day (WHD) Forum held Tuesday (April 9). WHD was officially observed on April 7, 2019.
National Health Insurance Authority (NHIA) Chairman Dr. Robin Roberts, was the guest speaker for the event which was held in the Rand Memorial Hospital’s (RMH) foyer under the theme, ‘Universal Health Coverage: Everyone; Everywhere.’
During his presentation, Dr. Roberts spoke to who is covered, what is covered and the cost of that coverage with NHI.
To this end, Dr. Roberts took attendees through the life of the average, relatively healthy Bahamian, noting that realistically, the Bahamian population is aging and the numbers are getting higher for health insurance premiums and health care.
“People who lost their jobs, retired and lost their health insurance then developed illnesses like Cancer and persons, who were born with illnesses like Sickle Cell Anemia or have non-communicable diseases are often the people who cannot afford health insurance or good health care services.
But these are the builders of this country,” said Dr. Roberts.
He added that this is the purpose of National Health Insurance (NHI), so that the persons who can least afford health care can receive.
After launching NHI in April 2017, the main focus was providing primary care to the Bahamian populace. “We find this is the best way of spending our health care dollars, for individual health care.”
He furthered that primary care does a great deal in focusing on prevention of non-communicable diseases, like diabetes and heart diseases which often lead to other deadly health problems.
“In this lifestyle behavior that we have, we are now detecting in our children that they have diabetes in their teens,” Dr. Roberts revealed.
He disclosed that the NHIA is now moving into Primary Health Care, which focuses on community health, whereas primary care focuses on individual health. The NHIA plans to conduct activities such as distributing vaccines and various initiatives to educate the public.
The establishment of a Standard Health Benefit (SHB) will ensure all health insurance plans in The Bahamas offer the same benefit package outlined by NHI to all Bahamians. This includes an expanded primary care package and high cost treatments, such as diagnostic scans like X-rays, mammograms and ultrasounds and treatment for certain cancers, heart attack and kidney disease, said Dr. Roberts.
Those packages of benefits which are called Standard Essential Health C-are Benefits will include common cancers, “we have cervical cancers, breast cancers in women, prostate cancers in men, colon and rectal cancers in both men and women.
“It will also include having pacemakers available for those individuals who have those potentially fatal rhythms of the heart.
“The package will also dialysis for persons with kidney failure and he expressed that the NHIA looks forward to adding kidney transplants to the dialysis program at some point in the future.”
When discussing the cost of NHI, Dr. Roberts expressed that it is important to look at how much patients can afford to pay.
He shared that the NHIA looked at having a health premium of $1,000 per year per person, which is $84 per month.
There will be two categories of individuals enrolled in NHI, the employed and unemployed.
For those individuals that are employed the NHIA is proposing an Employer Mandate and that employer mandate is that the employers have the responsibility to make sure that all their workers have a private insurance coverage.
This states that every employee must have health insurance paid for by a shared contribution between the employer and employee. For the employee it would be 1.5 percent of their income and the employer would pay no more that 1.5 percent in terms of sharing.
Under the proposed model, the NHIA will provide the Standard Health Benefit to those who do not fall under the Employer Mandate, including children, retirees, indigents and unemployed persons.
He added that private insurance coverage, the contributions that are going to be made by the employer will be paid through the private insurance industry, not through the government.
“The government’s responsibility is to provide health insurance coverage to those who are unemployed and more importantly to those who cannot be employed or who are unemployable including our senior citizens, our children, our pensioners,” Dr. Roberts said.