The National Coalition
For Health Care Reform

Article - 8th March, 2007

WHAT SHOULD BE DONE TO PROVIDE BETTER HEALTH CARE COVERAGE FOR ALL BAHAMIANS?
Find out where the National Coalition For Health Care Reform stands on the issues related to the proposed NHI!

The National Coalition for Health Care Reform (NCHCR) has repeatedly noted that it supports improvements to the health care system that will bring tangible and sustainable benefits to the Bahamian People. We are not simply about objecting to the creation of a National Health Care Plan. What we do believe however is that there is a better, more efficient, more effective way to ensure that Bahamian get access to the best possible health care at the best possible prices.

This series of articles will take an in-depth examination of the key principles of the NCHCR and demonstrate what significant issues we have with the current plan proposed by Government. We will also point out alternative approaches that we believe will lead to real and tangible improvements to the delivery of health care in our Country.

The Coalition is comprised of a wide range of organizations – from medical associations, to workers unions, to advocacy and research bodies, to private sector organizations. A casual look at our membership list would reveal the vast range of constituencies and viewpoints represented in the Coalition.

Therefore, at the outset of our exercise, it was important for us to agree upon the core principles and views that we share. These are encapsulated in our Statement of Purpose which articulates the eight guiding principles that we collectively agree should shape the health reform process in the country. So while our member organizations may articulate specific views and opinions that are in addition to the points highlighted in the Statement of Purpose, each member has subscribed at a minimum to the views expressed in the Statement.

Part Two of the series highlights the second principle in our documented Statement of Purpose.

2. All Bahamian Residents should have access to health care: Reform must improve and ensure access to primary, secondary and critical care for all Bahamian Residents.

Despite the fact that we have documented our principles in writing and repeated our objectives over and over, there are those who would wish to mislead the Bahamian people into thinking that we do not support the idea of universal health coverage. This is the complete opposite of what we stand for! Not only do we believe that all Bahamians MUST HAVE access to quality health care, we pursue our objectives because we want to see this goal accomplished as efficiently and effectively as possible. Indeed, we believe that if we do not get the reform effort right, the quality of health care could actually get worse, as opposed to be improved by this process.

As it exists today, Bahamians are entitled to health care whether they can afford it or not. This is not a new policy. This policy has been in place for many years. This issue today as it will be in the future is on whether or not the reform effort will IMPROVE and ENSURE access.

The very important issue is not whether you and I will have a shiny new NHI insurance card. The very real life and death issue is whether when you need medical care, will there be sufficient doctors, nurses, diagnostic equipment, operating theaters, medicine and hospital beds to be able to deliver the medical service you need in a timely and efficient manner?

As both the government and Coalition recognize, to do this requires more money. Clearly you need to be able to pay the additional doctors and nurses, and purchase the necessary supplies and medicines.

But just as key, we will need to ensure that the monies that are now allocated and the additional monies that will be raised will actually be spent on doctors, nurses and medical supplies and not be wasted in an inefficient bureaucracy! The way in which these health care resources are managed must be examined carefully and be subject to international best practices and strict accountability measures.

The current legislation makes no provision for management or financial oversight over and above that which is provided for the National Insurance Board (NIB). To our knowledge, the NIB has not released publicly, their audited financial reports for at least four years! The public health authorities have never been required to produce audited statements. Therefore, how will we ensure that monies are being utilized to actually improve and ensure access to health care for Bahamians, and not simply be wasted and mismanaged?

The reform effort must be much more than throwing money at the problem. Without proper management and strong accountability, we will NOT see the improvements in quality health care that are being promised.

Recommendations (An Alternate Approach):

We truly and sincerely believe that all Bahamians should have access to quality health care and we commend the government for taking a very serious look at this most vexing issue.

We accept that our policy makers and supporters of the current NHI plan sincerely wish to make a tangible difference in the lives of Bahamians by providing them with financial and emotional security in respect to very costly health care requirements. Thus, if we can accept this position, then we are at a lost as to why some of the critics of the Coalition would seek to demonize our sincere objection to the methodology and strategy that the government is seeking to use. Feel free to object to our positions and opinions, but set aside the evil characterizations of the thousands represented by the Coalition.

Whether you agree with the Coalition or not, we would implore Bahamians to maintain a respectful tone as we engage in a healthy and robust debate. Let us demonstrate the evolving maturity of our democracy through our ability to disagree without resorting to petty and juvenile name-calling!

We categorically condemn the efforts to turn this discussion into one about rich vs. poor, PLP vs FNM, business interests vs. workers interests, doctors vs. patients, or insurance companies vs. their customer base.

This is a critical issue that is calling for a national contribution to a national problem. It involves hundreds of millions of dollars, the massive reshaping of our private and public health care industry, a very complex bureaucracy, and the collection and management of very personal and intimate information of all Bahamians.

In whatever form it is finally implemented, it will touch upon the lives of every Bahamian resident. Thus, we would hope that the government would welcome the debate and discussion and not shy away from the hard issues and questions raised. This is too important an issue not to be challenged vigorously where deemed necessary!

Go forward to Part Three of this Series.

Go back to Part One of this Series.