The National Coalition
For Health Care Reform

Press Release - 15th November, 2006

Statement by Dr. Robin Roberts
Chairman, National Coalition for Health Care Reform

Good morning. My name is Dr. Robin Roberts. I am Chairman of the National Coalition for Health Care Reform and also Chairman of the Medical Association of The Bahamas. Speaking with me this morning is Mr. J. Barrie Farrington, our Coalition Vice Chairman and President of the Bahamas Hotel Employers Association. We are joined today by representatives for the various member organizations of the Coalition.

First and foremost please let us clarify the position of the National Coalition for Health Care Reform as it relates to the National Health Insurance initiative. The Coalition supports major reform of the nation's health care system, including universal coverage. We believe that no Bahamian should be left to suffer undue hardship because they cannot afford health insurance.

The Government is to be commended for taking the initiative and demonstrating the desire to meet this most daunting challenge.

The Coalition has no hidden agenda. Ours is not a political agenda. Our intentions are honourable. Given the enormity of the decision to undertake unprecedented national health care reform, we believe it is absolutely essential that a plan be established which is financially viable and sustainable for generations to come. Simply, for the sake of our nation's fiscal health as well as the well-being of our people, we must take the necessary time to get it right.

History has shown that countries which have failed to look far enough into the future in addressing the questions to shape the right kind of reform have suffered from inefficiencies, mismanagement and out of control spiraling costs. A nation of our small size cannot afford the luxury of spending precious time and national resources to correct a problem which we believe can be avoided if we take the time to get it right.

The plan as advanced by the Blue Ribbon Commission raises many unanswered questions. We believe it to be our responsibility and the responsibility of all right-minded thinking Bahamians to raise those questions and to engage in true and meaningful consultation with Government in seeking answers. We believe that this consultation will unleash the creativity and enterprising spirit of Bahamians in shaping a program which can meet the intended objectives of Government without creating undue and unintended hardship on the health of our people and the economic health of our nation.

There are many emotional issues that can be raised to garner public support for national health care but it is vital that we take a dispassionate, logical and practical path toward developing the right plan.

Having begun the process of examination several months ago, the Coalition has reviewed the public information provided by the Blue Ribbon Commission. We have taken the time to review reports and information on the subject matter by various Bahamians and have looked at other national approaches. From our investigation, many questions have been raised.

Among the questions raised are:

• What specific plans are in place to upgrade the present heath care physical, human and administrative infrastructure before implementing a national plan? The Blue Ribbon Commission report identifies 34 points that require attention as part of a strengthening effort if the proposed NHI is to be executed with some measure of efficiency and success.

• What assurances, backed by data and a business plan, can be given that all Bahamian residents will have timely, efficient and capable access to health care? Will the proposed plan result in better care, more nurses, shorter waiting lines, available medication, timely treatment and adequate beds? Experience globally with similar plans as to that being proposed have proven otherwise.

• What is the breakdown of detailed benefits which will be provided under the proposed plan? Broad promises have been made. What studies and data supports not only the ability of the plan to pay for itself over the long-haul but the ability to deliver on the promises.

• Why should the public be restricted from choosing between a Government-financed plan or selecting their insurance carrier and health care provider? The principles of choice overwhelmingly favour the consumer in assuring better quality and price.

• What assurances can be given to the Bahamian public that Government will be able to efficiently run a national health care program? We have spent years trying to divest the public sector from running hotels, airlines, airports, telecommunications and other endeavors which have cost the taxpaying people of The Bahamas dearly, added to the cost of doing business, and fueled public frustration.

• How can the public have confidence in having the program administered by National Insurance when the administrative costs by their own admission are excessively high and that leakages from those who avoid or abuse the system are exceedingly high?

• What plans exist for putting in place an integrated information management system, with the necessary technical expertise, to administer and manage a program of this magnitude? We understand that the project team has advanced that implementation of NHI should not proceed without a strong information technology system in place.

• How is national health insurance being viewed in the broader context of other programs which have been proposed. In the pursuit of transparency, this must be considered, particularly with regard to proposals which have also been advanced for expanding social security. The broader ramifications of all proposals must be considered and discussed.

• Why the rush? Proper consultation is essential for the Government to get this right. Consultation with our respective organizations to date has been extremely limited and one-sided.

We must be careful that we do not allow our passion for a resolution to the problem to blind us from seeing the practicality of solutions.

Individual member organizations of the Coalition as well as the Coalition itself have been seeking to attain information and answers to our questions from Government, which to date have not been forthcoming. The Minister of Health has clearly expressed his intention to meet with us on the matter and provide us with additional information. We are anxiously awaiting that opportunity.

The Government has repeatedly and clearly expressed its desire to advance health care reform in full consultation with the Bahamian public. Our comments to Government will continue to be constructive. We intend for them to be the basis for true, meaningful and transparent consultation on national health care reform.

Our nation needs to draw on the collective thinking of stakeholders such as ourselves. We are committed to helping to solve this critical national problem. We believe it to be unprecedented elsewhere in the world for a cross-section of organizations such as ours to embrace universal coverage and demonstrate the willingness to volunteer our time and expertise to help solve a national problem of this enormity.

We urge the Government to take the time to engage in true and meaningful consultation with the Coalition to discuss the many unanswered questions which the proposals which have been advanced to date have raised.

For our sake, for the sake of all Bahamians, let's take the time to get it right!

Press Release 1st November, 2006   ||   Press Release 28th November, 2006