The National Coalition
For Health Care Reform

Press Release - 28th November, 2006

Most Important Legislation in Three Decades
Can't Be Rushed

Dear Fellow Citizens:

This week the House of Assembly began deliberation on the proposed National Health Care Insurance Program. This is the most important social policy legislation facing our nation in decades. It is Government's intention to enact it as law within less than 30 days.

The National Coalition for Health Care Reform reiterates its unanimous support for health care reform. Every Bahamian should be provided with access to quality health care and none amongst us should suffer undue hardship because they cannot afford it. We have a responsibility to assist those who genuinely cannot help themselves.

This is not a partisan or rich versus poor issue as has been characterized by some. Our Coalition partners represent hundreds of employers and tens of thousands of union members and insured employees who have raised legitimate questions about their right of choice and the sustainability of the proposed program. We find such devisiveness counterproductive.

Dating back to 2003 a number of our Coalition members have posed the same questions which we raise today and repeated and unsuccessful requests for information which supports the Government's plan.

The Government has held extensive public meetings on this matter but not open consultation. General information has been provided about what the Government intends to do but details have been sorely lacking. How can the public participate in meaningful consultation without proper information?

Among the information we have requested which we have not received at the time of this writing, and deem important to determine the sustainability of the Government's proposed approach are:

• A complete report on the components, cost and financing of National Health Insurance (partial information has been received)
• Actuarial studies that support the Government's decision making process
• Income and Cost projections for the ten, fifteen and twenty year periods following implementation
• Any Economic Impact Assessments conducted to support the initiative
• The five year Health Care Infrastructural Development Plan
• A progress report on the Health Care Administrative adjustments as outlined in Chapter 4 Section 4.1 of the Blue Ribbon Commission's Report
• Analysis and Status reports on the National Insurance Board's capacity to administer the proposed NHI and any necessary institutional adjustments that will be required
• A status update on the improvements to NIB as per the recent recommendations by external consultants

That information is critical for the public to understand the true sustainability of the proposed plan. In other countries where such plans have been implemented - costs through the years have spiraled out of control. We could find ourselves in the same kind of situation. Then it will be determined that the 5.3 percent tax is insufficient and the tax will be increased or services to the public will need to be curtailed. Our country cannot afford such a miscalculation.

Legislation will be rushed through Parliament during the coming month. It should be deferred until there is sufficient time for the public to receive, analyze and comment on the data. As written, the Legislation will lock us into a flawed approach. It will:

• Take away an employee's right to choose, requiring that they pay for two plans - the Government's plan and their privately insured plan
• Impose stiff fines and penalties for non compliance
• Not allow for a sufficient level of relevant medical and financial professionals to serve on the Commission where such expertise is essential
• Not hold the Government accountable for providing timely and annual audits, actuarial reports and relevant information to the public
• Allow for increases in contribution rates by employers and employees with relative ease every three years when there is no guarantee that existing and projected costs and program management details are made pubic on a timely basis
• Not provide for an independent legislated oversight body, an Ombudsman, to address public or health care provider concerns
• Not allow sufficient time to develop a phased-in flexible plan which considers stakeholder concerns.

We urge Bahamians to join in the call for meaningful consultation before the Legislation is passed in Parliament. Please join the growing number of Bahamians who want to get it right by signing the Coalition's online petition or calling the Coalition's hotline at 394-1162.

National Coalition for Health Care Reform

Press Release 15th November, 2006   ||   Press Release 11th December, 2006