No more free for all, say BAMP, NIS officials
The Barbados Association of Medical Practitioners (BAMP) wants Government to scrap the current system of universal health care and only pay for those who canno afford to meet their own costs.
During the second of three town hall meetings organized by the Ministry of Health to solicit public opinion on how the country should finance its growing health care costs, BAMP President Dr Carlos Chase stated that state-sponsored health care should no longer be a free for all.
“We think that the Government should focus on those people who are least capable of taking care of themselves, and let other people who can take care of themselves
“Make it so that they can afford to look after themselves and you look after those who are least capable of looking after themselves,” he added, explaining that in most countries it was only about ten per cent of the population that was unable to look after themselves, which translates to about 15,000 to 20,000 people in the Barbadian context.
Also taking part in the panel discussion was Director of the National Insurance Scheme Ian Carrington who suggested that the current health care financing model was unsustainable.
“The issue that we face right now and the issue that we will be facing going forward as a country is having sufficient funds to take care of the nation’s health.
“We can discuss whether those funds are effectively and efficiently utilized. It will not however diminish or remove the substantive issue that we face as a country and what has been driving health care costs, that is, . . . we have a much larger aging population, a lot more persons who are over the retirement age, and a much older healthcare plant, and therefore we need to make those decisions now.”
He predicted that in under 15 years, more than a third of the island’s population would no longer be contributing to any financial health scheme, but taking from it.
“Thirty-eight per cent of our population is going to be past retirement age by the year 2030,” said Carrington, suggesting that the average life expectancy of Barbadians was
Based on recent research conducted by the Planning and Research Unit of the Ministry of Health, Government currently provides for 55 per cent of the $732,703,759 spent on health care.
However, 39 per cent or $285,754,466 is met through out-of-pocket spending by Barbadians, while private health insurance plans contribute five per cent or $36,635,188 of the total costs.
In terms of the private health insurance coverage, only 27 per cent of the population has coverage, including 13 per cent by employer-based plans and 14 per cent by individually funded health plans.
Though the statistics are based on a 2012-2013 study, officials say it was revised in January 2015.
Therefore, the figures remain relevant given that 98 per cent of health costs are recurrent.
In light of these findings, Chase also raised the issue of health care litigation saying it was a major driver of health care costs.
“Everybody expects to have a perfect outcome if they have any sickness . . . if they don’t get perfection, they [sue and] get punitive awards and that is what is driving the cost of health care, legal fees and insurance costs,” the BAMP spokesman said.
He also pointed out that the largest paying professional group of doctors on the island was obstetricians, whose annual insurance was over $60,000, given the new $2,500 professional tax which was introduced at the beginning of the year.
“So if my output before I start is going to be $62,000 and you come to visit me for a delivery, you expect I will have to charge you peanuts, but I will have to charge you Mercedes Benz-type fees,” he warned.
The BAMP president therefore suggested that both the QEH and polyclinics operate as commercial entities with both employees and the general public be given the option of purchasing shares.
He also recommended that a special share allocation be set aside for corporate Barbados, that would haul in an estimated $300 million in revenue.
Such a business model, said Chase, would protect the Government system from losses.
“The other issue the hospital has is people taking home things to use in their own house, pilferage,” said Chase, who called for proper accounting controls.
“This is the 21st century. It hurts my heart that the hospital is not yet fully computerized. It is ridiculous,” the BAMP President said.
QEH staff nurse Bernard Beckles, who was also a panellist at Tuesday night’s town hall described the abandonment of the elderly as a “silent” area that was also impacting on the cost of health care.
He suggested that Government needed to tap into the assets of those who have been abandoned at the hospital by their beneficiaries.
“It makes no sense these persons pulling on the country’s resources while their relatives live lavish lifestyles having no regard for the costs it places on an already taxed system.
“We can also look at the pensions being paid to persons in the geriatric and the psychiatric hospitals, and either stop same or find ways for their families to play a more contributory role to their care,” he said.