THURSDAY, JANUARY 19, 2017
business@tribunemedia.net
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Doctors to drop NHI pay moan ‘within three years’ By NEIL HARTNELL Tribune Business Editor nhartnell@tribunemedia.net
Scheme has ‘pretty good cushion’ against losses
A Canadian healthcare expert yesterday predicted that Bahamian doctors will drop their opposition to National Health Insurance’s (NHI) preferred payment mechanism “within three years”. Dr David Price, who is advising the Government’s NHI Secretariat and consultants, KPMG, on the scheme’s rollout, said the capitation mechanism was being designed with “a pretty good cushion” that would prevent physicians from suffer-
Modelled on patient visits ‘three times’ norm ing financial losses. He told Tribune Business in an exclusive interview that the capitation rates were being based on doctors receiving 2.22.3 visits from each patient per year, which was more than three times’ the Bahamas’ 0.7 annual visits average. Capitation, which would pay
doctors a set fee per patient, per year, is NHI’s preferred mechanism for compensating physicians. However, many doctors in the private sector are opposed to it, having previously told Tribune Business that their remuneration would be cut by up to 70 per cent. Dr Price and KPMG executives argued, though, that capitation had numerous merits, as it provided doctors with a predictable, set income upon which they could base their business and investment decisions. They added that it would also “incentivise” doctors to keep their patients healthy and en-
gage in preventative medicine, resulting in better treatment outcomes and greater patient satisfaction. NHI’s current design attempts to accommodate physician concerns, as it gives them the choice of capitation, feesfor-services or a hybrid of the two as their preferred remuneration method. However, Dr Price, chair of the Department of Family Medicine at Canada’s McMaster University, expressed confidence that private Bahamian physicians would switch to capitation once they See pg b6
Freeport ‘depopulation’ Bahamas can ‘leapfrog’ fear over resort closures rivals on health reforms By NATARIO McKENZIE Tribune Business Reporter nmckenzie@tribunemedia.net
FNM deputy: Constituents applying to Baha Mar
The FNM’s deputy leader yesterday expressed fears that Grand Bahama would again “depopulate” due to uncertainty surrounding its major hotels, as Memories’ parent denied claims it was pulling out. K P Turnquest, the east Grand Bahama MP, told Tribune Business that with both Memories and the Grand Lucayan yet to fully re-open following Hurricane Matthew, some of his constituents were already applying for jobs at Baha Mar. Memories has previously made clear its frustration with its landlord, Hutchison Whampoa, to effect post-Matthew repairs, and Tribune Business can reveal that several of its beach vendors and tenants have been told to remove furniture and other items from the property. See pg b7
Memories parent denies Grand Bahama pull-out Committed to ‘swift resolution’ over re-opening
K P Turnquest
Govt to address Business Licence ‘double tax’ woe By NEIL HARTNELL Tribune Business Editor nhartnell@tribunemedia.net The Government has promised to address the Business Licence double taxation “anomaly” identified by the construction industry, the Chamber of Commerce’s chief executive said yesterday. Edison Sumner told Tribune Business that the Chamber had raised the issue in a meeting with Ministry of Finance officials this week,and received assurances that it would be remedied if necessary. “We did have an opportunity to meet with some executives at the Ministry of Finance to talk about these things, where we realised some concerns were raised over the Business Licence, particularly from the construction industry who felt they were being double taxed,” he told this newspaper. “That was one of the pressing issues we had a chance to address this week, and are satisfied that the Financial Secretary’s office is paying close attention to it and will make the necessary adjustments once they’ve done their own internal review of the system. “Where it’s found to have anomalies, they will address it appropriately.” Tribune Business revealed the construction
Chamber told it will review construction ‘anomaly’ VAT site ‘more efficient’ than Business Licence rival ‘Consistency’ urged between both sites
Edison Sumner industry’s ‘double taxation’ concerns last week in an interview with former Bahamas Chamber of Commerce and Employers Confederation (BCCEC) chairman, Robert Myers. He warned that the resulting increased construction costs for consumers See pg b6
By NEIL HARTNELL Tribune Business Editor nhartnell@tribunemedia.net
The proposed National Health Insurance (NHI) scheme has put the Bahamas “in a privileged position” of being able to “leapfrog” rival jurisdictions on implementing universal health coverage, the Government’s advisers said yesterday. Dr David Price, a Canadian healthcare expert who is assisting the NHI Secretariat and its consultants, the KPMG accounting firm, said the planned scheme was “particularly” impressive because it was designed specifically for the Bahamas’ needs. “What’s wonderful about what the Bahamas is doing, combining this with years of statistical-based evidence, is that it can leapfrog other countries, and use best evidence from around the globe to implement it properly,” Dr Price told Tribune Business.
Govt advisers say in ‘privileged position’ on NHI Scheme being designed purely for Bahamas’ needs ‘Short-term plan’, dates in place for roll-out “That’s what’s impressive about the model here. Nobody said we’re going to implement the New Zealand, the UK, the Canadian model. They’re taking what has been the evidence from around the world, and are contextualising it in the context of the Bahamas. “Every country has cultural-specific needs, and that’s what the group have been See pg b4
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NHI ‘can’t wait’ for public health system reforms No ‘immediate’ fix possible, said Govt advisers Confident ‘silent majority’ of doctors will sign on NHI benefits package ‘very close’ to finalised By NEIL HARTNELL Tribune Business Editor nhartnell@tribunemedia.net The Bahamian public health system’s many flaws cannot be fixed “immediately”, the Government’s advisers conceded yesterday, as they expressed confidence that a “silent majority” of private doctors were willing to sign on for National Health Insurance (NHI). Dr David Price, a Canadian healthcare expert who is assisting the NHI Secretariat and its advisers, KPMG, told Tribune Business that the problems should not be used to delay the Government’s reforms indefinitely. “I don’t think you can fix those things immediately,” he said, after Tribune Business questioned whether NHI could succeed without first fixing the numerous structural weaknesses in the public system. “You have to have a plan and vision to get to the end point, and that’s what’s being developed here.” Many healthcare industry professionals have argued that the Government’s plan to introduce universal health coverage (UHC) in the Bahamas, for which NHI is the financing mechanism, will be doomed to fail without the public system being strengthened. Dr Kevin Bowe, the NHI secretariat’s deputy project manager, acknowledged to Tribune Business that much needed to be done in terms of improving the public healthcare system, but implied that it was no reason to delay NHI’s implementation. “We know there’s a lot to be done in terms of those facilities, and quality of service in those facilities,” he conceded. See pg b4