FRIDAY, JANUARY 20, 2017
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NHI advisers ‘look at healthcare in vacuum’ By NEIL HARTNELL Tribune Business Editor nhartnell@tribunemedia.net
The Government’s National Health Insurance (NHI) advisers were yesterday accused of “looking at healthcare in a vacuum”, and failing to account for the numerous economic and social factors that drive high Bahamian medical costs. Dr Sy Pierre, the Medical Association of the Bahamas (MAB) president, told Tribune Business that foreign consultants had “no idea” utility and other operating costs were five-six times’ higher in this nation when compared to their home jurisdictions. Yet they were seeking to im-
MAB chief: Bahamas’ high costs not factored in Adds: ‘Template’ enough in Canada, but not here Says: ‘I don’t want people to be fooled by this’ pose their own healthcare “template” on the Bahamas, he added, arguing that their cost and utilisation estimates were more
suited to Canada or the US. “Everyone is looking at healthcare in a vacuum,” Dr Pierre said. “You have the [stabbing] at Government High today, we have an unemployment rate that is truly around 30 per cent, we are being taxed to death, have electricity costs that are the highest in the world, and medical equipment that attracts a 100 per cent tax at the border. “These guys come here, these consultants, seeing this amount of people and amount of money, and are trying to stick it on a template for healthcare. These guys haven’t seen gas at nearly $6 per hour. You can’t look at healthcare in a vacuum. See pg b4
Advisers: All three offers had ‘local elements’
Private Bahamian underwriters are involved in all three bids for the management of the National Health Insurance (NHI) public insurer, the scheme’s advisers suggesting this showed the industry had “bought in” to the scheme. Simon Townend, a KPMG (Bahamas) partner and head of the accounting firm’s Caribbean advisory practice, confirmed to Tribune Business that a ‘recommendation’ had been made as to the ‘preferred bidder’. Declining to reveal its identity, or those of the Bahamian insurance companies involved in the process, Mr Townend implied that the winner’s selection now awaited the Government’s approval. Disclosing that the three offers to manage BahamaCare “all had local insurance elements to their bids”, Mr Townend said: “All of these bids included private insurers from the
But $100m primary care can launch without sector NHI Authority Board to be unveiled ‘very shortly’ Bahamas, suggesting they buy into the model. “The bids have been shortlisted, and a decision has been made to move forward. That recommendation [winning bidder selection] has been made in terms of the next steps.” Mr Townend said the recommendations had been made by a committee of public and private sector representatives, which included representatives from KPMG and the NHI Secretariat, although he did not See pg b4
MAB chief doubts NHI hospital savings forecast By NEIL HARTNELL Tribune Business Editor nhartnell@tribunemedia.net The Medical Association of the Bahamas (MAB) president yesterday expressed doubts that the $100 million National Health Insurance (NHI) investment in primary care would help reduce spending on the hospitals. Dr Sy Pierre told Tribune Business that “there’s nothing primary care can do” for obese individuals who consistently over-ate, meaning they would still represent a burden on secondary/tertiary care providers. He said the best counter, education and wellness promotion to encourage Bahamians to alter their “lifestyle behaviour”, was a long-term effort that would not generate instant results. “Out biggest problem is obesity and over-eating,” Dr Pierre told Tribune Business. “Once you start over-eating, there’s nothing primary care can do for you. “Let’s say the average Bahamian goes into the doctor obese and overweight. They’re [the NHI architects] asking those people at an early age to not eat macaroni and cheese, peas and rice, and to get up early and exercise. “I’m not saying it can’t be done, but if you’re going to consume 2,000-plus calo-
Says ‘nothing primary care can do’ for obese Scheme architects target tertiary/ secondary savings ‘Greater returns’ from $100m primary care spend ries per day and sit around watching TV, there’s nothing primary care can do for you,” he added. “If you’re going to tell a Bahamian to cut out their favourite foods, they look at you as if you have two heads with an eye in each forehead. When I tell them how many calories they need to give up, they say: ‘Doc, you’re trying to kill me.’” The MAB chief said it was possible to change Bahamian lifestyles and behaviours, but he warned that it was “going to be very difficult to do this in a short period of time”. Dr Pierre’s comments thus appear to undermine one of the key NHI rationales articulated to Tribune Business by the NHI Secretariat and its advisers, namely that the $100 million primary care investment will boost efficiencies, See pg b4
By NEIL HARTNELL Tribune Business Editor nhartnell@tribunemedia.net
The Bahamian financial services industry “will do all we can” to ensure this nation does not appear on a threatened European Union (EU) ‘blacklist’, Tribune Business was told yesterday. Tanya McCartney, the Bahamas Financial Services Board’s (BFSB) chief executive, said this nation’s implementation of the Common Reporting Standard (CRS) for automatic tax information exchange was a critical defence to any EU moves against this nation. Europe’s aversion to international financial centres (IFCs) was laid bare again yesterday, after EU legislators rejected a proposed money laundering ‘blacklist’ on the grounds that it included no IFCs. The EU parliament re-
Govt ‘reconsiders’ $1m residency bar following push back Minister: Decision on ‘doubling’ in next few weeks Indicates ‘lead time’ for adjustment will be given ‘All efforts’ made to retain existing, active business By NATARIO McKENZIE Tribune Business Reporter nmckenzie@tribunemedia.net
Dr Sy Pierre
Bahamian insurers in NHI ‘buy Bahamas will ‘do all it can’ to avoid EU blacklisting in’ via public carrier bids By NEIL HARTNELL Tribune Business Editor nhartnell@tribunemedia.net
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Industry working on ‘policy recommendations’ EU lawmakers reject list; Want Bahamas, IFCs on it Automatic tax regulations’ release ‘imminent’ jected the 10-strong list presented to it, which included the likes of North Korea, Iran, Afghanistan, Iraq and Syria, because it was seen as “too limited” by not including IFCs. An Associated Press report even singled out the Bahamas by name as one country that EU lawmakers wanted to include on the See pg b5
A Cabinet Minister yesterday conceded that the Government had been forced to “reconsider” plans to double the permanent residency investment threshold to $1 million, due to the “considerable pushback” by realtors and developers. Hope Strachan, minister of financial services and local government, said a final decision on increasing the threshold from the existing $500,000 is expected “within the next several weeks”. Hope Strachan Addressing a Society of Trust and Estate Practitioners (STEP) Bahamas luncheon, she moved to reassure Bahamian realtors and developers that regardless of the Government’s decision, “all efforts” will be made to maintain business currently “on the table”. This reflects calls for the Government to give a one-year warning of the change, so that all market participants can adjust, and for it to ‘grandfather in’ developments that are already selling to foreigners in the $500,000 to $1 million price bracket. Some realtors have estimated that increasing the threshold for accelerated See pg b5