It is not a done deal yet, but the Freundel Stuart administration has all but decided the way it wants to take the country in terms of its future financing of health care.
Delivering the Astor B Watts lunchtime lecture at the headquarters of the ruling Democratic Labour Party Friday, Minister of Health John Boyce revealed that a National Health Insurance Fund was currently in the making.
However, Boyce said the decision was yet to receive full Cabinet approval even though his ministry had already made a final presentation to Cabinet’s Sub-Committee on Social Policy.
The minister further disclosed that the fund would operate on a similar basis as the National Insurance Scheme (NIS).
However, he said it was yet to be decided if it would be financed through contributions of workers and employers, or the level of contributions.
“It is very much along the lines of the National Insurance Scheme. Certainly it has to be the kind of investment which will grow over the years and become like the National Insurance Fund,” the Minister of Health said, while stressing that any such fund “must have a very strong basis on which we can draw for health care services”.
Currently, the island spends about $750 million per year on health care, 55 per cent of which comes from Government contributions to the national budget.
Of the total figure, $373 million goes directly to financing primary, secondary and tertiary health care, with the state-run Queen Elizabeth Hospital receiving $150 million per year and polyclinics and district hospitals $200 million.
While acknowledging that a large percentage of the current health spend goes to paying salaries and wages to nearly 2,000 employees, Boyce said the proposed National Health Insurance Fund would help to guarantee that even as the cost of health care increases it would not become a burden to taxpayers, but would be part of an investment by employees and employers.
“So I think it is a worthy idea and one which we support very highly, but as I said it is not policy yet,” he said.
The matter has been the subject of national discussion over the past year with the Ministry of Health engaging the public during a series of five town hall meetings, which were held last year.
At the end of that process last June, former Opposition Shadow Minister of Health Dr William Duguid had sought to warn Barbadians that Government was preparing to go the way of a health insurance scheme that would see Barbadians paying directly from their wages for health care services.
“It is my understanding that there is an intention to bring a change in the law where health funding will no longer come from your taxes, but instead will come directly from your pay packet, like how the national insurance takes a levy out of your pay packet now, with part put by the employee, and part put by the employer,” Dr Duguid had said at the time.
Friday, Boyce all but confirmed Dr Duguid’s suspicions while stating that both his ministry and the Ministry of Finance had been wracking their brains to find out exactly how they can maintain the quality of health care which gave Barbados a rating of seventh in the world in emergency care.
He recalled that last year the Minister of Finance had introduced a two per cent National Social Responsibility Levy (NSRL) as a means of financing health care and for waste management.
This tax has since been increased to ten per cent in this year’s Budget amid a national outcry that it was simply too onerous.
However, Boyce said if heath care services were to be continually provided by the State, there had to be a means of financing them.
“If you visit a modern hospital in the very developed world, the whole question of bed care has changed. When you go to a bed you are an acute patient, no matter what’s wrong with you, all your monitoring system, all your intervention systems are part of that bed,” he pointed out while arguing that health care costs had become extremely high.
With the situation as it stands, he suggested that Barbadians should listen to health care debates in the United States and the United Kingdom with a view to understanding who pays medical bills.