News from the Turks and Caicos Islands for
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Commentary: The National Health Insurance Plan... Full steam ahead!
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| Published on Wednesday, October 28, 2009 |
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By Candy Herwin
I beg to differ from the opinions expressed by my learned friend David Tapfer and so it would appear from many of the opinions asserted on the TCI Journal. The NHIP is sequentially timely with a hard line transformational move on the part of the Governor to rectify the abysmal state of this economy.
In spite of the global recession, the concept of a mandatory health insurance plan is being debated in many corners of the world, with strong arguments for and against, but the bottom line is, if all goes according to plan, then the Turks and Caicos will be in the mainstream of the latest trend in healthcare reform, which will provide coverage for each and every citizen residing legally in the country.
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| Candy Herwin has lived in the Turks and Caicos Islands for 17 years and runs a guesthouse on Salt Cay called "Pirates Hideaway". She was formerly a reporter for Radio One in Beirut, Lebanon, but now prefers the quiet life in Salt Cay |
At present, there are many in the community that cannot afford any form of coverage and likewise many families that can afford healthcare insurance but have preferred that the government pick up the bills for overseas treatment. This was a huge drain on government expenditure. Under the new plans, those genuinely unable to pay will be covered and the balance of the population will share in providing universal health care.
Without confusing the overall benefits of the Plan and the fact that this country needs a plan, there is a growing number of people across the TCI that are asking the question… How can the government enter a contract with Inter Health Canada, on behalf of the people without disclosing the pertinent facts?
The question then arises is this decision constitutional or has the Governor an ‘overriding’ right to exercise his discretionary powers on behalf of the mother country and do what is perceived to be the more expedient solution for the TCI in light of the current economic crisis and heavy debt that threatens to cripple the country?
We can assume that the government has examined and reviewed the contract anew with a panel of capable experts and concluded that it is and still remains a legally valid and binding contract. They have more then likely earmarked the problematic, weak and contractual areas of contention but deemed it economically viable to continue full steam ahead without falling into the cumbersome financial pit of legal wrangling and excessive expense.
Drastic measures require drastic action and, within the realms of jurisprudence law, proponents for contract disclosure and intellects may argue and debate the moral, legal and monetary implications of the Governor’s reasoning and resolve all day long but the fact remains that the National Insurance Health Plan needs a firm hand to move it forward quickly in order to lighten the financial drain on the government coffers.
Should the details of the contract be made available? Probably yes, if only to break the downward spiral of public confidence in governmental processes.
Are some of the rumours and financial projections circulating in the media accurate? More than likely the answer is no but they do serve as a platform for heated debate. Financial forecasts and predictions, as well we know, depend on a person’s or a government’s particular viewpoint and reasoning behind the calculations; and at this point in time there are too many variables to measure the true success of the Plan ‘as is’. Of course, there are going to be some stumbling blocks, there always are…
It is when this country can get an accurate reading on the breakdown of the composition of its citizens that the overall picture will become clearer.
This is good common sense and one reason why every legal citizen has a civic duty to register and sign up for the NHIP, which will provide a means for the country to accurately log figures that can benefit not only the health plan but every department that can be made more effective and productive by having access to accurate statistics of demographics throughout the family islands.
Adjustments can then be made accordingly. while ensuring that everyone is included in a blanket health plan.
Those who oppose such a plan do have some valid arguments but at the end of the day the real question is, will the overall benefits of the plan lead to a more efficient healthcare system for this country in the foreseeable future?
The opponents argue:
♦ That the people who will carry the greatest burden during this recession are the small businesses, which are already struggling and will be obliged to pay 2.5% for employees and a further 5% for their own coverage. This will kill the efficiency of the small business as owners let go employees to save money.
 The hardship will definitely fall on this group in which there are many small local business owners that do not carry any form of health coverage and even those that do. If they can ride the recession by trimming now, then the benefits will inevitably come down the road for the owners and their dependants who will require essential health care at some point in time.
It must be remembered that if you can genuinely show and present your inability to pay then you will not necessarily have to pay the full amount, if at all. Blood after all cannot be squeezed from a stone.
♦ That mandated insurance creates a monopoly, which as yet has unknown factors as to the standard and quality of health care and the efficiency of services provided.
The hospitals are near completion and, whichever way you look at it they need to be funded and utilized, ensuring good health care closer to home. The medical skills and state of the art equipment they bring in will be a vast improvement on what exists now and the services, healthcare team and partnerships will grow stronger once the economy turns around.
The two key factors driving the decision for ‘no option’ enrollment in the NHIP are based on what measures will effectively expand coverage and how can the overwhelming costs to the government under the present cumbersome system be driven down.
♦ That restricting a person’s right to choose may place unnecessary hardship on those already with insurance that meets all their needs and who then are obliged to carry a second mandated insurance or switch to one that does not meet all their needs such as traveling abroad and children away in college.
Absolutely true, this plan like any other plan in existence will disappoint and frustrate a segment of the community.
♦ That the NHIP violates a person’s privacy and gives credence to the point of view that before long the government will develop a national system of electronic medical records.
Perhaps it can be argued that this is a good attribute merely from the urgent necessity of collecting accurate data on those in the country, for example, that have diabetes, high blood pressure or HIV. The latter is a serious problem that is escalating out of hand.
Accurate statistics, careful monitoring and healthcare for HIV patients, for example, will create openness and better acceptance of a disease, which in this country is still perceived as shameful. With new facilities and treatment for all, the perception of the disease will quickly change. More workshops and open education in schools, with professional, no nonsense advice, could remove the stigma of living with HIV and ultimately prevent the spread of HIV, especially amidst school children, who after all are the next generation of community builders.
♦ With the ongoing exodus of foreigners at an alarming rate, can one accurately predict costing if many of those same people will not be supporting the health plan?
The recession and political turmoil may be driving foreigners away now but, as the country comes to order, a new influx of foreigners will arrive, as they always do in exotic climates, and will meet the mandated requirement in place to pay into the NHIP
♦ That many large employers have already let go many employees because of the lack of tourism and the recession and yet the employee names are still logged in computer databases that have not been updated. How widespread is this and how again does it affect the figures for revenue generation?
This is yet another reason why it is imperative that every citizen sign up in the following days so that accurate figures of those employed can be assimilated.
♦ That it is unfair that hard working and law abiding citizens should support criminals, alcohol and drug addicts, especially with the high rate of repeat offenders?
This is a tough one! Who wants to pay for criminals and their dependants especially when the recidivism rate is high?
Besides conforming to international laws on human rights, it could be argued that the NHIP can be seen as the starting point for many important improvements throughout government departments in near related fields, i.e. establishing better rehabilitation centres, professional counselling and more community work programmes for the incarcerated.
With all of these questions and many more, the task of introducing a national health plan seem daunting and no doubt the start up process is going to be a rough ride with a lot of resistance, especially since the hospitals are not yet complete, capital needs to be raised and the equipment, expertise and staffing are not yet in place.
No doubt the hospitals will open on time. They are on schedule and it must be remembered that Inter Health Canada is under an obligation to perform and will be heavily penalised for delays and thereafter will be closely monitored to ensure compliance in maintaining high standards of health care.
Paying into the plan for a few months ahead of time and building some cash flow, in many people’s opinion, is a small price to pay for building a healthy nation. This may seem unjust to many people but is certainly within the scope of the law and the doctrine of ‘executory consideration’.
Perhaps the question should be asked, what happens in the worst case scenario that the plan falls flat? This is always a possibility but it seems more logical to assume that the British government has a secondary plan of action to guarantee and ensure its success, especially since many neighbouring countries are closely watching the implementation and outcome of a mandated NHIP introduced by an interim government that is calling all the shots at present, in their pursuit of restoring order and ‘good governance’.
Even with all these debatable pros and cons, this health care reform package is the start of a progressive move in the TCI to finally give health coverage to the poor, of which there are many, and oblige those who can afford insurance to participate in their own health coverage and that of their dependants or be heavily fined for failing to comply. The fines are unfortunate and without a doubt too excessive but, let’s face it, if the fines were not there as a deterrent many of us would be complacent and not sign up. Accurate statistics can be the start of many new and improved laws and reforms to push this country forward.
Tough times and no money in the TCI kitty requires tough measures. The NHIP is not perfect but as the needs and demands become more apparent and the economy stabilises, which it eventually will, adjustments can be made to fine tune the package.
At the end of the day, your good health is your most precious possession. All of us are vulnerable to injury and disease and the close proximity of the hospitals and the immediate availability of expert medical attention can save lives. In many more ways than one, the NHIP provides a practical solution for extending health care coverage to everyone. Is the timing right?Only time will tell! | | | | Reads : 494 |
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