BASSETERRE, St. Kitts - THE long-awaited National Health Insurance (NHI) scheme could come on stream as early as 2024, but that is now dependent on officials on Church Street making it possible by tabling legislation.
That comes as the government and technical personnel tasked with developing the scheme have completed their work, and working documents have been with the government headquarters.
This was disclosed by Government Advisor for National Health Insurance, Dr. Patrick Martin, who suggested that based on the way the Prime Minister has been speaking on health, “it looks like he wants a 2024 implementation”.
When questioned on its possiblity, Dr. Martin said, “I can say that we’re getting there. There is something already on Church Street.”
He however noted that getting to the point of implementation depends on the “political timetable” of the Cabinet, where the document currently sits.
There has long been talks about a possible implementation of a NHI by the Team Unity Administration which collapsed last year over a number of issues.
The problem, this publication understood at that time, was the cost and how it could be funded.
The Government Advisor however noted that it is a question still to be answered, explaining: “In the final analysis, it is how we are going to pay for it. It’s an EC $220 million question per year.”
In his explanation of funding, Dr. Martin said, “When things appear to be slow, it’s either a lack of political will or the dance is not paying for the lights.”
When asked about a possible increase in taxes for sugary beverage as an option to cover all or part of the cost, the former CMO noted that it is not possible to undertake such because the population volume is not at the level for that to be sustainable.
He declared that the Citizenship By Investment Programme should not be used as an option, but direct taxes of the public instead.
“It has to be a tax on income, and it cannot be CBI,” Dr Martin told reporters at a media engagement. “You do not pay for Health and Education- those core subjects [from the CBI]. You don’t pay for those from non-tax revenue because non-tax revenue can fluctuate.”
There has long been concerns by health officials and various governments alike that there needs to be a health insurance scheme for the public, as cases of Non-Communicable Diseases continue to increase.
In the case of Diabetes, for example, there are 3,000 active cases in St. Kitts alone, and Cancer continues to be one of the leading causes of death.
Compounding the problem for St. Kitts and Nevis is the fact that many of the younger people, who are expected to pay any such fund, are being gunned down.
Treatment and caring for gunshot victims remain an enormous problem for the health sector, and, according to Dr. Martin, many of those who sustain wounds do not pay for their treatment.
“The gunshot culture has really driven up our cost,” noted Dr. Martin. “...the cost of resuscitating him from the ambulance to the operating theatre, to ICU (Intensive Care Unit) is higher than the cost to keep the hospital open per day by a factor of two to 1.”
In dollars and cents, he recently estimated that it costs in excess of EC$30,000 per gunshot victim.
With insurance, the Government is able to recoup the cost per treatment but, as noted by the Advisor, only 30 percent of the population are insured.
In February 2018, the then government signed onto an agreement with the University of the West Indies to provide specifications for the implementation of Universal Health Coverage for this nation. That body had presented a Green Paper to Cabinet in October of the same year with the government then consulting with the public on how it should be implemented.
The UHI was part of a commitment by the then government to have it implemented within its first term in office.