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At the PLP's recent convention the speakers spent considerable time lamenting the fact that the FNM have not implemented their much ballyhooed National Health Insurance scheme. Their intention, if re-elected in May 2007, was what amounted to a hostile take over of the health care industry. Promising that no Bahamian would have to endure the hardship of cookouts to raise money to help defray medical expenses ever again. But as Greg Mankiw, professor of economics at Harvard points out, people in Britain, where they have had a form of NHI for 60 years, still have to raise money for health care services. He writes in a recent blog: "Some people like to think of health care and education of basic human rights. Maybe they are. But they are also normal goods. That is, the income elasticity of demand is positive. It is hard to escape the conclusion that the right cost-benefit calculation for providing the good depends on the income of the consumer." "Achieving both efficiency and equality in the provision of these goods is impossible. Dealing with this conflict will provide a major challenge to the political system in the years to come." Not to be out done, the FNM appears to be playing politics with the NHI now by saying they are in favour of such a scheme. Some say they have to make people believe they want nationalised health care as that is the 'political thing' to do. Of course many politicians don't realise that the Pied Piper of Hamelin was a fairy tale. The difference with the NHI story is adults are being sold a bill of goods that will further enslave their children to an even larger debt load for the country and the attendant tax burden. The Bahamas has endured the 'political' thing being done for too long. Just look where it has led. Failed public education, failed public health care, among many other failed public institutions and services. It's high time some economic principles were applied to government services and that most certainly does not include nationalising health care. And how might that be accomplished? As Nadeem Esmail, of The Fraser Institute, suggested in his analysis of the Blue Ribbon Commission's plan, the cleanest solution to the health care problem is for government to mandate that all working employees buy their own health care insurance. This would leave the unemployed and indigent for the government to take care of through a catastrophic health plan. While as a general principle government mandates are not the best thing for a free society, it sure beats nationalising health care. Some compare it to the law that forces drivers to buy vehicle insurance. There is no other course for a viable future. Unless the PLP or FNM have a wizard in their back pocket, wiping every tear from every eye, and creating a national health insurance scheme whereby no Bahamian will ever have to raise money to pay for health care services, or do without services again, is a pipe dream. A mere bill of political goods.
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Comments
Rick - 1 March 2008 21:21- Pied Pipers of Health Insurance
- This article http://www.fee.org/in_brief/default.asp?id=1916 might help?
G.Wirth - 1 March 2008 10:10- Health Insurance
- Precisely that is the issue... during your working life possibly til 65 years you are covered, religiously pay the premium might never claim because you are never sick but one day after retiring that is gone. I ask a simple question; Is that ethically correct? Please do not tell me that is what you purchased. Policys should permit continuance after retirement. Why is it that Insurance Cos only want to cover you when the risk is in their favour? It is obvious - they want and will at all accounts limit their risks and improve their profits.
There lacks a genuine interest in the Insurance sector to be proactive and demonstrate that a free market system works. Surely this is the challenge unless you want, God forbid, Government to have to put a scheme in place and we will see a further extension of NIB.
Rick - 1 March 2008 05:38- The Pied Pipers
- Thanks for stopping by and commenting.
As pointed out, the indigent and unemployed might have to be taken care of through a catastrophic plan. If that can be private, so much the better.
I'm sure if all employed Bahamians were mandated to buy health insurance the risk of the insured pool would improve dramatically and things like no claims bonuses might be possible.
Having faced family issues where no health care was in place I understand your point about retiring and then facing illness.
There seems to have been a shift in expectations about insurance. We pay the premiums while we work in the event of catastrophic illness during our working years. We do not pay premiums to take care of our illnesses when we retire.
Maybe the insurance companies should devise a policy for that, but I would be scared to see that premium.
G.Wirth - 1 March 2008 04:47- Health Insurance
- It is all well and good proposing health schemes like what Nadeem Esmail proposes however The Bahamas does not have Income Tax which allows you to write-off the premium cost - no Health scheme gives you like with Vehicle Insurance a no claim bonus.
Isn't it therefore in true reality in the US you have a Government Health scheme but it is hidden or no one is willing to admit it ? If you can write-off the premium for Health Insurance there is only one party paying for the Insurance - Uncle Sam.
Almost all health Insurances cancel effectively when you retire and most cannot be transfered from one employer to another.I know many who were never sick but became sick 2-3-4 years after they retired and boy with no insurance thats tough in any language although you had paid into the scheme thousands.
In our context I have never understood just why the private Insurance sector has not addressed a private Castrophic Insurance programme as that is where the real trouble is. If the private sector put a viable programme when considering the 118,000 employed persons surely that monthly premium would be very very small. The scheme must continue after retirement.
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