Government selling a false narrative on health care

First Published: 2016-04-01

Since 2003 successive governments have promised to launch a national health scheme, now known as National  Health Insurance, with the over used talking point that private healthcare is not affordable so poor people have to do without medical attention. Meanwhile there are public clinics and heath services that provide free care or medical services at very low rates.

This narrative that private health care is unaffordable falls flat because if costs are in fact containable would the Ministry of Health budget have risen the way it has each year? Estimated expenditure for *“total government spending on health care has doubled in just over a decade from 4.9% of GDP to 9.7% in 2013 to $800 million”. The difference is, these cost rises are reflected in the budget deficits and ever increasing government debt. Whereas the private sector has to pass the increases on in direct charges. * Sanigest International, consultants to the government on NHI

The numbers confirm P.J. O’Rourke’s quote that “If you think health care is expensive now, wait until you see what it costs when it’s free”.

The reality is, if the government was concerned about the health care of the indigent or people with catastrophic illnesses their push would not be on primary care and a systematic takeover of the health care industry.

Now that the NHI scheme will be delayed for six months it presents a perfect opportunity for the private sector health care professionals to change the discussion from the proposed industry takeover to a more reasoned one of how the government might fund medical care for the poor and destitute.

As the Free Market Foundation of South Africa (FMF) noted in a recent article; “it is neither necessary nor appropriate for government to assume responsibility for the “health of the nation”. The very idea of a National Health Insurance fuels the erroneous general perception that government is the foundational source of our health and is thus entitled to regulate individual and private sector provider’s activities.”

Back in 2006 The Nassau Institute commissioned a study of the proposal for universal health care at that time ( ) and it pointed out that; “All indications are that health expenditures in large developed nations are growing significantly faster than their overall economies, bringing the sustainability of public health expenditures into question. Given that the future growth rates of NHI spending in the Bahamas are likely to be similar to those in developed nations, their sustainability is an even greater issue given The Bahamas slower growth economy.”

Since then, the economy has taken a decided turn for the worse and this was exacerbated by the introduction of a Value Added Tax in 2015.

The private health care industry must be vigilant and not be sucked in by the usual tactic of government that they keep the discussion out of the public domain while they “negotiate” an arrangement. This has only ever worked to strengthen the government’s position and to the detriment of the private sector and taxpayers.

In a presentation here in 2007 Dr. Michael Walker, a Canadian expert in health care, cautioned the audience, “They’re going to turn your private hospital into a public institution. They’ll do it over a number of years…by the Trojan horse of the finance the government provides."

The FMF cautioned, (paraphrased here), Governments in The Bahamas have “struggled so that ordinary people could have the right to vote, to make their own choices and to determine their own future. Those rights surely include the liberty to make their own choices about their health, and how they want to spend their money, whether or not by procuring or providing their own medical care. If only the present Bahamas government would remember this and set about adopting policies that grant all our citizens the economic freedom to increase their wealth, then thousands more people would be able to afford proper health care. The government must stop thinking people need cosseting and are not capable of making their own decisions. It should leave the private sector alone, let all Bahamians decide how and where they want to spend their money, and dedicate its energy rather to fixing what is almost completely broken and rapidly deteriorating – the public health sector.

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