The language of the politicians surrounding the debate over the country's hostile takeover of the health care industry is less than inspiring.
While statements like Bahamian's will never have to hold a cookout to raise money for an operation again, and your $60,000 operation will only cost you $2.65 sound impressive, they only create misperceptions.
Then there are the emotional stories of people denied health care because they lack insurance or money to pay for services required. Of course there are the dramatic stories from single payer health care systems like Canada or the United Kingdom as well, but these are ignored by the proponents of NHI.
Along the way the politicians and bureaucrats will play the envy and resentment card accusing employers and doctors of only being interested in themselves and not the "small man".
There is no doubt that employers have to be concerned about their businesses or they will not have the opportunities for employment for him/herself nor the people employed there.
Every individual is concerned about his/her self interest, including those (politicians and bureaucrats) now promoting the NHI. It's how they get paid, and without the NHI they will have to find work elsewhere.
Consenting adults or emotional participants?
Theoretically, consent to NHI is being sought through consultative meetings with the various groups involved in the health care business and other interested parties. And on November 6, 2006 the first of what will presumably be many town meetings was held.
Reports are the private "consultative" meetings held to date simply instructed various groups what the government intends to do. And the public (Town meeting) was rife with political rhetoric and included few facts for people to make a reasoned assessment of the NHI scheme.
In other words the so-called "consent" of Bahamian taxpayers will be achieved by convincing them that there are large numbers of people suffering without medical care or the insurance to pay for it.
When government takes over
Hans F. Sennholz, Consultant, Author, and Lecturer of Austrian Economics defines the concerns of those opposed to a hostile takeover of the health care industry by government when he writes:
"…When government takes special interest in an industry, political judgments and motives take preference to the people's choices. When government on all its levels enters health care, the industry has to adjust to every dollar spent and every order given. Surely, there are pains of readjustment but no particular economic crises. People readily accommodate. While they are not free to choose in the market place, they may plead and supplicate in the halls of politics. Some courageous observers may even point to needless expenditures and waste as every health-care administrator may want to expand and improve his facilities. After all, they no longer are limited by market orders but only by political considerations and favors."
"Politics is likely to shape the future of medical care as far as the eye can see. It builds upon popular political ideas, on old habits and predispositions, even resentment and envy. It inflicts pain without end."
Government has jumped in with both feet
On Wednesday, November 15, 2006 Prime Minister Perry Christie presented The National Health Insurance Act, 2006 to Parliament with the intention of passing it into law by December 26, 2006. He very proudly proclaimed that "The National Health Insurance plan will prove to be less expensive than private insurance for the majority of Bahamians" (The Tribune, Thursday, November 17, 2006).
As P.J. O'Rourke noted in his treatise, Age and Guile: "Getting sick has always been cheap, often free. It's getting well that costs a whole lot of money. When the price of an item is fixed above market value, there is a surplus of that item – as the Arabs discovered with oil. When the price of an item is fixed below market value, that item disappears – as the Russians discovered with everything. We have here a basic law of economics. The price of health care will be fixed below market value. And we're all going to die."
Leave Bahamians free to choose
The Bahamas economy is one of the strongest in the region, so most employed Bahamians can afford to purchase private health care. Yes, it might be necessary to prioritize personal spending, but it is possible for many of the uninsured to protect themselves without inviting the intervention of the government.
For those that are legitimately too poor to purchase private health care insurance or may have been disqualified for one reason or another there may be a role for government supplementing the cost.
Based on the evidence from first world countries that currently offer state controlled health care, it is more important that Bahamians have a less than perfect health care industry rather than a failed system run by the government.
The country can hope that as Parliamentarians educate themselves on this massive effort, they will decide that Bahamians should be free to choose who their health care provider and insurer will be rather than go further down this disruptive path.