Minister of Health and Wellness Lieutenant Colonel Jeffrey Bostic has added his voice to the debate on alternative financing for healthcare, saying a national health insurance scheme is the preferred option at this time.
Delivering remarks at the opening of today’s sub-regional dialogue on health, hosted by the Pan American Health Organisation (PAHO) and World Health Organisation (WHO) at the Hilton Barbados Resort, Bostic acknowledged that there was no single, ideal model for health financing.
[caption id="attachment_277350" align="aligncenter" width="400"]
Minister of Health and Wellness Lieutenant Colonel Jeffrey Bostic (second from right) chats with PAHO officials, including (from left) Sub Regional Programme Coordinator Jessie Schutt-Aine, Director of Health Systems and Services Dr James Fitzgerald and representative for Barbados and the Eastern Caribbean Dr Godfrey Xuerev.[/caption]
However, he suggested that a “homegrown” benefits scheme, similar to what currently obtains for payment of national insurance, was the way to go.
“The path to universal coverage for Barbados and the wider Caribbean must be homegrown with universal health coverage becoming the goal for reform. Pooling of funds is preferred to out-of-pocket payments, and public or compulsory pooling is preferred to private pooling,” he said, adding that the recent introduction of a Health Services Contribution of 2.5 per cent, which is shared between the employer and employee, was a move in that direction.
Ironically, it was Bostic’s Barbados Labour Party (BLP) that had sounded the warning to Barbadians two years ago at the height of the national health debate that they would soon have to pay for health services.
Back then, the former Opposition Shadow Minister of Health Dr William Duguid had warned that based on all that was said at the Ministry of Health’s town hall meetings on health care financing, Government was prepared to go the way of a health insurance scheme that would see Barbadians paying directly from their wages for health care services.
“It is my understanding that there is an intention to bring a change in the law where health funding will no longer come from your taxes, but instead will come directly from your pay packet, like how the national insurance takes a levy out of your pay packet now, with part put by the employee, and part put by the employer.
“From my visiting those consultations I got the impression that is the way that the Government is looking to go to fund health care,” Duguid had stated at the time.
But without reference to those discussions, Bostic, whose BLP took up office here three months ago, also suggested that the current funding system in which Government meets the majority of the costs was unsustainable.
He made reference to a 2012-2013 Health Account Study which showed that the island’s total health spending amounted to $737.7 million or 8.7 per cent of its gross domestic product. Put another way, the total figure amounts to $2,582 per capita - the third highest in the Caribbean.
While noting that 98 per cent of spending was in recurring expenditure, Bostic pointed out that “the increasing burden of non-communicable diseases, an ageing population and new health technologies are projected to increase demand, adding fiscal pressure to healthcare systems”.
Therefore, while successive Governments have kept access to public healthcare free for citizens, he said alternative financing methods now had to be considered.
“The Government of Barbados finances a range of health services from tax revenues. However, the absence of specially earmarked funds for the provision of healthcare has seen the need to review our funding mechanisms and to develop initiatives which support increased coverage in a strengthened healthcare system.
“This will be especially critical in ensuring the health gains achieved are not lost and we can therefore move forward with the agenda of sustainable development,” Bostic said.
He also pointed out that access to preventative healthcare was an area of deficiency, as well as financial aid for persons needing medical services abroad. (CM)
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