By NICO SCAVELLA

Tribune Staff Reporter

nscavella@tribunemedia.net

PRIME Minister Perry Christie yesterday said reports that his administration is seeking to implement a government-run “death panel” to decide who would be treated or not for catastrophic diseases under its proposed National Health Insurance scheme was “absolute nonsense.”

Mr Christie said “death panels” have not existed in the Bahamas since 1977 when he was minister of health under the former Pindling administration. Mr Christie said the fact that some media outlets would suggest the possible existence of a “death panel” under his government “purveys the intensity of the industry to bring what we’re trying to do into challenge.”

On Monday, The Nassau Guardian reported that a state-run group that would decide who is treated for serious illnesses, a so-called “death panel”, had been criticised in a PricewaterhouseCoopers (PwC) on NHI.

The PwC report, which was completed in May of this year, but only recently made public, is critical of several findings of an earlier NHI report by Sanigest Internacional, the government’s NHI consultants, specifically the proposed amounts to finance care for catastrophic illnesses each year - reportedly $20m for the vital package, $50m for the core package and $70m for the expanded package.

PwC noted that “a committee of experts” chaired by the Ministry of Health with representatives from relevant stakeholders would manage these funds. It added that the Sanigest report is “silent on the protocol or rules” that would govern such a panel.

However, PwC said that a “committee or expert panel tasked with deciding who receives and who does not receive treatment can be viewed as biased if protocols are not open and transparent.”

“Elected officials can expect to hear from constituents who are denied timely access,” PwC noted, essentially suggesting that if adopted, such a model would give the panel the power to determine who receives potentially life-saving treatment and who does not.

Mr Christie said yesterday: “This morning I woke up and saw the headline

‘death panels.’ Such absolute nonsense, but (on) front pages of newspapers, probably because it purveys the intensity of the industry to bring what we’re trying to do into challenge.

“…The last time it was a death panel in this country was when I became minister of health in 1977. There was a small dialysis unit in the Princess Margaret Hospital with two machines, and the country had to make choices as to who would live, who would go on the machine.”

Mr Christie explained that at that time, a situation arose where two people were in need of the dialysis machines, one being a 14-year-old girl from Harbour Island and the other being a “well-known Bahamian” who was a great friend of his mother.

He said the government ultimately made the decision “that we didn’t have a machine to help him because it had to go to the 14-year-old girl.” The individual later died, Mr Christie said.

“That was the last time a decision like that was made by a politician, because I then brought in Mr William Thompson, and said this is something that preachers should deal with and priests and people who are much nearer to an assignment of life and death,” Mr Christie said. “But our country has gone well beyond that now. There’s no such thing, there’s no such consideration.

“But people in our country, when we’re talking about suffering and alleviating suffering, we must have an informed approach to it.”

NHI will be phased in over a five-year period, the government has said. The government intends to introduce the first phase of NHI in January 2016.

Officials from Sanigest have said that the scheme could cost up to $633 annually if implemented as a comprehensive package. If introduced on the low end, NHI could cost around $362m.

The government has allocated $60m for the first phase of NHI.

Regarding that first phase, Mr Christie said on Friday that the government’s main goal ahead of the proposed implementation date is ensuring the country’s medical infrastructure can deliver the quality of service “that fits the amount charged”.

He said, despite public fears, his administration would not institute any form of taxation for NHI prior to July 2016, which is the start of the new fiscal cycle. He stressed that none of the timeliness associated with NHI has changed.

However, the report by PwC stated that the Bahamian healthcare system is “not ready” for NHI, and will face a major challenge in coping with “an initial surge in demand” for services.

This, PwC warned, was likely to “compound” the Bahamas’ challenge in controlling healthcare cost growth. It added that the demand-driven rise in healthcare costs will impose “significant pressure” on the Christie administration to either increase taxes, or re-allocate spending away from other high priority public services to finance NHI.