By NEIL HARTNELL

Tribune Business Editor

nhartnell@tribunemedia.net

The Bahamas Insurance Brokers Association’s (BIBA) president yesterday branded plans by the Government’s National Health Insurance (NHI) scheme to eliminate them, and their value-added role, as “totally, totally crazy”.

Felicia Knowles questioned why the Christie administration, and its Sanigest Internacional consultants, were seemingly hell-bent on removing “something that works” in favour of ‘one-size fits all’ healthcare financing and a publicly-owned insurer.

She argued that Bahamian brokers performed a vital role in terms of “transparency and checks and balances”, ensuring clients received the correct health insurance plan and designing benefits packages tailored to their needs.

And the BIBA president said brokers had in some cases reduced 100 per cent-plus loss ratios (where claims exceed premium income) on employer-sponsored plans to 60 per cent or less, proof of the ‘value added’ service provided by intermediaries.

Yet Sanigest, the ‘architects’ of the Government’s NHI proposal, this summer told Tribune Business that the scheme would effectively eliminate any role for Bahamian insurance brokers when it came to health coverage.

It even suggested that brokers might have to find a new role, such as certifying and verifying that healthcare facilities were up to the standards demanded by NHI.

This position was reiterated in the recently-revealed PricewaterhouseCoopers (PwC) report on NHI, which revealed how Sanigest believes the Bahamas can contain growth in healthcare costs by eliminating “unnecessary expenditure”. Top of Sanigest’s list is the “millions paid to brokers”.

Effectively arguing that such a position was ‘short-sighted’, Ms Knowles said PwC’s review of Sanigest’s report “found fundamental major gaps they could not validate”.

Yet she argued that the Government was “continuing on course” as if the PwC report did not exist, given that it gave 100 per cent backing to all the NHI concerns raised by BIBA and other health industry stakeholders from the get-go.

“Are you health economists or are you here to fulfill an agenda,” she asked of the Costa Rican consultants.

Ms Knowles also queried how Sanigest could be chosen “to build” NHI in terms of a scheme that will actually be implemented, since as health economists it did not seem to have the required skill set.

“Brokers serve a purpose,” she told Tribune Business. “They bring transparency, and checks and balances, for health insurance products. If you want to remove the one thing that people rely on to confirm the product they are getting is what they wanted, it leaves a lot of room for error.

“As a broker, even if a company is purchasing a group plan, we are doing serious work to get the employees to sign up for health insurance. When you think it takes one or two days, it’s going to take months.”

The latter reference is to the Government’s and Sanigest’s expectation that around 85 per cent of the legal, resident population will be registered and signed-up for NHI by April 2016 - within the first four months.

Ms Knowles added that Bahamian insurance brokers were constantly having to educate employees on the benefits of signing up to group coverage, and running behind clients to encourage them to take annual physicals.

“The greatest battle is to encourage people to use it and access it,” she said of health insurance. “There’s so many more things that the Government can do to say they care about the health outcomes for Bahamians.”

Ms Knowles said the Government could “improve the health and welfare of its people” by focusing more on preventative care and combating non-communicable diseases.

“These are the things that insurance brokers and companies have been doing, but they want to switch something that works for something that doesn’t,” she told Tribune Business, referring to the proposed public health insurer under NHI.

“It’s totally, totally crazy. Our clients have seen tremendous savings through the benefits they desire to give, and we have educated so many Bahamians on how to use their insurance products.

“We’ve had clients who have had loss ratios of 100 per cent and brought them down to 60 per cent, making them exercise and eat and drink well. And you’re [the Government] going to say we don’t add value, and you’re going to separate us from that?”

Suggesting that the Government should focus on its regulatory role rather than running a public insurer under NHI, Ms Knowles questioned what effects the current scheme would have on the economy and its growth, with the insurance sector accounting for around 10 per cent of gross domestic product (GDP).