Health Insurance In The Bahamas - Report

A report commissioned by The Nassau Institute, "Health Insurance In The Bahamas", has been made available to the Bahamas Employers Confederation, courtesy of The Nassau Institute. This report is an analysis of the Blue Ribbon Commission's proposals and an examination of alternate policy options prepared by Nadeem Esmail, Director, Health System Performance Studies, The Fraser Institute of Canada.

This report examines the current health care situation in The Bahamas, compares the Blue Ribbon Commission's recommendations against similar performances in other countries, and presents various options for improvement based on best practices in those countries that have sustainable health care systems.

Mr. Esmail reveals that health care in The Bahamas is currently more costly than those found in any of the world's most developed nations except for the United States. This high level of expenditure purchases relatively good access to health care. However, the quality of health care in The Bahamas is below what might reasonably be expected from the high level of expenditure.

In order to compare The Bahamas with the thirty most developed nations represented in the Organisation for Economic Co-operation and Development (OECD), it was necessary to account for the fact that The Bahamas has a relatively young population, as there are relatively few Bahamians over the age of 65 relative to the population over that age in OECD nations.

The high cost of health care is seen by comparing health costs as a percentage of the various countries Gross Domestic Product (GDP). After adjusting for age, The Bahamas spends 14.9% of its GDP on health care compared to the average OECD nation cost of 8.6% of GDP.

The quality of health care in The Bahamas was determined by a measure known as Mortality Amenable to Health Care. This measurement examines the ability to prevent deaths from conditions where such an outcome should be preventable through appropriate medical intervention. When compared with the performance in select developed countries The Bahamas ranks 20th out of 20 nations with a mortality rate that is roughly 70% greater than the average mortality rate. This level of performance is well below that which should be expected in a nation that has a relatively high level of health expenditure and that has relatively good access to care.

In examining the question of affordability and sustainability of the generous and comprehensive National Health Insurance proposal of The Blue Ribbon Commission, Mr. Nadeem Esmail concludes that the verbatim implementation of the proposal would produce a substandard health care system whose cost would far exceed what is necessary.

Many of the world's nations are struggling with the implementation of newer technologies in health care. While new medical technologies and pharmaceuticals can and do provide better health outcomes and more comfortable treatment for patients, their cost must somehow be tackled by any National Health Insurance plan.

It is noted by Mr. Esmail 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 National Health Insurance spending in The Bahamas are likely to be similar to those in developed nations, sustainability is an even greater issue in The Bahamas given The Bahamas slower economic growth.

The next issue of BECon's News Bulletin will utilize Mr. Esmail's report to focus on comparisons of the Blue Ribbon Commission's recommendations against similar performances in other countries, and look at the various options for improvement based on best practices in those countries that have more sustainable health care systems. All Bahamians will be affected by a government imposed National Health Insurance plan, therefore this authoritative and comprehensive report, "Health Insurance In The Bahamas", should be read by all Bahamians. With the permission of The Nassau Institute, this report is available for download at the Bahamas Employers Confederation's website. The report can also be downloaded from The Nassau Institute's website. The Nassau Institute also has an abbreviated version of the report available for download and is accepting orders for a printed bound version of the full report for $20.00.

Nadeem Esmail is the Director of Health System Performance Studies and Manager of the Alberta Policy Research Centre at The Fraser Institute. He completed his BA (Honours) in Economics at the University of Calgary, and received an MA in Economics from the University of British Columbia. His recent publications and co-publications for The Fraser Institute include "Waiting Your Turn: Hospital Waiting Lists in Canada, the How Good is Canadian Health Care?" series and "The Alberta Health Care Advantage: An Accessible, High Quality, and Sustainable System". His articles have appeared in Canadian newspapers across the country and he has been a guest on numerous radio and television programs across Canada.

The Nassau Institute, founded in 1995 is a non-profit foundation focusing on public policy in The Bahamas. Its philosophy is based on market liberalism or what has come to be referred to as libertarianism. Its mission is to advance knowledge and appreciation of the classical "liberal" principles relating to individualism, private property and the rule-of-law. For additional information please visit their website at www.nassauinstitute.org.

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