Former Public Health Commissioner Maria Buncamper-Molanus is concerned is asking what the status of the efforts made to establish a national health insurance system on St. Maarten.
The councilwoman told the media that after having engaged a Dutch Consulting firm which delivered it’s finding in 2007 and having established a NHI committee, steering group, having several stakeholder meetings and the engagement of an actuary to prepare scenario models, the expectation is that Government has information to share with us to share with the Island Council.
Council lady Buncamper-Molanus recalled that just before the Democratic Party left office the Actuary Keesen was preparing a scenario model for the contribution system of the proposed National Health Insurance system.
Issues under consideration were the overall cost of this NHI which, as the name already implies, would ensure that everyone would have health insurance on St. Maarten. The Councilmember stated that the Actuary’s specific task was to develop a scenario model which would indicate how much it would cost to ensure that every insured person would receive the coverage they are entitled to and that the organization would remain financially healthy on the short and long term. Buncamper-Molanus said that whether Government would have to make a contribution towards the NHI for those who could not pay the premiums and whether there would be a need for a nominal contribution by employers, employees or a combination thereof would also be looked at. Simply said, the answer expected from this exercise would tell us how high the premiums and other financial contributions would have to be, to make sure that all medical bills of those insured would be paid for on the short term and long term.
In addition to this aspect a decision would have to be made regarding the operation of the Health Insurance organization. The options under consideration were for the NHI-organization to be run publicly or privately or a combination of both. The option of Government establishing the package of coverage, the tariffs and the contribution while the organization is run by a private company was a discussion which was on the table in June of this year.
Councilmember Maria Buncamper-Molanus questions what is on the table now.
I will be very blunt; we have seen government apparently redirect funds allocated for the improvement of the Raoul Illidge Sports Complex to the building of a cricket field, knowing full well that a large campaign contributor to the NA has been lobbying for a cricket field.
Can we then expect that the operation of the NHI or perhaps the entire health insurance system will be privatized to a (health) insurance company owned and operated by the same financier?
If the result of all the studies, discussions, stakeholder meetings and calculations indicates that we should privatize health insurance then so be it. Then bring it to the Island Council and let’s debate it. It must however be fair game for all insurance companies to participate.
To emphasize the seriousness of this issue I would like to point out the fact that a tremendous amount of work and money has already been invested in this issue:
• The development and approval of the project plan was completed by the project leaders while a steering group was formalized.
• The development of the scenario model started in February and a decision was scheduled to be taken no later than September. Included in this phase would be a final decision by the Executive Council regarding the basic package of coverage, the contribution system, a guarantee fund and the issue of a Public or Private organization.
• According to the planning, a decision by both the Executive Council and the Island Council regarding the operation of the NHI organization would be taken between September and December of this year.
• Terms Of Reference for the following projects should have been taken already:
o Setting up the NHI Organization
o Collection system
o Transition
o Communication
o Health Information System
o Tariffs
o Legislation
• By September 2009 the Executive Council should have made a decision as to the execution of the projects listed above.
• and legislation decides upon by the Island Council by September 2010.
• Between December 2009 and January 2010 the organization is to be established.
• Business plan for the executing organization is scheduled to be approved by January 2010.
• According the schedule prepared when the DP was in office, by July 2010 the projects are to be completed
• Implementation new National Health Insurance St. Maarten was scheduled for July 1st 2010.
• And an evaluation was scheduled for July 1, 2012.
The former Public Health Commissioner Maria Buncamper has understood that the project group is no longer operational; this is of course very worrisome, because the sector cannot handle the going concerns and the preparations necessary for Country status. There are concerns about the investments already made and whether or not we can consider this lost tax payers money. Will the amount about Fls 538.000 allocated to this project still go towards the development of a National Health Insurance for our people.
Councilmember Maria Buncamper-Molanus reviewed the reasons that let to the start of the National Health Insurance Project:
o We have a rather fragmented health insurance system in the Netherlands Antilles of which is St. Maarten thus far forms a part;
o The socio-economic reality on St. Maarten which includes the migration, immigration, demands of the patient, the cost of health care and insufficient correlation between the healthcare system, its financing and the health care needs on St. Maarten; be reminded of the 2001 survey
How Healthy is St. Maarten”.
o The fact that as a result of the Constitutional development on St. Maarten, a decision will have to be made with respect to the health insurance for the people of St. Maarten
o The results of the study done by BMC and Hassink & Roos “Met de Welvaart Stijgen de kosten” – “With Prosperity Cost Increase” which indicated that a Health Insurance System for St. Maarten was a realistic proposition.
“ 538.000 guilders was allocated to the National Health Insurance project; under the SEI an amount of 1.6 million guilders has also been allocated for the development of a Health Information System and Fls 250.000 for Medical Care Tariffs. The information provided to you this morning should give you an impression of the work that was being done with respect to Health Insurance for the people of St. Maarten as we move into a new constitutional status by the DP government. Needless to say we hope that the present government is cognizant of the importance of continuing and finalizing the work that we have started” concluded Councilmember Maria Buncamper-Molanus.
