PHILIPSBURG (DCOMM):--- The Minister of Public Health, Social Development and Labor (Ministry VSA), Hon. Veronica Jansen Webster said on Thursday in response to a press statement by the Soualiga Employers Association (SEA) about the Sustainable Affordable Act (SAAHA) (formerly known as National Health Insurance (NHI)) that the implementation of the NHI is not hasty.
The first contours of the NHI were drafted in 2007. The unsustainable financial situation as well as the ordeals for persons who have no access to a health insurance, have been the reason to aim for a General Health Insurance (GHI).
A draft National Ordinance was sent for advice to Social Economic Council (SER) and the Council of Advice (COA) in 2015 and 2017, but it never reached Parliament. The deep socio-economic crisis after the hurricanes in 2017 and the COVID-19 crisis in 2020 has left no room for any further delay.
The financial situation has worsened progressively with every delay in the past years and is now in a critical stage. At this moment, the financial deficits of Social Health Insurances SZV as well as medical costs for uninsured persons have to be compensated by the Government.
The large of amounts of tax income used to compensate for deficits in our health system could have been spent on investments for economic growth.
With SAAHA, the deficits will be less than when we continue with our current health financing. Moreover, SAAHA will cover the uninsured, the government currently has to compensate for in case of lifesaving interventions.
The current deficits of the health funds necessitate the use of AOV to guarantee continuity of care. This leads to an accelerated depletion of the pensions of Sint Maarten citizens. Without SAAHA, the financial deficits in our health financing will continue to increase and the need for cross financing from the AOV funds will persist.
We fully agree that additional measures are necessary to stabilize the funding of our health system. SAAHA is the first and most important step, however, additional sources of income have to be considered, such as tourist tax, health taxes for unhealthy behaviors and medical tourism.
Regarding SEAs concerns of the challenges of a shared border and undocumented residents, the humanitarian approach of the French side towards healthcare actually alleviates rather than puts strains on our health system. Many prefer the provisions on the French side rather than the ones and the access on the Dutch side.
SAAHA is an individual insurance meant for all people who are entitled because of their residency status and others who are not resident but contribute to our economy: All registered persons living on Sint Maarten, irrespective of their employment status, are eligible for SAAHA.
Undocumented persons are eligible when they have a contract and pay taxes for more than 20 hours per week. To prevent abuse of the system, all others are not eligible. For example, undocumented persons with less than 20 hours labour per week as well as registered persons living abroad.
Moreover, there are provisions to prevent that people try to qualify for SAAHA solely to have access to expensive treatments they need. For example, people living with HIV who do not have affordable access to medication elsewhere.
