In the wake of the release of the pwc review of the proposed Sanigest National Health Insurance scheme it was suggested there would have to be a “death panel” to “decide who would be treated or not for catastrophic diseases (CD) under its proposed National Health Insurance scheme" which the Prime Minister called “absolute nonsense”.

But here’s what pwc said:

“Given the high cost of CD services and potential demand it is recognized that controls will need to be established to authorise claims and approve care plans within available funding. For each Benefits Package, a fund limit or budgetary ceiling of $20M, $50M or $70M respectively would be established and managed by a committee or expert panel chaired by the Ministry of Health with representation from relevant stakeholders. Rationing protocols would be established to manage costs within available funding levels and wait lists created to address situations where demand exceeded supply.”

The Prime Minister has already noted that there will have to be additional taxes to fund the NHI scheme and one must assume this is because there will be additional demand. As such, there is no doubt the scheme can expect more claims for critical care/catastrophic diseases.

All this in an environment where the insurance industry has consistently stated, and the pwc review confirms, that Sanigest has understated the numbers. And understated them dramatically.

Therefore, it appears obvious that there will be cases where the decision will have to be taken to deny services and no matter how the Prime Minister protests the politics of the question, there is not enough Bahamian Dollars in print to pay for it all.

The country doubled down on taxes, adding the burden of VAT, earlier this year, because of the fiscal imbalance created by deficits and debt, and not one dollar of the new taxes has gone to pay off any of the debt, yet the country will be able to meet any demand placed on the NHI scheme?

When politics tries to trump logic it’s a pathetic sight.