Former manager at Sagicor, Randy Rodney, has raised questions concerning the newly implemented National Health Insurance Pilot program (NHI) saying without premium payments involved, it will die.
On Monday, April 3rd 2017 the government launched the pilot program for the insurance scheme. $5-million was pumped into the program to assist mothers aged 35 or younger, and children three years or younger, who need help to deal with critical medical issues.
Rodney admitted that the program is a “good one” but his main concern is that no premium payment is involved.
“Unless you have a premium that is regularly paid into a program, it is not insurance, it is Salvation Army, you can call it a fund, you can call it anything like this,” he stated on Q95 on Tuesday. “That is why insurance companies very often stand to say ‘hey if you want to run an insurance scheme, run an insurance scheme. If you want to run a scheme where you give people stuff, then that’s totally different.'”
According to Rodney, without a premium coming in from the claimants, the program itself will only last a few years, for a few people and then “it will die.”
He also raised questions over who takes on the responsibility of paying the bills if there is no premium.
“If you don’t have a premium coming from the people who are going to benefit from it, then who’s gonna pay it? When that fund is depleted, then what? How many expectant mothers can be sustained? How long? What is the max in terms of the expense?” he questioned.
Under the pilot program, beneficiaries are expected to pay 2o percent of bills on their own and the alternative of taking a loan to pay off the costs was described by Rodney as “a joke.”
“That does not exist in real insurance terms. In real insurance terms, your deductibles are paid upfront before you get your claim amount. So that in itself has not been conceptualized properly. There are professionals at the Dominica Social Security (DSS) who should give proper advice in that regard,” he said.
Rodney stated that persons involved with the facilitation of the Pilot program must be “upfront” with the information to the public.
Concerning the $5-million being placed in the program, he questioned what is going to happen when the funds are depleted.
“The idea of throwing five million dollars into a bank and deciding that it is going to be used for a certain sector can be considered something in the wind except if there is an actual report to say that ‘well we have X number of people who get pregnant, their cost is going to be X amount within a certain period of time.’ Even when you have that, the question must be asked, when that fund is depleted in terms of the claims, how does it get reimbursed?” he stated.
DNO is attempting to get a response from the DSS on the question raised.