It has been some time since the Anguilla Social Security Board made a comprehensive presentation of its stewardship. I was therefore very happy when I heard that such a consultation would take place on Tuesday August 19, 2014 and broadcast over Radio Anguilla. As I can recall, from time to time (prior to 2010) the Director of Social Security, Mr. Timothy Hodge, as an aspect of the governance policy, would make such presentations at the beginning of the year. On those occasions he would present the actuarial report; the budget; and a strategic plan for the future. Those exercises provided an excellent opportunity for all stakeholders to get information about the situation at Social Security. He provided clear facts and figures and there was absolutely no politics involved. One of the most memorable of those presentations was entitled: “Business Unusual.”
Let me take this opportunity to congratulate the presenters for their effort. It is clear from their reports that the period under review (2004 – 2014) indicates a sharp decline in the growth of the Fund beginning 2009. This can certainly, among other things, be attributed to the recession that evolved in the latter part of 2008. However, in terms of the overall condition of the Fund, there is no question that it continues to be robust.
On a platform in Sandy Hill on Saturday, June 19, 2014, I expressed concerns about an alleged proposal to implement a “pilot” project for National Health Insurance funded by Social Security. It was my view that there was a lack of public consultation on the way the Fund would be sustained, and what appeared to be a hurried schedule for the launching of the pilot project. I therefore strongly expressed the opinion that the launch should not be pursued until a clearly “thought-out” sustainable plan is in place. Apparently, the Chairman took serious offence to my comments and fired off an angry release that clearly missed the point of my presentation. The clear intent of my presentation was to evoke discussion on the proposal before having it hastily implemented. My article in The Anguillian newspaper entitled: “Say It isn’t So” ends as follows:
“As I said on the platform at Sandy Hill, I would be very happy if the Chairman or the powers that be would say that I am totally wrong about all of these rumours — even if they have the pleasure of calling me dirty names in the process. So, Mr. Chairman, you don’t need to be defensive or make oblique remarks about my sixteen years as the Minister responsible for Social Security. I have absolutely nothing to be ashamed of during that tenure, or for the work I did, along with the Hon. James Ronald Webster, to implement the system almost thirty-four years ago. I just want someone to please say it isn’t so.”
There are many persons who are of the view that my comments triggered the consultations last evening. If that were indeed the case, my intervention would have served a very useful purpose. I must therefore thank the Chairman for responding so quickly to some of the questions raised — even though I regret that in the process he created some very embarrassing moments for the Board Secretary. As I pointed out, saying it isn’t so makes me very happy. However, what I remain unhappy about is that they still intend to implement the pilot project for a National Health Insurance Fund financed by Social Security.
While I was very happy to hear the reports at the consultations — these still did not answer the questions I raised regarding the sustainability of the Fund. I note that the date for implementation has been put off by two months to November 2014 — but contributors still have not been adequately informed of how it will be sustained. Indeed, the Board Member who did that presentation was very articulate — but did not give a single costing for the project nor provide any budget or business plan. I must congratulate the newly appointed CEO on his position — but I fear that it seems that he will be undertaking an almost impossible mission. I am sure that citizens over 65, like myself, would be looking forward to reduced medical fees — but the question is, for how long? The point I am making is that we seem to be using a “hit or miss” approach to the delivery of a very critical need in our community. It would be tragic to raise expectations and have them dashed away by lack of thorough analysis.
The three presenters, from the Management Team and the Social Security Board operated within the scope of their topics by delivering the facts and statistics without colour or bias of any kind. But it was clear from the Chairman’s remarks that he was both defensive and offensive. He also gave the impression that it was all about his determination to get the Fund in place and, in that vein, he made the point very strongly that he was not worried about getting it right – he was more concerned about getting it started.
I was also not surprised that the Chief Minister, in his remarks, made sure that he exonerated himself from any blame that would occur, if the project floundered, by declaring that he did not have the time to focus his attention on the project and therefore left that responsibility up to the Board and Management of Social Security. Neither was I surprised that he once again tried to rewrite history by implying that he was a supporter of the Anguilla Social Security System from its inception. However, the minutes of the Anguilla House of Assembly clearly record his opposition to the introduction of Social Security – and it is further documented that he was one amongst only two persons who were ever taken to Court for not paying social security contributions on behalf of their employees. Nevertheless, it is clear from the Chief Minister’s welcoming remarks that he too has concerns about the sustainability of the project as designed.
I do not intend to spend any time reacting to the clearly political comments by the Chairman because that has never been my motive. My motive has always been to ensure that a well-needed National Health Insurance Fund is implemented for the benefit of the people of Anguilla. And being fully aware of the need to get it right, I am concerned that less than three months before the planned launching, we do not have any budget or figures for the project.
I was made aware very early that the Chairman intended to be confrontational in his response to questions about the pilot project, by questioning my stewardship as Minister responsible for Social Security for fifteen years. I therefore decided that I would listen on radio and use this medium to raise and share my concerns with readers. The purpose of my questions is to raise awareness constructively – not to be obstructive. And I am certain that readers with open minds would appreciate that. My questions, though not exhaustive, are as follows:
• How many persons (as opposed to categories of persons) are estimated to be covered in the pilot project?
• What is the estimated cost of the pilot project?
• How long will the pilot project last, and how will it be funded?
• What plans are in place for funding the roll out?
• What is the proposed funding mechanism for the eventual National Health Insurance Fund? Will it be the Interim Stabilization Levy?
• Have private insurance providers been consulted in the design of the system?
• What will be the financial obligations of the beneficiaries?
• Will both public and private health care providers be involved in the services?
• Will the Government be required to make any contribution to the pilot project?
These are certainly not all the questions. But I need to make the point that the Chairman’s enthusiasm and bluster will not be sufficient to make this project viable. It would certainly be irresponsible to launch a system without providing some answers to the taxpayers on these important questions. And it seems that this is the only time that any consultations have been held. If it takes my interventions to irritate the Chairman into being more responsive to these issues — I have no problem with his incisive comments. However, with regard his veiled threats about legal action my only response is : “Oooh! I’m scared!”
