One of the matters that came out of Tuesday’s public forum on “Anguilla Social Security Board’s Performance from 2005 – Present” is the planned introduction of a National Health Insurance (NHI) Pilot Project. The overview was delivered by Mrs Jacqueline Bryan-Niles, a member of the Social Security Board, who joined other speakers in reporting on the functioning of the organisation.
The Chairman of the Forum was Board Member, Mr Roosevelt Harris. In addition to Mrs Bryan-Niles, the speakers were Mr Hubert Hughes, Chief Minister and Minister of Finance and Social Security, who delivered greetings; Mrs Dorice Fleming, Financial Controller, who delivered the Board’s Financial Report; Mr Carlyle Franklin, Investment Manager, who delivered the Investment and Development Corporation Report; Mr Colonel Harrigan, Chairman of the Board of Trustees, who delivered the Social Security Staff Pension Fund Report; and Mr Alkins Rogers, Chairman of Social Security, who spoke about the performance of the Board from 2005 – Present.
Mrs Bryan-Niles described the mission of the National Health Insurance project as being aimed to “improve the quality of life through a sustainable and accountable Health Care System”. Her presentation, which should be of much public interest, was delivered in power point form as follows:
BACKGROUND
2010 – ASSB took a decision to become involved in providing National Health Insurance (NHI), held consultations with and received a report from ASSB’s Actuary.
2012 – Meeting with SSB, NHF Board and Government Representatives – Agreement for partnering.
2012 – Team established and visited TCI NHI to look into the operations of NHI and the Hospital System.
2013 – Team established and visited Belize NHI with a view towards implementing a similar system, and attended the CCHFI Conference, Jamaica.
2014 – Ongoing consultation and preparation for the 2014 launch of ASSB NHI Pilot Project. Meetings were held with the ASSB Actuary to review finances . The NHI Project Manager was recently selected to assist with the development and management of the Pilot Project.
NHI OVERVIEW
? In an effort to assist the Government of Anguilla with reforming the Health Sector in Anguilla, the ASSB has taken the initiative to introduce National Health Insurance.
? The objective of NHI is to improve the inadequacy and allocation of resources within the Health Sector so that quality care is made available in an efficient and effective way to all residents on Anguilla.
? Focus on proactive care through Primary Health Care to avoid secondary cases this would be in consultation with other key stakeholders such as Private Insurance Companies, Medical Officers, Ministry of Health etc.
? ASSB looked at different models in the Caribbean region to determine a suitable model for Anguilla – namely Belize NHI Model, TCI Model and BVI to name a few.
? The introduction of NHI would begin with a one (1) year Pilot Project which is scheduled to commence no later than November 2014.
ROLE OF THE SOCIAL SECURITY BOARD
? ASSB to introduce NHI Pilot Project funded by Social Security Development Fund (SSDF) for a period of one (1) year.
? ASSB /SSDF to contribute to facility upgrade and procurement & distribution of supplies for the Health Sector.
? The NHI funds are administered by the Social Security Board.
? The NHI Unit falls administratively under the Social Security Board as well and as such it complies with the board’s policies and regulations.
ADVANTAGES OF THE PARTNERSHIP WITH ASSB:
? ASSB has the capacity to manage the large database of registered populations.
? NHI utilizes the ASSB # as the unique identifier and pre-requisite to qualify for NHI services.
? Relies on the IT technical support to populate and host the Registration, Purchasing and Planning database.
? A NHI Unit would be established in ASSB to manage the Administrative functions and would be governed by a NHI Board of Directors. (Roll Out Phase)
? By pooling resources the NHI Unit functions effectively with minimal administrative costs.
NHI POPULATION COVERAGE:-
Island wide: –
? Care of the Elderly 65 years and over & Children 5 years and under.
? Self-employed non-professionals under a pre-determined income level.
? Unemployed persons – case by case basis
? Registered/Active Contributors to the HNI system. (Not covered in Pilot)
Copayment: 10% of total cost (Exempted Populations). (Not covered in Pilot Project)
SAMPLE:PRIMARY CARE PACKAGE OF SERVICES
? General Medicine and nursing services
? General consultations
? Minor surgery that can be carried out in a General .Practitioner’s clinic
? Pediatric Care
? Obstetric Care
? Maternal and Child Health
? Limited normal hospital deliveries
? Eye examination for children and annual eye examination
? Support Services:-
? Pharmacy
? Laboratory
? X-rays
? Ultrasounds
? Testing
MONITORING AND EVALUATION OF NHI PILOT PROJECT
PROPOSED/EXISTING PROGRAMMES THAT NHI WILL SUPPORT:-
? Health Education and Programmes
? Clinic Sessions
? Outreach Community Activities
? Nutrition Consultation
? Senior Steppers (fitness programme)
? Ophthalmologist with DIABETIC Patients
? Footcare Education for Diabetics
? Parental Sessions
? High School Students
? Primary School Students
? HIV/AIDS
FUTURE PLANS FOR NHI
? Rollout in 2015-16
? Co-payment Plan
? The introduction of the Contract Model
? Payment for Performance
? Government Contributions to NHI budget
CHALLENGES
? Full support of all stakeholders
? Funding Mechanism
? Roll out/Utilization of NHI Services
? Improvements: infrastructure
? Procurement of supplies and equipment (finances)
