Anguilla has a new pet project emerging out of the pipeline, so to speak. It is called the “Anguilla Social Security Board National Health Insurance (NHI) Pilot Project,” due to be rolled out in two months’ time. The initiative, though suddenly manifesting itself, in terms of being launched, is really not new having been spoken about, and attempted as well, for over two decades.
The Chairman of the Social Security Board, Mr Alkins Rogers, who is one of the main proponents of the NHI, now thinks it is time to get on with the project without delay. Needless to say that, over the years, there has been some hesitancy, or perhaps even timidity, to pursue the project either because the time was not considered appropriate or fear of failure.
While the initiative had always been thought to be a good one, in a growing society aiming at providing modern social and medical benefits for our people, the original precaution, as it was then, and should now be, is that the project should be done in a right and careful manner. The obvious and sensible intent was to avoid mistakes or failure, and for the project to be both effective and successful within what should be a wide scope of healthcare service, touching the lives and medical insurance needs of as many persons as possible.
It is no doubt that, in the past, there were efforts to get proper advice from experts in the field and probably someone qualified to introduce and steer the project. How successful and at what cost those efforts were, are not known. Further, it is uncertain what legislative and regulatory processes have been thought about, explored or implemented, to establish the project on a firm legal footing, to govern its functioning and to give effect to what should be its national provisions and guarantees.
If, on the other hand, however, one of the drawbacks over the years had been the need for an experienced professional, that requirement now appears to be met by the appointment of Dr Lanny Hobson, as the Project Manager, who is not only well-qualified in the field, but is an Anguillian national whose expertise and patriotic commitment should be welcome characteristics and hope for the effective introduction and administering of such a technical pilot project. His work across the United States with insurance companies, and health personnel, should also be a good asset for use and tailoring to meet the needs of Anguilla, albeit the scale is smaller, given population and insurance business size and other factors; but smallness should also assist in establishing and managing the project well. He has made it plain, and rightly so, that he has not come to Anguilla to experience failure, thus indicating a commitment to do his part to make the project a success. He will certainly need the support of all and sundry in his endeavours, and the best of luck.
Whatever are the reasons for the Chairman of the Social Board, his fellow Directors and the Government, to think that the time is ripe for the NHI, it cannot be denied that it may well be a Herculean task ahead. One of the tasks is to get the population of Anguilla, including all stakeholders, fully sensitised and conversant with the project both at its outset and as it progresses.
To date, this is the second public forum in quick succession about the project. The first, in mid-last month, was for the general public. It was broadcast for general information, but was actually poorly attended. The second forum, this week, Tuesday, September 2, was for stakeholders. The event was not broadcast – reportedly one reason being to attract a greater attendance by encouraging persons to attend and participate in the discussion rather than staying at home and listening to their radios.
A large crowd was expected, given the mass seating arrangement, but the attendance, like the previous occasion, was poor. To start with, the Government was poorly represented by only one Minister – Mr Jerome Roberts who has responsibility for Home Affairs. Chief Minister, Mr Hubert Hughes, who is responsible for Social Security, and who should have been a main spokesman, was absent. There was perhaps only one Insurance Company representative present, and that person’s spouse is a Director of the Social Security Board. The only fair showing of attendance was from the Princess Alexandra Hospital which, as stated at the forum, is expected to play a pivotal role in the roll-out and functioning of the NHI. It appears that there will be a need for a greater degree of public awareness about the project.
Unfortunately, the time for this is relatively short, given the fact that the roll-out or official launching of the pilot project is scheduled for November 1. Assurance was given at the forum that a lot of planning work had gone into the project, but it is generally felt that very little of the plans has reached the ears of the public until now. For instance, what information – written or spoken – is available for circulation on radio and television, in the print media, on the internet and other forms of social media? In short, what legislative provision, policy documents and other statements have been crafted and brought to the attention of the public?
When the recent background of the proposed NHI is examined, it is found that the present Government may have hoped to introduce the project early in coming to office. The original attention was that the Interim Stabilisation Levy (ISL), to which workers and business establishments make monthly financial contributions, would cease after one year. Thereafter, the payments would be made towards a National Insurance Health Fund. That has not happened since the ISL is being used to prop-up or balance the Government’s annual budget; and the Chief Minister and Minister of Finance has made it clear that the Levy is still needed for that budgetary purpose and cannot now be applied to the NHI instead. Accordingly, Social Security, which has about 3 million East Caribbean dollars in reserves, is to fund the project for the time being.
There was much commendation at the forum for the Board’s initiative to work towards introducing NHI, but there was some useful cautionary advice which should be taken on board as well. There were also a number of concerns expressed and, when examined, it appears that there were more questions than answers. As a consequence, a whole lot of written information is really needed to be provided to ensure and bolster the awareness and success of the Anguilla Social Security Board National Health Insurance Pilot Project. This would, to a large extent, enable stakeholders and the public at large to fully understand what it all entails and to come on board in a meaningful and supportive manner.
