The Minister explained that the report is the product of a study that was conducted to assess the financial conditions of the National Health Insurance program and the adequacy of the contributions to support the benefits.
As he drew the attention of the members of the House of Assembly to the document and the serious message it contained the Minister said: “This is not one of the reports that we simply just lay on the table and hope that it goes away. We have to do something about it.”
Hon. Malone explained that the report included an analysis of the utilization of the system as well as expenditure, funding and other trends. He pointed out that the document also included projection over the next five years, a review and discussion around reserving requirements, an outline of the risks relating to the financial viability of the National Health Insurance plan and recommendations on the funding required to maintain the financial viability of the National Health Insurance Plan.
The Minister, in an effort to drive home the disquieting findings in the document read an excerpt from the report’s executive summary which announced that NHI is in a deficit.
The report said: “The National Health Insurance program is exposed to numerous contingent events and risks and being a relatively small insurance plan … in year to year claims, expenditure can be expected based on current contributions, rates and similar future funding from government the National Health Insurance Plan is expecting on a best estimate basis to experience an accumulated deficit over 2018 to 2022 of some $34M.”
“If the deficit is to be solely funded by an increase in the contribution rate, the contribution rate would have to be increased effectively from 2018 from 7.5 percent to 8.7 percent. Alternatively, the contribution rate could increase by point four percent per annum in each of the following five years, so that it rises to 9.5 percent,” the document further outlined.
One of the suggestions for addressing the NHI situation was the raising of contributions. However, the Minister did not harp on that notion. Instead he said: “While it might be prudent to immediately increase the contribution rate we’ll suggest that any commitment or further review in expenditure or reimbursement or clarify derive from a funding policy be considered prior to implementing the increases,” Hon. Malone told the legislators.
As he emphasized the seriousness of the situation the Minister noted that the report was conducted in 2017 and that a lot has changed since then: “We must know as a people that the numbers have increased even more because after the hurricanes of 2017 there have been increases in every disease known to man relating to stress and certainly it would continue.”
Therefore, he suggested that an updated actuarial report review may well be needed to get a better understanding of the situation. However, in the interim he suggested that a brainstorming meeting involving all stakeholders be called to avert what he said could be a crisis. “It is the intention of the Ministry and of the government to hold a health summit to incorporate the Social Security, the NHI, the BVIHSA, practitioners at all levels to come into the same room, the same hall – all 13 of us (legislators) Mr. Speaker and yourself included coming into the same room because it is going to be a national crisis.”
Meanwhile, the Minister explained that people from the Territory are currently in need of assistance from NHI and therefore it is imperative that the funding issue be addressed. “We have our very own people sitting in hospital waiting room waiting for some word from NHI or from the representative as to whether or not their contribution or their part of their contribution – “could you send me some money so I can get my child in to see the doctor? Who is going to pay for this? Who is going to pay for that? It is an issue that we have on hand. It is one that must be addressed.”
I’d rather live with a good question than a bad answer.