Appearing before the Standing Finance Committee (SFC) late last year, Smith said he does not view the challenges faced by the NHI as a structural issue.

The Chairman’s comments came after the Deputy Premier, Dr Natalio Wheatley, stated that the overall structure of the NHI scheme does not work to the advantage of the BVIHSA.

Smith told the FSC that he was familiar with the NHI from the time of its initial assessment.

According to Smith, the NHI is a universal insurance scheme that is based on numbers, spending risk and identifying how you would supplement premiums for whom the risk is being diverted.

He further suggested that it is a feasible time to examine the NHI to ensure it is meeting the needs of the territory and promoting wellness for the community.

Should BVI make public health facilities mandatory for some?

Meanwhile, during the SFC hearings, Labour Minister Vincent Wheatley complained that the government pays for health insurance on behalf of persons and a majority of those persons choose to go to private institutions instead of public facilities.

He then asked the Chairman if the BVIHSA would be better financially supported if persons were mandated to use public health facilities.

Smith said that he would not suggest any mandatory enforcement but noted that some reform is presently needed.

The Chairman said persons have a right to choose their own health facilities. However, he advised that the NHI’s funding formula needs to be equitable.

The chairman indicated that persons who tend to lean towards public health are higher-risk patients with higher morbidities than those who have financial access to go to private entities.

Private entities, he continued, can set their prices to what they think these should be in order to recoup their full cost.

According to Smith, this is something the Authority needs to consider if it were to ensure that the BVI can recoup most of the cost for delivering services.