Analysis | Opinion

Analysis: IS A NATIONAL HEALTH INSURANCE SCHEME FEASIBLE, SODELPA ASKS

A SODELPA government will commission a study on the fea­sibility of a national health in­surance scheme. The plan is in its 2018 general elec­tion draft manifesto. While no other details
16 Mar 2018 13:24
Analysis: IS A NATIONAL HEALTH INSURANCE SCHEME FEASIBLE, SODELPA ASKS
SODELPA

A SODELPA government will commission a study on the fea­sibility of a national health in­surance scheme.

The plan is in its 2018 general elec­tion draft manifesto.

While no other details are available about this idea, the party is no doubt thinking of the cost of improving our health services.

Health is one of the ministries that take a big chunk of the national Budg­et annually. It is common knowledge that it is the most criticized ministry because it deals with matters of life and death.

While the FijiFirst Government has invested millions of dollars in Health Infrastructure upgrade and improving pay and working conditions of doctors and nurses, it would take time for the results to be seen and felt. One thing our health service lacks is medical specialists. It takes years and a lot of money to train them. However, after that there is no guarantee that they will remain here because they can be snapped up by other countries.

The need for specialists is not con­fined to Fiji alone. Several of our best brains and skilled practitioners now work in foreign hospitals and health providers after being lured there by big bucks that we simply cannot com­pete with. This is the reality that we face. No amount of political debate will change that. Obviously, there is still a lot of room for improvement.

A National Health Insurance (NHI) scheme can be financed by public funds through taxes and managed by Government or one of its agencies. It can also be funded and managed by a public-private sector partnership.

At the moment the country’s basic health service is fully funded by the Government. But people are free to take out private health insurance which allows them to go overseas and seek specialist medical treatment that cannot be performed here.

It also allows them to access private hospitals here, in Suva and Nadi.

The proposed NHI requires a thor­ough study and examination. If it’s funded by taxpayers, will it also cover those who do not pay taxes? What level of health and medical care can it af­ford to cover?

In New Zealand, the publicly funded District Health Boards fund all opera­tions and medical care for all New Zea­landers and foreigners on residence visa. The DHBs manage hospitals in their designated areas. Visitors have to pay.

Often, there is a long list of people queuing up for surgery. But if they have private medical insurance, they can choose to have it done quickly in a private hospital. Because the stand­ard of medical care is comparable be­tween a private and public hospital, many are prepared to wait for the free service.

Obviously, for the NHI to be mean­ingful, our health and medical service would have to be lifted to a level where most, if not all of our medical proce­dures, are performed locally. We would also attract people in the region to come to Fiji for specialist operations.

The draft manifesto includes the fol­lowing:

  •  Review the free medicine scheme to address availability and access;
  •  On NCDs, there will be compulsory screening in villages and other set­tings to detect diseases early at regular intervals;
  •  Strengthen national policy on healthy school lunches including a ban on the sale of sugar-based prod­ucts and unhealthy snacks in schools;
  •  Introduce a sugar tax for sugar-based and carbonated drinks;
  •  Place greater emphasis on alterna­tive and traditional medicine as part of the overall health care system;
  •  Review drug procurement proce­dures;
  •  Subsidies health costs and charges where necessary;
  •  Provide free outpatient medical services;

Economy

  •  Controlling of borrowing to sta­bilize debt through careful economic and financial management;
  •  Review the taxation system to rea­lign it with current policies to ensure predictability;
  •  Target debt level of around 40 per cent of GDP;
  •  Run an operating surplus over time;
  •  Maintain a balanced budget;
  •  Maintain a level of net worth that provides a buffer against unforeseen future shocks such as natural disas­ters;
  •  Improve the ease of doing busi­ness; and
  •  Intervene to maintain an equitable income distribution and ensure equal­ity of opportunity to basic services like education.

TOMORROW: Concluding part

Feedback: nemani.delaibatiki@fijisun.com.fj

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