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NHI hopes to limit health coverage of select beneficiaries

SSB Director Antoinette Skelton.

By Davion Smith, BVI News Staff

Authorities responsible for the National Health Insurance (NHI) scheme are hoping to effect policy changes to reduce revenue losses; some of which are projected to affect the scheme this year.

Director of the Social Security Board (SSB), Antoinette Skelton said her organisation will be recommending changes to limit the places where select NHI beneficiaries can access healthcare in the territory.

These select beneficiaries have been identified as persons who are legally exempt from making NHI contributions and, therefore, receive free healthcare.

Persons exempt from making NHI contributions include children and persons 65 years and older.

While addressing the Standing Finance Committee recently, Skelton said these beneficiaries have been opting to seek health care at private facilities instead of public ones — a practice, she said, “could negatively affect the scheme”.

As such, Skelton said the SSB will “send forward a recommendation to the Minister [of Health] to have that legislation amended because those persons were not contributing, and NHI should not have to pay if they utilised the private facilities”.

Private healthcare facilities are known to be more expensive than public ones.

More than half-million lost

According to the SSB, the NHI recorded losses of more than half-million dollars last year.

The NHI’s total expenditure ($80,476,662) was more than its total income ($79,882,819) and this disparity resulted in a net loss of $646,843.

Director Skelton projected “a bigger loss” for 2018. She said this is because a number of hurricane-affected businesses are still nonfunctional.

Some 36,057 persons were registered with NHI at the end of 2017.

Copyright 2018 BVI News, Media Expressions Limited. All Rights Reserved. This material may not be published, broadcast, rewritten or distributed.

59 Comments

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  1. Albion says:

    Not too many surprises here. There was a good reason why the Government never showed us the actuarial studies before launching NHI.

    What is amazing to me is that we have 36,000 people registered for NHI, but pre-Irma our resident population was only 31,000. By now our resident population is probably down to 27,000 or so. There is clearly abuse of the system going on – who is investigating that and trying to ferret it out?

    It is equally amazing to me that in a state payor system we have STILL never introduced fixed price agreements with the primary service providers to control costs. This is what mature countries do in similar systems – I just cannot understand why we are incapable of doing so.

    • you looking much says:

      they set a bald heads, got —- brains too

    • Silent says:

      The price agreements have not been implemented because they backed down when the healthcare business owners rejected it. NHI admin. did not push back. Could this have been because some of our political leaders are investors in healthcare businesses?

    • Morals says:

      Please ensure your public healthcare has the best workers then. Because although these minority groups does not contribute, they are your nation’s most vulnerable and BESIDES isnt there something in your policy indicating that those who contribute are doing so for those who don’t?

      • Liddy says:

        They need to ensure that NHI has good workers too. I find that there is a problem with customer service in that organization and they do not educate the public. They receive payment for NHI and chuck it on the side if you do not know that you need to complete a change form but they do not forget to put in the system that you are in default and therefore cannot receive benefit. That is down right ignorance. People should be reminded if they need to do something and if my employer pays contributions on my behalf they should be credited to my account whether or not a change form was completed or the employer or employer should be asked a question or payment should be returned and that will certainly raise a red flat. It is expected that people will be educated where they have obligations that they may not be aware of.

  2. Hmmm says:

    Just give up the ghost and let the people have their regular insurance back.
    Everyone knows NHI was a Ponzi scheme to oppress the poor and enrich the rich.
    It’s criminal to force the people to give up their decent insurance to pay for this mediocre crap that leaves people vulnerable when they need help the most.

    Another reason why this current government must go.

    • rastarire says:

      National healthcare is the best solution on the planet for the benefit of ALL. I you wish to have private coverage that’s fine but don’t come begging to NHI for payment

    • Theo says:

      I agree, just wish you didn’t say “this current government”. Yes it is the current government, but the current government is also a product of a larger systemic virus plaguing the British Virgin Islands. Deal with the government, but once that is done I hope everyone continues to ferret out corruption.

      The population of the BVI isn’t so large that we don’t have incidents of loss of life on large scale due to negligence, it’s small enough that things get pushed to the edges and just disappear from the radar.

    • King Kong says:

      Anyone can have a regular insurance, but if it is through your employer, remember that it does not belong to you. When you leave, get fired or retire it stays. That’s when some people want to turn to NHI and that too would be considered unfair too.

    • Rubber Duck says:

      No privately run health insurance system provides overall better results than state run health care schemes. Look at the USA, they pay the most on Earth for healthcare ( 3 times per head what the French pay) and have lower life expectancy and higher infant mortality rates than virtually every other developed country. Private health care insurers are in business to make a profit, not to keep you well.

  3. VI Gyal says:

    I have both NHI and private insurance. I think that I should have a choice as to which I wish to use rather than NHI being first preference since you not making any money anyway.

  4. Duh says:

    I have a better idea – why not implement caps on what private health care providers can charge OR get people to pay out their own pocket and then pay them back plus 10% for their time as going and paying cash to visit the dr at a certain clinic is $60 cash or $250 NHI with the co pay. If the person paid cash and claimed it back it would cost NHI $66 rather than $225. The private drs are fleecing the system as they all put their prices up when nhi was implemented.

  5. Anonymous says:

    “Private healthcare facilities are known to be more expensive than public ones.” True statement. Also true is that public healthcare facilities is also known to offer substandard healthcare for a myraid number or reasons. Just bc you fall in the category of children and the elderly, does this mean you are “not entitled” to decent healthcare. Wow!!!

    I don’t believe persons would mind if doctors in the public facilities were capable ones, but they don’t see beyond the pain. They just continue to pacifer the problem with just pain meds or everything is muscle relaxant for them. Some can’t even diagnose a common stroke.

    My recommendation is to first seek “qualified and well experienced doctors” for public health care. Conduct the necessary background checks when hiring. In addition, put a cap on the cost of various procedures. Some facilities are just plain greedy and will continue to drive up the cost of healthcare in the Territory. But at the end of the day our children and elderly should not suffer.

  6. Nonsense says:

    Skelton You and the Government just full of —–. Most of these people who go private had their insurance policy that you all made secondary in the territory by bringing this NHI or forced them to give up. What is wrong with you h———— people.

    The board is taking the people money and investing it all over the place and paying these big salaries.

  7. Keen Observant says:

    What many would like to see enacted in any reform are tools to limit and or eliminate the misuse and flagrant greed and abuse occurring within the NHI system.

    Medical security is a critical component to the good health of any society, but too many professionals are simply milking it all for they can get.

    Many are on NDP’s case seeking/asking for transparency and accountability. Yet, they fail to recognize that they and the government are being ripped off daily by the medical institutions and professionals.

    Perhaps, if that field was a political one there would be such callings and or agitations? Or, perhaps there is a case of selective political criticism?

    • Foolish says:

      They don’t care about transparency, that’s just a buzz word to give credence to their petty arguments. Ask them to provide detailed information on their accusations against the Government and they cannot put forward anything with sense. There are other countries in the Region that have been struggling for decades to get NHI put in place and still can’t get it done. There are countries that have asked our Government to assist them with consultations to try and get their NHI up and running but here we are with a new system that have saved so many lives already and all we do is complain because it will cost us something. These seem like people who care about country?

    • But says:

      NHI is on the list of issues

  8. hmmm says:

    ST—-ING, MS, N—TY PEOPLE. i didnt ask for nhi. st—-ing people have the nerve to say they will willfully give people bad service.

    If them crazy ms sign that hmmmm problems in tola.

    scrap nhi, scrap nhi today

  9. wait says:

    I must pay same money AND GIVE MY CHILD AND MOTHER substandard service? WOW h———–ss r—— people

  10. Cromwell says:

    Just one more piece of discrimination, now it’s the very young and the very old, perhaps the BVI deserves everything that’s coming down the line, because it’s all self inflicted.

  11. Wait says:

    So why is everyone surprised? This is how insurance works, just because it’s linked to Government doesn’t mean it should be suffering a loss.

  12. Sad says:

    This is what happens when everything is pandering and a populace is not educated about matters affecting their country. So many will read the headline and scan through and then blog vitriol without understanding the issue at hand. If people are not contributing to a scheme but still spending top dollar from the said scheme, how will it survive? All they’re saying is that they are tightening the system so that those who do not contribute will probably pay a higher share of their private healthcare bill than previously. There’s no such thing as FREE in this world so we need to snap into reality. NHI is far from perfect but has saved a lot of lives since inception.

    • Oh my says:

      Get good Public Health Care facilitates and we won’t mind.

    • Stunnified says:

      Are you even listening to yourself? “All they’re saying is that they are tightening the system so that those who do not contribute will probably pay a higher share of their private healthcare bill than previously.” Really? And you say we (the bloggers) did not read the article. For your info, it is the elderly and children that are referenced. They cannot afford to pay NHI and will be forced to use public healthcare, so how will they be able to pay a higher share of their healthcare bill than previously. Are you going to give it to them?

      Why don’t you address the real issues and lobby for qualified doctors in the public healthcare system. Lobby also for legislation to set a cap on cost medical fees and related costs, lest some of our LOCAL doctors will continue to raid the pig of his ears, tail, snout and stomach lining.

  13. schemers says:

    half million lost. Same thing US tried to do with obamacare and that was failing as soon as it started. NHI forces ppl to pay into a govt system. Has the govt run anything well?

  14. Soyousay says:

    What happen to the lawsuit that JIPA brought against the NHI? I guess those who needed to benefit the most and rammed the NHI down the peoples throats before we were ready are either seeing the writing on the wall or running out of space to store the sacks of gold.

    Why don’t they let the public know how many contributions they have lost since the hurricanes instead of running around telling employee, Check Again, Check Again. Sad!

  15. VICKIE says:

    Who isn’t dying from post hurricanes stress the NHI will kill out with all the money they are collecting and investing they can help pay for their people to get good health care. I am very disappointed in SKELTON I for one always defend her but I have to defend the young and the elders when will these people in power care for their citizens. What I really see it that as long as their bread is buttered they do not care. And this NHI set up wrong and they did not listen and what ever this government put on their people mouth they eat it now they have the running belly sad to say.

  16. nonsense says:

    I still cant get over the fact why should insurance (NHI) be a percentage of your salary. Insurance has always been a fixed rate for what ever coverage you sign up for. I think NHI is just another fancy term for another Social Security hence the reason both offices are practically one unit. They tried to get rich on the backs of the poor man and now it’s back firing because we have 36,000+ registered but how many are actually contributing? Every minute a scooter man under somebody vehicle and when you look they make no NHI contributions. Get rid of this NHI nonsense and let people get their preferred insurance

  17. Concerned says:

    Why do you have 38000 registered when we do not even have so much population. Because every Belonger living anywhere is registered and the children and people over 65 come here to receive free health-care. Why don’t you limit the 65 and over to the people who previously have been registered with Social Security and paid their contributions and when it comes to children the one’s where the parents are actually paying contributions. When it comes to using Private facilities just make the co-payment amount the person has to pay to the private facility larger instead of trying to force them to pay all of it or use inadequate facilities. So somebody has a good income and pays ridiculous premiums and then has to turn around and pay for their elderly parent’s health-care again.

  18. Cancel says:

    Is long time I want to cancel mine. This is bull crap

  19. UNFAIR says:

    This is unfair…I thought NHI was for the vulnerable…why they don’t stop the local medical facilities from overcharging the public and NHI…since NHI came in…medical fees sky-rocketed. It’s the greed of these medical facilities…they need to start capping medical fees so that NHI can be affordable…or is it that NHI was pushed through to make some people rich…deal with the problem at it’s source (the overcharging local facilities) …don’t penalise the public…or else cut this crap out..repeal NHI and let us get back to private insurers…we were better off it seems…

  20. Katniss says:

    Nhi is a scam

  21. hmm says:

    This is some BS. nobody wanted the tacky NHI that was force on residence and for the said reasons now you want to go and do this now, impose this on our children and elders. when is the BS going to stop here. i think i can speak for all when i say that we enjoyed our private insurance as our children especially could have seek medical attention privately and not publicly,because it should be our choice and not your say so. When serious matters arise NHI is quick to send our patients to ludacris patients in order to seek help. the bill is one think now this BS is a next.

  22. O says:

    The other reason NHI has been losing money, is that there is no cap on what the clinics can charge the government for their visits. If NHI is looking to cut costs, start there before you start cutting benefits.

  23. Fine says:

    Ok so it’s costing too much at the private clinics… fine. Make sure there are ****PROPER**** public medical clinics. The innocent children of the future shouldn’t get crappy healthcare!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

  24. concern says:

    The bvi health systems, specifically pediatric dept are not equip to handle that amount of traffic of kids who will be accessing heathcare. We need to equip the system with well qualified pediatrician and specialise Equipmnet to deal with pediatric care.
    We are talking about thousand of kids here so abviously parents hae to wait very long periods of time.
    This is certainly a step backward. The aim of the public sector is not to make a profit but to serve the the country.

  25. professional says:

    why bvi children have to suffer or their healthcare been compromise by poor decisions of adults
    parents would rather contribute more to nhi than to have their children healthcare been compromise
    nhi should scrutinize the private health care facilities a bit more ,I agree that people are abusing the system but we cant take children’s rights to seek excellent health care remember the bvi public never ask for nhi everyone for the most pary were doing just fine with their private health insurance

  26. professional says:

    This is certainly a form of child abuse, from any angle you look at it

  27. Easy says:

    If I was the Government I would reverse the NHI requirement, close out the fund and put a policy in place where all residents have to get their own insurance because Government would no longer be footing the bill when they have to be flown overseas. Let’s see how you feel then. Nobody had concerns when Government had to magically find funding to fly persons overseas for treatment and not getting a dime back, but because this is something we pay for everyone is upset.

  28. Political Observer (PO) says:

    Government must established set prices with medical providers services, ie, medical visits, X-rays, MRI, labs……etc. To partake in the NHI, medical providers must agree to the set prices. Agree with the Director, a network of medical providers must be established; persons going outside of network for non emergency services should incur the additional cost.

  29. two cents says:

    NHI is water down health insurance

  30. Lily Ann says:

    So they force NHI on us … and now coming to limit us ???? Absurd

  31. Not the answer says:

    WHAT ANTONIETTE AND HER TEAM NEED TO LOOK AT IS THE INCREASE OF FEES THOSE PRIVATE MEDICAL CENTERS HAVE PUT IN PLACE AS SOON AS NHI BECAME AVAILABLE. YOU SHOULD OF LOOK AT THE CONSULTATION PRICE BEFORE NHI AND THE CONSULTATION PRICE NOW AFTER NHI WAS INITIATED. ITS NO MAGIC TGAT THESE PERSONS RAISE TGEUR PRICE TO RAPE NHI AND TGE GOVERNMENT. YOU SHOULD A BUT A LIMIT ON THE AMOUNT OF MONEY YOU WOULD OF PAID. AND PERSONS WOULD OF STOP GOING TO THAT BISINESS OR WOULD OF MADE A CRY TO THE BUSINESS FOR RAISING THEIR PRICE.. BUT YOU SEE PERSONS DONT COMPLAIN TO THE BUSINESS CAUSE TGEY DOBT REALKY FEEL IT.. NHI IS WHO FEELS IT. TELK THESE BUSINESS THEY DID WROBG IN RAISING THEIR FEES! YOU ALL DID NO INVESTIGATIONS ON THESE BUSINESS PRICES PRIOR TO NHI. WHRE SEE A DOXYOR WAS 80 ITS NOW 160 JUSY BECAUSE NHI PAYING MOST OF IT! LOOK INTO THAT FIRST.

  32. Care says:

    How old is Skelton? Where does she access medical care?why is she attacking the vulnerable children and elderly? If she had young children and a mother or father would she be so quick to attack? Individuals must be in charge of their health care not miss Skelton. NHI was forced on the people before it was carefully studied. . It was taken to the House of Assembly in a rush.Everyone in the territory was forced to take it even if they were not Virginislanders or belongers. We were told it is primary.. Many who could not afford had to give up private insurance. Even government give up their insurance for their workers before they knew if NHI would work. Just know which gov.groups were allowed to keep theirs. Has any study been done to show what the projection of income will be needed for a few years ahead? Be careful what you ask for. Your turn may be next.

  33. Hats Off says:

    Well done BVI Gov… Slow Clap…
    Your get rich scheme not working now you further limiting the ppl to mediocre care. Well done well done.
    I hope everyone in these Beautiful British Virgin Islands takes advantage and milks this before it is enacted

  34. Where is the Government's Humanity? says:

    “How a society treats its most vulnerable is always the measure of its humanity.”

    Statement by Ambassador Matthew Rycroft of the UK Mission to the UN at the Security Council Open Debate on Children and Armed Conflict

    https://www.gov.uk/government/speeches/how-a-society-treats-its-most-vulnerable-is-always-the-measure-of-its-humanity

  35. Vg68 says:

    There should have been prearranged caps on services. NHI failed to do this. Result, private facilities increased their fees. In some cases, dramatically. To punish the children & the elderly, at this stage, is cruel. Regulate capped fee’s on services rendered.

  36. Wes says:

    You will find that they are paying BVIHSA more than the private sector and all overseas care combined.

  37. Boo says:

    Did — get this memo before embarking on their multimillion dollar expansion?

  38. Getoffyourasses says:

    If you think this is a fraud to loot your public money, do something about it. There are confidential reporting procedures you can use such as with the Financial Investigation Authority, FCPA in the States (they have been using the Federal monetary system so, like FIFA are subject to US jurisdiction on the monies) and the Governor’s office. Show how the prices have gone up since NHI and that there is a massive discount for cash and then this should be a straightforward case, particularly if healthcare provider and their family and associates are also in Government. As well as the criminal side, there are civil law remedies potentially. If you see something wrong and do nothing, you are part of the problem.

  39. Yass says:

    After the hurricane, someone is now talking sense! Exempts should only be seen in community clinics and Peebles. The exempts are draining portion of NHI funds which should be reserved for overseas consultations in cases wherein specialties and subspecialties are not available. A lot of unnecessary tests and procedures are being done in private clinics who are manned by pseudo-specialists.

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