NHI landed in deficit the day it was launched
It was January 1, 2016, when the historic National Health Insurance (NHI) scheme was launched to help residents cover a range of healthcare needs.
But even before it came online, experts who implemented the system cautioned government officials against tapping into the fund until a substantial reserve had been built up over several months.
That caution didn’t hold for long. According to Health Minister Vincent Wheatley, an accident on the very first day triggered a payout from the fund — and NHI has been operating at a deficit ever since.
“The actuaries told us not to get into it until we acquired a certain volume of funds. But the first day NHI came online, there was a motorcycle accident, and it never caught up. It never caught up from that day to this day,” Minister Wheatley told the Talking Points show.
He explained that motorcycle accidents are among the most burdensome on the system, often costing at least $250,000 to care for a single victim.
But vehicle accidents are only part of the problem. The NHI is reportedly running an annual deficit of roughly $600,000 due to a range of issues — including the large number of students, indigent persons, and seniors whose coverage is funded by the working population.
Delinquent employers have also put a major strain on the system by failing to deposit contributions they’ve deducted from employees’ pay.
“We’ve seen over the years where some employers deduct NHI on paper but when you go to NHI, nothing was deposited for whatever reason. In that case, once you can show receipts, NHI still honours your request. So we lose twice—we haven’t collected from the employer, but we’re paying out to you. And millions of dollars are outstanding for this very reason,” Wheatley explained.
He said the government is taking swift action to fix the issues and bring efficiency to the NHI scheme. This includes improving communication between NHI and the Health Services Authority, and updating draft legislation that will create a better regulatory environment.
Stakeholders are expected to meet soon to finalise proposed actions, which will then be taken to Cabinet for approval.
“The whole thing is to address the issues — funding, how do we offer more services and do proper billing,” the Minister said.
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1st identify WHOM was in charge of implementing NHI lol laughable. ACCIDENT on the 1st day? No this tola it was intentional FRAUD. Everyone involved in bring NHI live has a crooked mentality and morals. Debate me.
they are all doctors and benefited directly.
Educated successful people with gangster mentality and moral compass. They worse than the actual gangsters.
Cancel the trade licence of any business that is not paying across NHI deductions and put the owners on a blocked list not allowing them to have any other trade licenses until they clear the arrears. This is theft plain and simple and needs to be stopped.
@ quick first step. Sounds good but They do not have the internal fortitude to do that.
It’s much worse than that, to take money from an employee and not pay the government is theft, prosecute the employers and hold them accountable.
They know who the Employers are but they are not doing anything about it because some are their friends and family. Why was the Certificates of Good Standing that was required for Work Permit renewals at Labour department discontinued? My guess is as good as yours, but it brought to light a lot of delinquent employers not paying their staff and their contributions to NHI hence they could not receive a Certificate of Good Standing.
Not renewing a Trade license until Good standing certificates are produced from IRD, NHI and SSB would be a good start if they want to get some money in the system and keep it fair to all.
Remember there are small businesses with just the owner running it that can’t afford paying nhi, what about those businesses? There shouldn’t be a penalty, except that if you do not have coverage you pay for service in full. That’s the only penalty that should occur.
It would take a week to get a list of employers that need to be looked at for not paying into NHI. If a business is on the list a trade license won’t be renewed until the matter is settled.
no the problem is you guys allowed every doctor that owns a private healthcare place to jack up their rates almost overnight. *** use to be 50 dollars for a doctor visit / eye exam, last time i went it was 250 dollars and nhi only covered 50 dollars. If you had a law in place saying they couldn’t raise prices by more than a certain amount in a year we would be in better shape now.
Yall ain’t going do those employers nothing cause half of them is yall. “Who said that?” especially the one WE with the popular bar
In the grand scheme of things, a healthcare service focused on providing affordable healthcare running at a deficit of 600k annually is not the worst thing to hear right now. It’s like crashing your car but then also breaking your phone. You can fix the phone easily and its easily not the worst thing that happened.
Don’t believe a word they say. It is more like 6million deficit.
Thank you Monister Wheatley for giving roo causes rather than surface blame. Let those you act as if the issues started the moment you was elected and refuse to acknowledge some senior management members who have ben there and shaped policy from the beginning needs to be held accountable.
“He explained that motorcycle accidents are among the most burdensome on the system, often costing at least $250,000 to care for a single victim.”
Yet here we are nine years later amd we see no enforcement of speed laws, helmet wearing, insurance or mandatory skills training for the riders. It’s almost as if we don’t want the project to suceed.
Mek it mek sense.
sir this is the bvi, we don’t do common sense things here
The problem is that there is no cap on health care providers. Once you fix that the problem will be fixed. Health care cost is out of control and doesnt need to be so. Its called GREED!
Put a cap on what providers can charge for procedures even simple visits and the problem will regulate itself.
Also get serious in collecting outstanding contributions from employers. Its criminal what they are also doing to employees. It not a science to get this matter fixed.
“Put a cap on what providers can charge for procedures even simple visits and the problem will regulate itself.”
Be prepared for some providers to refuse to take on patients in non-emergency situations if you institute fixed-fee for service protocols.
Alternatively, be prepared for them to leave the Territory if they feel that they cannot make a decent living if caps on what they can charge are instituted.
I’m not saying some form of fee-for-service should be off the table, but it will at least increase the paperwork each provider has to undertake, and then there’s how they code each visit/service, and who will audit them.
Just understand that like any instance where you seek to solve a major problem, you’ll likely create other problems….
lets scrap that crap
@hmmm and replace it with what? you haven’t made any suggestions but you are blogging shit. jack Donkeys like you are a big part of the BVI problems.
The person who said let us scrap that crap do not have no idea what they are saying. you do not know how beneficial NHI is to the country. When people get sick is when they realize how important it is. with private insurance every year the premium goes up especially if you your medical expense for the year before was high. They also do not cover preexisting conditions. I can go on, but I think these are two important points.
Before NHI you know how much money it cost the ministry to send patients oversees, sometimes they assisted and never got the money back. please think before you write crap.
BS, we survived decades without NHI. NHI was created to offset the huge cost of the hospital but it backfired.
Vincent you all full well know the main problem for fixing NHI. Its the greed of the medical practioners who carry up the prices of their services and medicines.
Fix the public clinics like the one in VG. You all are the Government you have money to help sponsor concerts that could pay salaries of two Doctors for five years.
But no you all want the private greedy medical practioners facilities to be better than Governments.
You all just took a loan for 100million which only 10million has been drawn down so far you all can do better.
Its not the people or even the employers who are struggling is causing NHI to go belly-up its the greedy Medical estanblishments who set the prices and pay themselves.
It is alleged these doctors working NHI are working for some of these companies and the Politicians and those responsible for carrying out the rules are turning a blind eye. The people were forced to give up their private insurance.
THE NHI MADE ALL THE DOCTORS IN THE BVI INSTANT MILLIONAIRES
Check what the caps are on the many countries that provide healthcare are. Like Medicare. Then make the list of recalcitrant contributors, STARTING with members of the HOA, who run businesses, and Permanent Secretaries, and we will be off to a good start!
National Hes* Insurance
Instead of going after the doctors and healthcare for excessive fees you want to cancel business license to fund a scheme that enriches certain business. NHI did not put people in business it started in 2016 and if your employer gives you a pay slip but does not pay your health insurance that is fraud of the employer when you have private insurance it would be the same theft. That has nothing to do with NHI.
The problem here is that the system is funded by payroll deductions and that means only profitable employers and working people are paying into it, and thus the indigent and unemployed don’t contribute. Whatever your thoughts are on that issue, it means that there’s a limited source of funding. In the US we fund our federal system for healthcare for the indigent (Medicaid) by various methods, but it’s not solely our federal government, and our individual states raise revenues via income, sales, or property taxes.
It seems to me that as much I detest any new taxes, notable is that the BVI has no VAT, sales, income tax below $10K, or inheritance taxes. Property taxes are nominal after the ghastly 12% stamp tax is paid.
Does the Territory increase property taxes? Offshore incorporation taxes? Import duties? Stamp tax? Any increase will hurt the respective sectors, so consideration should be given to broadening the base by a 1% sales tax that would, by law, have to be dedicated to the healthcare system. Yes, it’s “regressive” but there are too many beneficiaries paying nothing.
Those are the two choices – either institute new taxes, or raise existing ones. The latter strikes me as untenable. As an aside, if auto and motorcycle accidents are a major source of claims, institute an annual fee for every license renewal and motor vehicle registration.
Govt dropped the ball by raising the bar too high from the start and the clinics and drs jumped on the bandwagon and blistered, bled and sweated us (and the scheme, of course).
In the BVI when prices go up they don’t come down. We the people suffering as a result.
Don’t even talk about getting the racehorse back in the stable after it done bolt and gone on the tracks.
The vehicles insurance companies should be paying medical costs , uninsured drivers/ riders should pick up their own bill at the hospital no exceptions .
You need people paying into the insurance for it to make sense. How does an insurance open first day and a person who is already insured gets insurance on an accident costing 250k. Sounds like a scam to me.
some became millionaires within a few years of the complacency and graft but God sees all.
And yet still, they refuse to cover certain procedures or conditions. But take our money EVERY SINGLE MONTH!
FIX IT! NOW!
This is BS that NHI is running at a deficit. NO WAY IN HELL. How is it Eureka and Bougainvillea raked in 5M in the first 6 momths of its inception. Soon after B&F expanded, the birth of Wellness Center, Apex etc. Every corner now is a clinic since NHI was implemented. NHI is a good idea, but it needs to be revisited to fund the hospital and all public clinics only. Anyone seeking private healthcare should pay out of pocket and if NHI covers it, NHI should only cover 10%. Currently NHI only benefits private healthcare, while the hospital is under staffed and runs at a loss.
…. AND LACK OF SCRUNTINY WITH PRIVATE HEALTH PROVIDERS RIPPING NHI APART MONETERILY.
LOT OF SQUARE PEGS IN ROUND HOLES – LOOK CLOSELY AND SCRUNTISE THINGS – CAN SAVE NHI MILLIONS ANNUALLY
I remeber well,,
Skeleton was the minister whom started it,, as usual he took advice from no one ,a whatever I say goes, actitud ,, its his way or not way,,
this does not require brain surgery is simple give the doctors a cap and is up to the people to choose who offers the best price in regards to the co pay difference. create a competition between the medical doctors and you create your cap and done. a bet every body run hospital .. get proper good doctors in the hospital and you will see. have students pay a yearly school insurance even if it $20.00 something..
After reading this article it only highlights that NHI was underfunded from jump street. The harsh reality is that government had no business in the insurance industry and is now crying about the sustainability of the program. If you go to Wikipedia it tells you that the bvi government decided to set up nhi because it was spending too much money $7million at the time to send persons overseas who did not have insurance nor the financial means to pay for necessary and sometimes life saving procedures abroad. I am sure that given what has transpired during the years since the existence of NHI they wish they were only spending that $7 million rather than the $40 million plus annually they are spending today. When the concept of nhi was first introduced to the public, to justify its need, they said that fewer than 30% of the population had insurance. This was largely incorrect as government had insurance with bupa and Atlantic southern, all the trust companies and most of the larger employers in the territory had their own insurance program. As a matter of fact I knew when Peter island was given coverage for all of their employees back in the day at a ridiculous rate of about $20 per month, a lot of persons who would not have been able to afford their own policy without this specific group rate would have to go without insurance.
The fact of the matter is that most employees in the bvi had insurance prior to the implementation of nhi and only about 30% of the population didn’t have insurance. Wouldn’t it have made more sense to focus on those that didn’t have insurance rather that to collect tax revenue based on pay scale for all employees. What nhi did is caused a lot of people who were paying one fee for insurance to have two insurance to provide the same coverage because nhi is primary insurance but cannot match the services offered by traditional health insurance. Primary means they have to pay out first before any other insurance you may have. Also because nhi is primary it will have to deal with a good chunk of the loses which is one of the reasons the program is failing.
Based on the way nhi was implemented it seems like the most likely winners of such a scheme which was purported to benefit policy holders was the service providers instead which today are building immaculate healthcare facilities. Nonetheless, one of the major problems I have with the system is that nhi is actually a tax as rates are based on your income rather than the service provided. Also the concept of nhi is misconstrued as it was supposed to be a program to help persons who could not afford traditional insurance. It was supposed to be cheap while at the same time allowing those with their own private insurance to continue to keep it and be excluded from NHI. Had they done this applying a 1% surcharge as tax to those with insurance to subsidize those who could not afford insurance might of been enough to make sure that everyone had adequate coverage and at a reasonable rate. Also the exorbitant charges by the service providers would not have happened had the focus been on providing coverage for those without insurance as usual and customary rates that you see in a health policy would continue to apply.
I would ask a few things
1) do you think the implementation was does no purpose to benefit the private providers or was it just oversight and a lack of input from different sector that would be impacted?
2) what would your suggestions be to course correct?
Based on what I have seen it looks like the intended purpose of nhi was for the government to become direct competitors to the private carriers but when they realize they couldn’t match the services they provide they asked them to provide supplemental insurance. This is rather disingenuous because you are cutting into my program as a private carrier yet at the same time you want me to pick up the pieces where you fall short in delivering services.
When NHI was being developed I wrote a paper explaining the consequences of setting up nhi in its current state. That paper also provided 3 ways nhi could have been established properly without the level of consequences it is facing. It is my understanding that that paper was never forwarded to the government and the government of the day was never in favor of its contents because the reason for nhi was to make doctors rich. There was also talk about the investment club being indirectly involved with nhi.
Concerning corrective measures I have had multiple meetings with Carvin Maloney, Natalio Wheatley, and the same Vincent Wheatley who have ran me around for years because they have no intention of fixing the problem. I tried to put a team of international experts together during Covid and when I spoke to Carvin Malone he asked me to send him a copy of the old paper I had on nhi back in 2017. Once in his hand he turned off his phone and the week after premier Andrew Fahie’s announced they had a new consultant to fix nhi. It is my understanding they were paid a lot of money. I believe a $1 million and a report was prepared and given to government but they never released the results of that report to the public.
To answer your question properly an audit of nhi has to be done. You have to identify a problem before you can fix it. There also needs to be collaboration with service provider, consumers and insurance companies providing health insurance with a view to coming up with alternative to what we have. Honestly there is not enough money in the system to make it viable. Nhi is trying to act as an insurance company but let me give you a simple scenario so you can understand what I am saying. How can a working population of under 20,000 people provide insurance coverage for under 40,000 people. Insurance is about the law of large numbers which means that you have to have a large number of people in the pool of resources in order for an insurance program of this nature to be viable. I don’t know what is going on directly in nhi but I think I know what to do. I even suggested to the government since 2018 to let me be an insurance consultant to review all insurance contracts entered into by the government for example the airport, the complex, bvi electricity or bvi port authority. As part of my mandate I can review nhi and would produce a report to tell them what needs to be done to help them fix the program. This proposal was rejected by all of those mentioned above. Government doesn’t care about the people.
It is clear to me that you have brought forward some bold and innovative ideas to address the sustainability of the National Health Insurance scheme — ideas that, if properly understood and implemented, could make a meaningful difference. But I must gently point out that your frustrations, seem to be overly concentrated on the current Minister, who has only held the portfolio for less than two years.
As someone who is clearly insightful and politically aware, you would know that the challenges go far deeper than any one individual. The structural constraints within which the BVIHSA operates have shaped both policy and execution across successive administrations. And yet, it seems those who have long held the reins of operational power — some for many years — have not been the focus of your scrutiny . Shifting entrenched systems is not easy — especially when there are powerful interests at stake, and when those who benefit most have access to the levers of finance, legal maneuvering, and influence over institutions that the average citizen does not. If you truly wish to see your vision come to life, you will need either a powerful ally who shares your resolve or a grassroots movement strong enough to carry it forward.But ALL must be held accountable directing it at 1 person has not proven to yeild result in the past nor will it in the future.
Are you sure you can read. I have not criticized anyone all I did was pointed out the facts. The facts are that government should not have tampered with the status quo. How can you go from $7 Million to $41 Million by creating nhi. I said it was designed for certain people to get rich. Did I say anything wrong by saying previous and current administration did not want to fix it. If they wanted to fix it you would have seen some movement. I am not auditioning for the job. When I had specific contact which could have help me crafted a solution the govt said they are not interested. Do you think I am losing sleep over their decision. Also in none of my the writings above have I brought out suggestions for fixing the problem so obviously you didn’t understand what I said. Please go back and read and what you don’t understand ask a question. Said an audit is necessary. You can’t fix a problem if you don’t know what the problem is.
You have an extremely short fuse and arrogant demeanor and cantt even take the slighest of constructive feedback . I would imagine that your actions are the same in person . Its no wonder that no of the previous or current ministers are willing to listen. Its not what yoyu say it how you say it. And in fact to write such a long comment you are obviously losing sleep over it. And by your response you appear to be partisan and un willing to hod those that are probably your friends accountable. You have no credibility.
I summarized everything but it’s obvious you cannot take the information provided for what it was. Obviously what I wrote in those two emails hurt you. I am not going to waste any more time on this subject. There is so much real information I could have shared on this topic but when we speak to people who are shallow minded we can’t change how they think. It’s sad that you could turn such a serious topic into a laughing stock because your only goal is to defend the minister in charge. I wish him and future ministers luck in fixing the problem. The funny thing is we don’t even know what the problem is or whether it can be fixed . All I did was provided context for you to see how we have talented BVIslanders here that we refuse to acknowledge that’s why only 29% of the work force are BVIslanders because of people like you. Good night I will not waste any more time with people like you.
Very good analysis. It was a political move to get votes for the NDP as I see it. But you are right, Government had no call to get into insurance business and when the experts were called in to do the study, it showed that one cancer case can wipe out the pool of funds! This is not a Pension scheme. Health insurance is very tricky.
THE PEOPLE INVOLVED IN BRINGING NHI TO THE PUBLIC IS THE REASON WE HAVE COI. CROOKED LINE YOUR POCKET 1ST THEN TO HELL WITH ANYTHING ELSE. THOSE PEOPLE WILL DIE MISERABLE DEATHS ENJOY YOUR FLESH NOW.