BVI News

Think NHI is a burden? Try not having it — Skelton


The BVI’s National Health Insurance scheme has been widely criticised for its perceived failures ever since its inception nearly eight years ago, but Progressive Virgin Islands Movement (PVIM) leader, Ronnie Skelton, has argued that the system is essential for the territory.

Skelton, while appearing on the Umoja radio show this week, said he doesn’t know the exact problem with the scheme, but argued that he could guess what some of the issues were.

Under current NHI regulations, persons exempted from making NHI contributions include persons 65 years or older, indigent persons, dependent children, wards of the state, risk officers (such as police, Customs, Immigration, and firefighters) prisoners, and persons qualifying under the UK/BVI Reciprocal Health Agreement signed in 1989.

Skelton, who was the Health Minister in a previous government when NHI was introduced, argued that this is a cost that was taken into consideration when the programme began and he said the government had already understood this when it was first implemented. 

“The government had to take on that cost and they were doing it, they know they had to do it. Now, they have subsequent governments believe that NHI is a burden. If you think that’s a burden, try not having it,” Skelton said.

The PVIM leader suggested there has been a pattern with governments over the years, where systems are abused because governments have operated as if they are not required to pay for services it uses.

“I am not just talking about this government,” Skelton argued. “Governments believe that they burn electricity and electricity is free, that there’s no cost to it so they don’t pay the electricity department, they don’t pay the water department for the water they use. Systems cannot exist with that kind of thinking.”

According to Skelton, the NHI scheme was studied for more than five years before it was introduced and was implemented on a principle of solidarity.

Skelton further argued, that if private entities continue to carry up their rates beyond what the NHI system was designed to accommodate and provide coverage for, then that cost burden will be left on the patient. 

A broken system

Deputy Director of the NHI, Roy Barry, previously said the entity is mired in a state of financial distress, a theme that has been echoed by the current CEO of the BVI Health Services Authority (BVIHSA), Dr June Samuel. He also blamed private healthcare facilities for the high copayment fees seen by NHI users.

Appearing before the Standing Finance Committee (SFC) in late 2021, Barry said the distress is as a result of having to pay for government-funded individuals (persons whose medical insurance is funded by the government) when they access healthcare at private facilities even though the NHI is not receiving monies for their care.

Part of the challenge, he explained, was that the NHI does not have the authority to mandate where government-funded individuals seek medical care even as many access services from private facilities, whether locally or overseas, and NHI is responsible for paying for the services received. 

NHI currently receives an annual government subvention of $42 million which is transferred to BVIHSA with the intent to pay for services for government-funded individuals.



Copyright 2024 BVI News, Media Expressions Limited. All Rights Reserved. This material may not be published, broadcast, rewritten or distributed.


Disclaimer: BVI News and its affiliated companies are not responsible for the content of comments posted or for anything arising out of use of the comments below or other interaction among the users.

  1. What an idiot says:

    there was private health cover for all employed persons in the BVI. NHI is costing 80 MILLION a year and it directly benefits all local doctors who overcharge for every single visit and procedure..look at their offices all constructed out of cash since NHI started!

    Like 81
    Dislike 1
  2. Lodger says:

    What they didnt take into account was private medical facilities increasing their fees by 300% on the day NHI was introduced. I suppose that was nothing to do with 3 doctors being in the HOA?

    Like 60
    Dislike 1
  3. Perhaps says:

    Perhaps if certain local businesses actually paid over their NHI contributions that they’ve deducted from staff, rather than pocketing them, things would work a little better!

    Like 44
    Dislike 1
  4. Truth says:

    As I recall our HOA representatives attempted to secure a private health care plan for themselves over and above the Common man’s NHI .

    Like 39
  5. 1st district original says:

    I keep saying, get rid of the greedy bill and bring them to our level. What a set of pirates with degreeze!!

    Like 15
    Dislike 1
  6. Carrot Bay says:

    Stay the Fxxx out the confusion!!

  7. Helmetless says:

    Tell them scooter riders, no helmet, no coverage.

    Like 20
    Dislike 1
  8. Resident says:

    nhi is good but it’s execution was bad, why didn’t government pair it with legislation that prevented the health care providers from jacking up their prices, that is why nhi will fail

    Like 48
  9. Yeah, but says:

    Good idea indeed but woefully underfunded. Many BVI employers withhold the monies from employees but do not pay it in. Not a one of them has ever been held accountable yet they are witholding employees contribution (3.75% of wages) as well as their own (another 3.75%), and are causing cash flow management problems.

    There is also the issue of economy of scale that seems to have been overlooked in the initial set up. BVIs comprises of about 35,000 inhabitants. About 40% are either retired or not yet adults. That leaves about 21,000 potential contributors. Call it 20,000 to allow for about 3% unemployed, people in Ballo, indigent etc. Assume 20% are working on a cash basis. That leaves you with about 16,000 employees contributing. The 2022 budget for NHI was about $ 34 million, meaning an average contribution of about $ 2100 per person per year. Half of that is supposed to come from employers, the other half would be paid out of employees wages. The witholding rate is 3.75%. That would mean that average salaries in the BVIs, where $ 6/hr is still minimum wage, would be in the range of $ 28k per year.

    Like 10
  10. Facts says:

    NHI is a good scheme and it can work if they would regulate the fees charged by the private medical facilities. The system is being fleeced by overcharging. Fix the price gouging and the system works! It needs to remain with a few tweaks to the approved pricing by practitioners.

    Like 30
    Dislike 1
  11. What needs to happen..... says:

    I agree that managed correctly, the NHI scheme is of great benefit to the majority. However, since its inception, it has not been managed correctly. What needs to happen is: 1. There needs to be a review of the fees being charged to NHI by private practices. They are deliberately inflating prices and NHI is paying these ridiculous amounts – this should never have been allowed to happen. The majority of the money being paid into the NHI should be put towards our local clinics and the hospital. These should be state of the art and should provide people with all the care that they need. Private practices should be an option for those who choose to go elsewhere, not a necessity because the government facilities cannot provide proper care. Once the funds are directed correctly, the doctors and nurses in the hospital and government clinics can be paid properly – so any local doctors/nurses can be hired by the government if they so wish at a good pay rate. The fact that they all own their own private practices and use the NHI as their own personal cash cow is a disgrace. 2. The Medical Board needs to be reviewed. The purchase of lifesaving equipment for the hospital is being stopped AT THE TOP because a certain person/persons private practice would lose revenue – this has to STOP. Once again, a prime example of the government working for their own interests as opposed to the interests of the people of this territory.

    Like 26
  12. Outlaw says:

    The scheme is a good one for healthcare but it was rushed, it was not properly thought out and as a result it is being totally abused and just making certain people get richer. Since its implementation, the cost of healthcare climbed sky high, everyone knows that and can see the blatant abuse of the system.

    Like 17
    Dislike 1
  13. Islander says:

    No actually the geniuses set the rates that was their first mistake or intentional act of greed. It would work better if they allowed the market to dictate the rates and providers charge as they please then people will match their pockets to providers they find are reasonably priced. Image a test at hospital costs the same as private providers, hospital should have lower prices to encourage the use of public facilities that do not operate for profit but should be sustainable. The rate hike has made it difficult for people that don’t have NHI to get any reasonable medical care, even pregnant women are skipping doctors visits due to the cost, these people are beyond Crazy

  14. WAIT A MINUTE says:

    isn’t Hon Skelton the same Minister that pushed NHI on us?

    Like 16
  15. @waite a minute says:

    Only Hon. Skelton can answer that question as it was the one that was instrumental in implementing it despite the cries at the time from the people that he represented.

    If NHI was for persons who didn’t have insurance, we would not be in this position.

    Like 8
    Dislike 1
  16. Anonymous says:

    Medical services far less in St. Thomas.
    Pap smear is $20 at East End medical. Here it is $300.

  17. wow says:

    things vary hard oh yea he rich

  18. sturpss says:

    No lie I had better health coverage before NHI came out and was made mandatory. NHI is crap that’s why the same elected officials try to sort out some real insurance for themselves. NHI exists to get people who working to pay for the healthcare of people who dont work then you let the healthcare providers tripple the cost of everything they provide just because it have this infinite pool of money being collected for this purpose. So in a sense you successfully increase the cost of healthcare in the BVI and trying to sell it like something good was done… Thanks

    Like 13
    Dislike 1
  19. Correctamundo says:

    Yes, yes he is.

  20. EVILNESS & GREED says:

    Those employers who is not contributing their fair share to NHI are ALLOWED to continue their WONDERFUL ways people with EVIL MINDS , like the chicken hawk Vincent and his COACH and the rest PUPPETS ,who joined together to double tax those people who already
    paid their taxes, by using money gram as an EXCUSE , just like they using RACOSM & COLONIALISM as a DISTRACTION to hide their CLANDISTINE ACTIVITIES

  21. My goodness says:

    A sturpss. It pain my heart to see you write such a comment. NHI is crap. before NHI i was in the position to see many persons suffer because of lack of finance. the elderly had to come up with cash to pay for their glasses, dentures etc. I remembered in particular an elderly man who had his sister who needed and Echocardiogram and it pain my heart to see that elderly poor gentleman coming with that money to make sure his sister got the necessary procedure done. that was years ago. Recently i was
    listening to a politician from one of the Caribbean islands and he was talking about implementing a NHI scheme. I will suggest that you visit NHI office before you write such crap. I can truely say Thank God for NHI.

    Like 7
    Dislike 2
  22. Facts says:

    Prior to the implementation of the NHI system, our hospital and public health system racked up millions of dollars in unpaid bills both locally and overseas. These bills were created by the residents of this territory. The governement of the day recognised that this was not sustainable and decided to find a solution to the issue hence the NHI was conceptalized this was the right thing to do. However, the country needs to make the necessary adjustments to make the NHI sustainable and to ensure that the quality of healthcare is improved for all the citizens of the territory. Unless there are politicians with the courage to make the changes necessary, we will all continue to suffer. Ronnie I believe would make the necessary changes to fix the system. Check the records the last two ministers of health have done lots of talking but have done nothing of significance to help…

    Like 5
    Dislike 3
  23. Suzy says:

    You already lying to the people and the thing only just start. You know exactly what the problem is with NHI and how to fix it. We have Mafioso health care in the BVI, run by a set of lazy, thieving, greedy gangsters. From the day of inception the NHI benefits became chum in the water for these set of sharks who had their people well placed from start to finish inside. The people need to wake up and see that they are the ones paying and getting the barest minimum, in other words nothing. A fancy staff-less building with underused equipment is not health care.

  24. NHI Is a good scheme. says:

    NHI is a good initiative but was roll out recklessly and with ignorants. How can it be good when personal medical care cost increased. Doctors who were charging $80.00 a visit started charging $170.00 for the same visit and these are facts and inspite of all the outrage by the public nothing was done. I had Nagico before NHI and it was 100% better. This was created to make a certain Doctor/s millionaires, Good but rolled out recklessly. NDP and Ronnie are responsible.

  25. Maybe those of us says:

    Who had loved ones flown out to have emergency medical services overseas will speak out and say that the NHI is a game changer. Before the Government had to sign guarntees of sometimes over $300,000 to receiving hospitals before someone was loaded onto the sir ambulance. The resulting hospital cost from some of those were phenomenal. Many people died because they needed specialist care and could not afford it. Hospital emergency services was also utilised and some never paid a dime for services. The elderly as well would lay in their beds at home and suffer with high blood pressure, diabetes, tooth aches because they did not have health insurance. I don’t think about myself only when looking at situations like this because health insurance can never be a bad thing. Certin things can and hopefully will be done to structure the system which I believe is not strongly managed. A scheme such as this should have highly trained individuals onboard with experience in administering insurance benefits.

    And also please, remember that doctors and lawyers are the most expensive services available in the world. The local private hospitals are making lots of money because lots of us are sick. Even our neighbours in the U.S. Virgin Islands I am told outprices our local doctors. Prices can be capped yes, but all they are going to do is send you a bill after NHI pays and you will be responsible for that. At least now you pay a small fee and NHI covers the balance. Government should be billed for seniors, children, the indigent et cetera once their NHI cards are used and they should pay. That way we will be able to afford specialist care at our hospital and not have to visit private clinics.

  26. Fix it! says:

    Even a “good idea” with sloppy thoughtless execution is a bad idea. Fix it thas all.

  27. Licher and Sticher Good says:

    This statement sounds like a man with regret. He should just apologize and say what he learnt and would now do differently. You don’t double down when you in the red. This is ego messin with him

  28. Reality says:

    Ummmm… bills still racked what rock you live under?

  29. for love of country says:

    Changes can still be implemented on a legislative level but of course this would not be good for a re-election bid because we all know who runs the Government. The rich folks

  30. Well says:

    At least it isn’t white doctors charging black folks so much..that would be terrible building their empires of the backs of black ppl…no it’s ok if your the same colour..carry on hypocrites.just like them 5 police who murdered their own not long justice is a farce.dont talk about the police hit squads on’s all good?

  31. Ronnie please hush says:

    The NHI is a good program and I am for it so every citizen can access health care. Thr danger is, all of you sat and watch all the health care providers just rape the NHI system without mercy and said nothing and made no legislation to stop them. Everything politicians do is to make sure their families and cronies are wealthy in the end. You all allowed this and encouraged it. Now here you.

    I am not voting for you and nobody in NDP or VIP. In fact I don’t see nobody to vote for so all ayo continue to run the coubtry into hell

    Like 1
    Dislike 1
  32. Out dated costing says:

    It will never be sustainable for two reasons: population is too small for a sustainable pool and secondly, the costing used in the calculations were ten years outdated. If they had used up to date costings they would have seen it was not sustainable and the implement a 3% health tax to help fund the system and leave the workers with their private insurance. The private insurance who are now smiling would then be bearing the burden and not NHI.

  33. hmm says:

    NHI is very good but as soon as the local private clinics jacked up their prices government should have intervene. imagine you used to pay a few dollars to visit a doctor and now your copay is like the same amount and the private clinics are sending a huge bill NHI to get reimburse for that visit. When the government sees this they should have put a stop to it or improve the services at the government hospital.

  34. The only X he getting.... says:

    Is in front of the word politician, Ronnie Skelton the X-politician. I WILL have fun skipping OVER his name on the ballot. He need to go SIT DOWN in his own concrete!

    Things DONE HARD already and he only gonna make it worse! Go sit down…in ya own concrete!

  35. Curious George says:

    Mr.Skelton why don’t you give us your opinion on same sex marriage, You want to be our leader just give us a direct answer.

  36. Not Jacking Up says:

    The private intuitions can’t over charge as medical pay out uses ICD10 like the USA, what they can do is jack up the co-pay. If you think I am joking many ICD10 codes can be googled chooses a procedure look for the code and pay out. You might be shocked how much health care really cost.

Leave a Comment