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NHI spends more than it earns

…will have to review services in order to stay afloat—Director
Director of the VI’s, Social Security Board (DSSB), Ms Antoinette Skelton. Photo: SSB
NHI in 2017 earned $79,882,819 but its total expenditure was $80,476,662. This represents a net loss (deficit) of $646,843 that year. Photo: SSB
NHI in 2017 earned $79,882,819 but its total expenditure was $80,476,662. This represents a net loss (deficit) of $646,843 that year. Photo: SSB
ROAD TOWN, Tortola, VI – The National Democratic Party (NDP) under Premier, Dr the Honourable D. Orlando Smith (AL), in January 2016, introduced a National Health Insurance (NHI) scheme, aimed in part, at providing increased and equitable access to medical services for those in the Territory, but its less than anticipated returns has now seen the government agency actively reconsidering paying for some of its services offered.

Director of the Virgin Islands' (VI), Social Security Board (DSSB), Ms Antoinette Skelton, gave the briefing recently, when she appeared before the House of Assembly’s, Standing Finance Committee, to examine the draft allocations for 2018, coming under the Ministry of Health and Social Development.

DEFICIT

NHI in 2017 earned $79,882,819 but its total expenditure was $80,476,662. This represents a net loss (deficit) of $646,843 that year. 

Mrs Skelton told Committee members that the situation is projected to get worse, as a result of the hurricanes that devastated the territory in 2017.

“She projected that in, 2018 they would see a bigger loss as a result of businesses being nonfunctional after the hurricanes,” the report said.

At present, NHI has paid out 138,000 claims totaling $41,147,839 had been paid to 23,819 members, and the unpaid claims totaled $3,720,718.

Further compounding the situation at NHI, Ms Skelton reported too that a significant number of employers in the Territory did not pay contributions for their employees, but the employees were benefitting from the system. 

The DSSB said too that another challenge that could negatively affect the scheme was the legislation that said that children and persons over 65 years of age were entitled to receive free medical attention.

 She advised that those persons were not contributing to the NHI system, but they opted to go to private facilities instead of the public health care centres.

AMEND LAWS  

According to Ms Skelton, NHI would, as a result, send forward a recommendation to the Minister to have that legislation amended, “because those persons were not contributing and NHI should not have to pay if they utilised the private facilities.”

Asked about the ‘Actuarial’ review that was conducted in 2017, “Mrs Skelton reported that NHI was at the time still awaiting the submission of the actuary report.”

That review looked at the financial sustainability of the system,” she said, and further reported that NHI’s Board, “had also made a decision that they would have a review of the benefit system.”

The Director said the agency has already been in contact with the Pan American Health Organisation (PAHO) to assist in, “conducting the review and if they could not undertake it, to make a recommendation for someone to look at the benefit package and the whole benefit side of the system.”

32 Responses to “NHI spends more than it earns ”

  • Senior65 (19/06/2018, 09:57) Like (17) Dislike (0) Reply
    For too long the SSB have been leading the "poor man" money to all and everybody without taking into consideration the possibility of what the Director is saying caused this deficit. It is the only "pension" many of us are looking forward to help in our old age.
  • cromwell (19/06/2018, 10:15) Like (15) Dislike (2) Reply
    When the NHI was introduced the government should also have nationalized healthcare and imported UK National Health Physicians and nurses, that way most procedures could have been provided on island with doctors employed at the hospital at a cost the government could control. It's not too late.
    • BVIslander (19/06/2018, 14:41) Like (7) Dislike (1) Reply
      @Cromwell: while your idea is noble, I can tell you that the UK has a shortage of doctors and is now trying to ease restrictions to allow doctors from outside of the UK to come in and fill the gap left by the current short fall. Matter of fact this is a good opportunity for young BVIslanders with medical degrees to move to the UK for two or three years to get some experience further afield...
  • 123 (19/06/2018, 10:36) Like (7) Dislike (1) Reply
    we knew it for years now
  • tretretrete (19/06/2018, 11:01) Like (29) Dislike (0) Reply
    no one said to impose that ---- on us!
  • tretretrete (19/06/2018, 11:03) Like (53) Dislike (1) Reply
    Some of these healthcare providers charge a hefty fee for just a simple consultation. Why not consider putting a price scheme in place for these healthcare providers. Just a suggestion
    • Heed (19/06/2018, 17:20) Like (6) Dislike (0) Reply
      This suggestion has been made a thousand times. Please stop wasting your time and energy. It will only tire you out.
    • THINK! (19/06/2018, 21:13) Like (1) Dislike (0) Reply
      That should have been job 1 at the beginning of the planning process. The whole country can not attend the hospital clinics and lab or receive filled prescriptions from the hospital. Was it not reported that 65 health care workerss left in 2017? The privte sector has a role to play with services and .specialist not available in the governments health system.
  • OF Course (19/06/2018, 11:24) Like (4) Dislike (0) Reply
    What were they expecting.......smh
  • It’s time (19/06/2018, 11:28) Like (30) Dislike (1) Reply
    How old is Antoinette?! Why is she still at the helm of Social Security? It’s past her time to step down man.
    • Good Point (19/06/2018, 17:42) Like (9) Dislike (1) Reply
      I wonder if those in power and position over 65 are also going to be limited to Peebles. Some persons have serious health issues such as cancer and have their health care since BUPA. Think of the many who made it to the morgue waiting on NHI approval. This is a population decrease plot from hell.
  • ------------------- (19/06/2018, 11:30) Like (15) Dislike (0) Reply
    so it will cash when the VIP gets in then they will blame um
  • work (19/06/2018, 11:31) Like (6) Dislike (0) Reply
    Seem to me some adjustments to their overheads may fix the problem under a normal business environment.
  • Political Observer (PO) (19/06/2018, 11:56) Like (8) Dislike (0) Reply
    Without government subsidy, is NHI dangling precariously off the survival cliff? May be. Any business, agency.......etc whose expenses consistently exceed revenues needs some serious structural adjustments to get it in the black. The NHI is relatively new and may be undergoing some growing pain. It needs a comprehensive evaluation for waste, duplication, fraud, proper management, effective oversight, effective stewardship, effective fiduciary responsibility, oppprtunity for structural adjustments.......etc.

    Moreover, children and persons over 65 should not automatically be relegated to just public care. What medical practioner (s) they see should be situational. By the way, chiren should be under parents/family plan. The NHI should have a network plan, ie, public facilities, private providers......etc. If a customer decides to go outside of network for non-emergency services, he/she should bore the out of network cost. Further, the NHI should contract with medical practioners for fix cost for services. If doctors decide to accept NHI, the cost for that is the price they should charge the NHI patient. Not averse to NHI patients having reasonable copays and coinsurance. Moreover, there must be a major focus on preventative care; this would improve health and lower cost over time.
    • Never wanted NHI (20/06/2018, 10:46) Like (2) Dislike (0) Reply
      Those suggestions are all good and well. However, the fact remains that we did not ask for this. My child had private insurance before this and I was ok paying that and taking my child wherever I saw fit before this NHI was forced down my throat. Not everyone is in a position to continue to pay for their insurance they previously had and still pay for NHI. Which might I add cost me more per paycheck only paying for myself than it use to cost me per month for both myself and my child.
  • onlooker (19/06/2018, 11:57) Like (6) Dislike (0) Reply
    they kill the goose that laid the golden egg
  • NHI contributor (19/06/2018, 13:36) Like (10) Dislike (0) Reply
    NHI needs to demand their monies from employers that are deducting it from employees and not paying it to NHI. But too much family and friends involve so they keeping quiet and suffering the small man. Employees cant get coverage because employers not making payments. THAT IS NOT FAIR. They not suppose to call the employees and tell them we cant pay you because your employer did not make your contributions, you should use the law and make them pay so employees can be covered. Keep covering up for your friends and family and it will get worse.
  • Obvious (19/06/2018, 13:51) Like (12) Dislike (1) Reply
    From day one it was obvious we do not have the population required to bring in large amounts of revenue from NHI. But no, as usual we must always do first and learn after. We were advised by several that it wouldn’t work for that reason. Who now will have to suffer? So many were forced to drop their personal health insurance because of NHI and we will now pay the price. As NHI sinks deeper into a hole, more and more services will be dropped leaving us with limited care. This is what happens when those in authority do not listen.
  • Past Stupidness ... (19/06/2018, 14:01) Like (7) Dislike (0) Reply
    Ms. Skelton: "Further compounding the situation at NHI, Ms Skelton reported too that a significant number of employers in the Territory did not pay contributions for their employees, but the employees were benefitting from the system."

    Reaaaaaaaaallllllllly??
  • Umm (19/06/2018, 14:31) Like (12) Dislike (0) Reply
    Ya’ll is the ones who force NHI on us now what to come talk shit!!!!! Ya’ll come tell me i have to pay full at any doctor visits!! Ya’ll full of it
  • wow (19/06/2018, 14:33) Like (9) Dislike (1) Reply
    Ms.Skelton your sickening me!!!! Honestly!!
  • Yep (19/06/2018, 14:41) Like (19) Dislike (0) Reply
    They really jacked up thier fees since NHI
  • smh (19/06/2018, 17:43) Like (7) Dislike (0) Reply
    “NHI in 2017 earned $79,882,819 but its total expenditure was $80,476,662. This represents a net loss (deficit) of $646,843 that year.”

    $600,000? I expected it to be much worse. Easy fix with a few adjustments.
  • Jessica Jones (19/06/2018, 19:23) Like (3) Dislike (0) Reply
    What? How did this happen? (In my sarcastc voice).
  • hah (19/06/2018, 19:58) Like (7) Dislike (1) Reply
    The irony is that NHI according to government was created because it was too big a burden to pay for the few uninsured people that had to be flown out each year at government's expense. We all know that it was a lie and NHI was created as an additional revenue bringer to offset the millions that was overspent on the hospital. Now we all know that NHI would not have worked based on our small population but a very desperate man does not think logically.
  • two cents (19/06/2018, 20:40) Like (7) Dislike (1) Reply
    One of the main flaws of NHI is that it was made mandatory that everyone use it as their primary health insurance even if they had private insurance. Another flaw was that private insurance companies where crippled into only being allowed to offer overseas supplementary health insurance. The cost of NHI deduction need to be lowered from being 7% split by employee and employer to about 4% and allow persons to have extra money to seek private insurance along with their NHI.
  • Like duhhhh (20/06/2018, 02:09) Like (13) Dislike (0) Reply
    It took these people so long before they could realise NHI would be a failure?? Incredible. I knew from the start. Seriously people if NHI deducted from ones salary is so high that they cannot afford private insurance, if everyone has no choice but to rely on NHI, what do you think would have ultimately happened smarties? Unbelievable! Reduce NHI contributions to the originally planned 2%, who want to use private insurance as well would be able to afford the coverage and I assure you that only the people who cannot afford private insurance would want to rely on the NHI coverage. Let me see how many years have to pass before they get it! An investigation should also be launched on those private medical facilities who charge exceedingly high fees since the onset of the NHI scheme. Stop blaming the people for everything.
  • Challenger (20/06/2018, 05:25) Like (5) Dislike (0) Reply
    its simple and ive said it for years......every year when a business goes to renew a trade license (which i think is required by law) they must present a letter of good standing from nhi and social security that the business is fully paid up or that year..
    if they dont have that...then they dont get a renewal trade license. start puting pressure on ALL businesses........not just foreign......to pay up. i hear of so many employees who have had deductions made but those deductions have not been paid over to nhi or ss. that is theft and is a criminal offence and employers who do this should have the police knocking on their door.
    • Agree (20/06/2018, 09:30) Like (2) Dislike (0) Reply
      Totally agree - all taxes, ss and nhi should be up to date to get your trade licence. I know of one that didn’t and hasn’t yet paid my contributions- despite taking them from my pay.
    • Yah! (20/06/2018, 11:05) Like (1) Dislike (0) Reply
      So that more businesses are forced to close and more people put out of work? Is that recovery? The whole thing needs to be reassessed and adjusted. It was built on a GDP that did not exist and was already DOA. Since the hurricanes there seems to have been no attempt to address the amount of contributors that are no longer there or the lost of business that those who are struggling to come back have to deal with because for some it is better to pretend that everything here is normal. Well the chickens have now come home to roost.
      • Challenger (20/06/2018, 23:22) Like (2) Dislike (0) Reply
        so "yah"......we must turn a blind eye to the theft of employees money just because it might make the thiefs business close ????
        where does it stop.....people should be alowed to not pay rent becUse it may over stretch the business cash flow. ?
        i understand where you are coming from...but if a business cant sustain its workforcw or is not intending to pay the ss or nhi then they shouldnt be deducting it in the first place.
        • Yah! (21/06/2018, 17:04) Like (0) Dislike (0) Reply
          Not paying was never mentioned or a consideration. That expense will never go away whether you close down or die. What I said was, if businesses are and have been struggling to pay for some time the system needs to be looked at, reassessed and adjusted. If not it affects the growth and expansion of businesses and contribute to employers paying off the books and under the table. Some small businesses, not all, are barely if at all bringing in the net payroll per week for a small staff but try to keep the staff employed praying and hoping that eventually things will get back to NORMAL. In some cases the money was never there to take out The fact is the BVI has lost a large number of contributors, this started before the hurricanes due to the closure of resorts and trust companies and this combined with the loss of population, revenue and the expense of rebuilding, if a rebuild is possible, is creating it's own perfect storm.


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