In some countries, wherever a patient’s coverage runs out that where their medical treatment runs out, but in the Turks and Caicos Islands the same is not true, according to Minister of Health Hon. Jamell Robinson during his Access to Healthcare News Conference on June 28.
The minister’s declaration was in response to some members of the public questioning what quality of benefits to derive from paying in the National Health Insurance Plan (NHIP). He stated that some persons paying into the scheme would take up to 20 years to repay just for Treatment Abroad medical evacuation (medivac) alone, without considering the cost of medical care at those overseas facilities.
“In terms of the Treatment Abroad Programme, I want to add some perspectives for some persons, because we have a lot of people who pay into the scheme, and they want to know what they are getting,” the minister said. “So, generally speaking, a medivac to the Cayman Islands is over $24,000.”
“If you are a person contributing about $100 a month, which is higher than the lowest rung, by the way, you would take 20 years to payoff that $24,000 medivac…and we are not talking about the (medical) services while you are in Cayman. So, (you pay) $100 a month, (which amounts to) $1,200 a year…$24,000 over 20 years to pay that off. That’s what you get. Now, that’s the lower end,” he said further.
As regards to the higher end of the payment scheme, the Minister noted: “In real figures it means that you pay $468 a month for persons paying on the highest end, assuming that such person is self-employed. Other than that, you have half of that…your employee pays half of that. So, that’s $5,616 for the year that you contribute into the scheme. So, it would take you four years and three months to pay for a medivac to Cayman if you have to pay by yourself.”
He added: “So, you ask, what do you get? You get the highest insurance policy in the world. Because, if you have a private insurance, they always do a deductible. So, you would have to pay a portion of that $24,000 because no insurance company gives you 100 percent coverage on any procedure.
“So, again, what do you get? You get 100 insurance policy, and we didn’t even get to the actual cost of the procedures while in the Cayman Islands or for any of our network facilities. So, we should be appreciative of what we have. This is the nuts and bolts, dollars and cents of why it is important for us to be appreciative of what we have, because it is almost not like that in any place.
“In many places, unfortunately, if you can’t personally afford it, then whenever your money runs out, that’s where your healthcare runs out. It is a reality here that we are very blessed, and trying to do what we do, and always want to do it better for the people of this country.”
NHIP TRIBUNAL FINALLY ESTABLISHED
In the meantime, Minister Robinson announced that the NHIP Tribunal is finally up and running.
Explaining how a matter reaches the tribunal, Minister Robinson stated that it begins with the hospitals who recommend external treatment. That referral would then go to the once-a-week convened Joint Referral Committee, which makes the recommendation to the NHIP director and the team, which scout the appropriate overseas locations within the network.
If the patient or the individual who has decision rights on behalf of that patient agrees, then the patient is either medivac or fly commercially to the agreed location. However, if the patient or the decisions rights individual is not pleased with the recommended facility, then they have the right to appeal to the board, addressing the letter to the chairman, which later deliberates as to whether or not the recommended option was suitable. In the event the board upholds the decision of the NHIP, the next point of appeal is the tribunal.
Minister Robinson hastened to point out that NHIP offers great flexibility within its external healthcare primary network.
“So, if they (NHIP) select the Dominican Republic, but you prefer to go to Jamaica, no big deal, they would send you to Jamaica. If you prefer the Cayman Islands over Jamaica, they would work with you,” he said.