Waiver system to decide who pays for health care

— Says Dr Ferguson

Alicia Dunkley

Thursday, February 16, 2012

HEALTH Minister Dr Fenton Ferguson says that his administration will retain the no-user-fee policy only at health centres across the island, while removing the facility from hospitals, replacing it with a waiver system monitored by a new Government of Jamaica (GOJ) health card.

"There are no mixed messages from the Government in respect of the reintroduction of user fees for services in hospital. The Government's stated policy on user fees is for the introduction of universal free primary care," Dr Ferguson told Parliament on Tuesday in response to questions raised by the Opposition Jamaica Labour Party's Dr Kenneth Baugh.

According to Ferguson, insurance companies are receiving a windfall of approximately $1.5 billion annually because some individuals opt to access health care under the government's no user fee policy instead of using their insurance policies.

The health minister said that as a result, the waiver system will be introduced at the secondary/tertiary care level (hospitals) to allow facilities for patients who have the ability to pay to be billed and charged.

Noting that a waiver system had existed prior to the 2008 abolition of user fees, Dr Ferguson said there were weaknesses with that system, including the less than satisfactory relationship that existed between staff and patients in some instances.

"The Ministry will seek to improve on that system starting with the introduction of the Government of Jamaica health card which will provide a mechanism for the pre-assessment of patients. The GOJ Card will allow the health service to generate income from private health insurance companies and to improve the monitoring of the use of resources to prevent abuse," the health minister told parliamentarians.

"We will not touch this policy until the review is done and the Government of Jamaica card is in place, no one will be turned away," he said.

The JLP when it formed the Government in 2007, removed user fees from all hospitals with the exception of the University Hospital of the West Indies and health centres in 2008, in fulfillment of one of its campaign promises. That arrangement, however, caused the policy to be heavily

criticised due to concerns that the health sector was under-resourced prior to the change and had come under heavier strain with the inception.

On Tuesday, Dr Ferguson said his administration had "weighed the odds" and come up with a reasonable solution.

He said it was his opinion that the introduction of an effective waiver system would significantly reduce the possibility of user fees creating a financial barrier to the access of hospital care, remove the possibility of the poor incurring debt to hospitals as well as the postponement of medical treatment as a result of lack of ability to pay.

"The waiver system is intended to ensure that no one will be refused care because of an inability to pay, as we cannot afford to undermine the fundamental principle of universal access to health care. Those who can pay should be required to pay. Those who cannot afford to pay; the State has an inescapable obligation to cover the cost associated with the care," Dr Ferguson insisted.

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Waiver system to decide who pays for health care