HEALTH Minister Dr Christopher Tufton says Government plans to formalise a system which would require private health insurance holders to utilise their coverage when they access the public health care system.

Tufton told Parliament last week that when user fees were abolished in 2008 the Government retained the requirement to collect private health insurance at facilities, but some hospitals discontinued doing so, which resulted in a greater loss of income.

However, he said that he has already signed the approval for the gazetting of revised fees to be collected from private insurers who interface with the public health system.

“We will be moving quickly to ensure that collection from health card holders is a norm, rather than an exception,” Tufton told reporters and editors at this week’s

Jamaica Observer Monday Exchange. “It happens now in an ad hoc way, but we’re going to standardise it across the board. Our position is if we treat with a patient that has private insurance and they do not contribute, not only is it adding to the strain of the system and costing the public system, in effect what we’re actually doing is subsidising the private insurance players and frankly speaking we don’t have the capacity to do that,” the health minister said.

Tufton added that insurers were not averse to formalising that structure; however, they would have to grant the Government access to their clients, which includes public sector workers.

“I have already met with and will continue the dialogue with the private personnel and general insurers, as well as the representatives of the Government personal health insurance scheme to ensure that this transition takes place smoothly and acts in the interests of the provision of better health care service.”

Tufton said, however, that these measures are a precursor to a more comprehensive reform and introduction of a National Health Insurance scheme to provide a more equitable and sustainable solution for financing the sector. He said this was a manifesto commitment of the Jamaica Labour Party, during its political campaign.

“… Even with our commitment to universal access, the budgetary allocation to health wouldn’t be sufficient to give people services that we all require, so the idea was to develop an insurance scheme that would see [persons making a] contribution…”

He noted that one of the major problems before the abolition of user fees was that people were required to pay up front when they visited the hospital, so people who couldn’t afford it didn’t bother to seek care.

“Frankly it was a little bit inhumane [with that] arrangement. So, the health insurance arrangement is a means of contributing to your health care without having suffered the frustration, indignity [and] inconvenience of paying at the window at the hospital when you’re in your most vulnerable state. This also almost signals that unless you can pay, you can’t access it and we are fundamentally opposed to that because it runs directly contrary to universal access, which is that whether you can afford or not you must have access,” Tufton said.

The health minister said the National Health Insurance scheme will not capture everybody because there are going to be people on the margins of society who are unemployed.

But, while those unemployed will not be required to pay, Tufton said they will have access, and those who are employed, whether self or otherwise, will be required to contribute.

“What it does is to give them an opportunity to enjoy a better quality of service based on that contribution. It’s going to take a little while, we’re going to start with the existing insured population. I suspect you will get a year or more for that team to work out the dynamics of that,” he said.

Meanwhile, the health minister announced that the National Health Fund (NHF) has approved a 100 per cent increase in the subsidy on pharmaceuticals covered under the NHF programme for beneficiaries between the ages 0 – 18 years. The proposed implementation date is September 1, 2016.

“The current subsidy rate is averaging 40 per cent and costs the NHF approximately $26 million annually. The move to an average subsidy of 80 per cent is projected to cost the NHF in the region of $70 million annually,” he said.

Tufton added: “We have done our assessment internally and figured that if you qualify under the programme and there is a need and that need translates to the needs that the parents have and it is difficult sometimes for the parents, so we thought it was worth it. Plus we did our stress test and accepted that the NHF funds could sustain it. The requirements, as we see, will move from $26 million a year to $70 million a year. It will affect almost 11,000 young people and if you add your parents and guardians it could affect anywhere between 20,000 and 30,000 Jamaicans, which is a fairly substantial benefit.”

Additionally, Tufton said the impact of this on NHF beneficiaries in this age group is significant, as it will reduce the out of pocket expenditure and assist in broadening of access to vital medicines.