Health insurance

Aug 27, 2017 Features / Columnists, Peeping Tom

The announcement that Ministers of the government have health insurance plans has come as a shock. It is also being suggested that the government has paid some $38M in premiums, a claim which remains unverified, but which can very well be true.
It is not viable for the members of Cabinet to be insured. Insurance premiums are dependent on the risks involved. In the case of health insurance, the older you get, the higher the premiums are generally, because your risk of serious illness increases with age.
Let us face facts. There are at least nine Ministers of the government who are believed to be over sixty years of age. A few others are approaching that age. The majority of Guyana’s Ministers are not young. Some of them have existing health conditions. The premiums for any health insurance for the majority of the members of Cabinet are therefore likely to be high, and would call into question whether it is viable for the government to be taking out health insurance for its Ministers. Cost, regardless of whether the scheme is contributory or non- contributory, is the first consideration.
The first objection, therefore, would be costs. It would make better sense for the government to pay the health insurance bills rather than the insurance premiums.
Ministers should be entitled to health coverage. The issue is why private health insurance for persons who do not enjoy security of tenure and who are liable to be removed at the pleasure of the President or by a change in government.
It would be interesting to learn whether the insurance covers them after they would have demitted office – that is, whether this health insurance binds any future government.
The second objection to the health insurance for Ministers is that it covers private health care in a country which enjoys free public health care. The government likes to brag about the option of citizens having public health care.
This very argument was used during the debate on the extension of VAT to a number of services. It was even suggested that VAT may have been applied to medical services – something which did not happen or was rolled back – and one of the justifications, as revealed in the Hansard, is that those who cannot afford private health care can always go to the public hospitals.
A similar argument can be made about the Ministers. Why should they be enjoying medical insurance for private health care when there is free public health care?
The third criticism of the health insurance for Ministers is that it will most likely only provide limited benefits. If a person has more than one insurance policy in force, then for every claim, the benefits to be paid are divided up between the various insurance policies.
So what this means is that if you go to the doctor and the consultation fee is $3,000, no one company is going to pay the full amount. It will be apportioned across the various policies that you have in force.
The NIS covers, in general, around 80% of your medical bills. The NIS is compulsory for all workers. The Ministers of the government will therefore enjoy NIS coverage. This means that under the NIS, they would be entitled to an 80% refund of certain medical bills. The private insurance would therefore be liable, at the maximum, to pay 20% of all claims. Why therefore spend millions, and ask the Ministers to fork out millions out of their pockets, just for a 20% maximum coverage?
The fourth criticism is that all government services should be put up for tender. This is provided for in our procurement laws. There has been the charge that the government did not advertise for the provision of health insurance for its Ministers but may have engaged a regional company to provide the coverage.
How does the government know that it has obtained the best possible deal when it has not tendered for the provision of such services?
Ministers should be entitled to free health care. If the care is not available locally, it should be provided internationally. But would it not be cheaper, rather than taking out health insurance for Ministers (which would allow them the option of seeking treatment overseas for medical care which can be had locally and for free) for the government to simply pay for that treatment as the need arises?

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