National Health Insurance

1. National Health Insurance UNDERSTANDING THE NEED Presented by David Stan Phillip Coordinator National Health Insurance Project

2. National Health Insurance (NHI National Health Insurance (NHI) is a health financing system that is designed to pool funds to provide access to quality, affordable personal health services for all Grenadians based on their health needs, irrespective of their socioeconomic status. NHI is intended to ensure that the use of health services does not result in financial hardships for individuals and their families.

3. Why National Health Insurance Implementation of NHI is a reflection of the kind of society we wish to live in: one based on the values of justice, fairness and social solidarity. Implementation of NHI is consistent with the vision that health care should be seen as a social investment and not be subjected to market forces.

4. Basis of NHI NHI will ensure a more responsive and accountable health system that is likely to improve user satisfaction, lead to a better quality of life of the citizens and improved health outcomes across all socioeconomic groups. This will contribute towards improved human capital, labour productivity, economic growth, social stability and social cohesion.

5. Do we need NHI in Grenada? • Improving the health care system will lead to a heathier and more productive Grenada • We must improve access and affordability of quality health care for our people • Not being able to afford health care can result in illness and even death. • Severe illness can be prevented often with a simple visit to the doctor, health education, and preventive activities

6. What would be covered? • Primary health care visits · • Inpatient medical & surgical care • Specialists visits • Inpatient and outpatient mental health care • Home health care visits • Personal prevention services • Accident & emergency visits • Laboratory & diagnostic services • Outpatient care • Room and Board • Acute Phycological Care • Rehabilitation • Physiotherapy • Basic Dental services • Prescription drugs as per the approved national drug formulary

7. Benefits PackageProposed • Out Patient Services • In Patient services • Oral Health • Eye Care services • Maternity Care • Emergencies • Programs promoting healthy lifestyles

8. Do I have to pay to access health care? • All services outlined in the benefit’s package will be provided at zero cost at the time you access the services • Once the client is registered with NHI, no payment would have to be made at the time the service is being accessed. • If the client is not registered with NHI payment would have to be made at the time the service is being accessed.

9. Will NHI be Available to everyone? • Yes, NHI will be available to all Grenadians and legal residents. • Registration is necessary to access the care provided under NHI • There would be no barriers as it relates to age, sex, health condition, financial condition or geographic location

10. Under NHI, do I have to give up my private health insurance? • No, you do not have to give up your private insurance coverage if you do not want to. • Your private health insurance can be used to access health care services that are not included in the benefit package • Total premium EC$4,658,000 – Dec. 2015 • Total claims EC$3,968,375 – Dec. 2015 • 85% Loss Ratio

11. Who will be in charge of NHI? • A National Health Insurance Division is proposed within the National Insurance Board to oversee implementation of NHI for the Government. • The Ministry of Health will continue to provide stewardship for the health care system as a whole, and oversee the licensing of health care providers.

12. How will NHI be funded? • Funding will be from the Government’s consolidated fund financed by general revenues. • Funding would also come from contributions by members. • Grant funds and other funds from organizations and Governments who support the concept of universal health care

13. Will there be a tax for NHI? • No decision has been taken as to the form the contributions would take. • Some of the options available are contributions based on employees payroll or contributions through a health levy on goods and services among others • Another option is a payroll based tax • Tax on remittances • Utility based taxes • Sin taxes and sweet taxes

14. How will the system handle the increased demand for health service? • Upgraded infrastructure • Clients would have a choice of public or private health providers • A public/private partnership among health care providers is expected

15. Would NHI cover children, the elderly, people with disabilities and those with pre-existing health conditions? • All Grenadians and legal residents will be covered under NHI. • No one will be excluded because of a pre-existing health condition, age or income

16. Reasons for supporting NHI • Individuals and families are protected against the financial hardships that may result from health care expenses • It provides for minimum contributions that is affordable to cover medical care services to the insured and their families • Individual’s visit heath care facilities as early as possible before their condition worsens. • Individuals are protected against huge  financial indebtedness to friends, families, church etc,

17. Thank You • NHI – Providing Quality, Accessible, Affordable Health Care for All and not just for a privileged few • Questions & Suggestions