by Larry Smith
Health Minister Dr Perry Gomez says the government has contracted Costa Rican-based consultants to help implement the national health plan which will be phased in sometime next year.
Gomez has put Bahamian healthcare spending today at almost 10 per cent of our $8 billion GDP. That represents some $800 million in total annual spending - including public and private as well as overseas health spending. The private sector accounts for about half of this money, experts say.
In 2004 Gomez chaired the commission which recommended that the Bahamas adopt a financing system called social health insurance, which pools payments from all residents to pay for universal healthcare. Individuals could still buy private insurance to cover areas ineligible for reimbursement by the public system.
This is the system operating in many countries around the world, including highly rated models like the French and Singaporean healthcare services. But the bottom line is this: Ideological arguments notwithstanding, experts say there is no single type of system "that performs systematically better in delivering cost-effective healthcare."
According to the 34-nation OECD, both market-based and command-and-control systems have their strengths and weaknesses. "It seems to be less the type of system that matters, but rather how it is managed."
And that is the key to the success of NHI in the Bahamas. Proper management is critical to the future health of our economy, as well as that of our citizens.
"the commission which recommended that the Bahamas adopt a financing system called social health insurance, which pools payments from all residents..."
And therein lies the problem with the 2015 proposal. A payroll tax is not paid by all residents, but merely by wage earners. Another move by the so-called Progressive Liberal Party to make our tax system even more unequal... After capping the tax on high end real estate transactions, after basically giving up on collecting real property tax, after VAT.
Posted by: Steve | February 25, 2015 at 07:49 AM
I hope you will remove this from your website after reading but that's up to you. I am a foreigner in your land and have no right to comment on the country's affairs.
As a followup to your article on stem cells in 2013, which I found illuminating, I think you might like to revisit the topic now that Okyanos is expanding it's therapies to such diseases as MS, Parkinson's and COPD, apparently using the stem cells derived from a patient's own adipose tissue.
The US MS website says "At present there are no approved stem cell therapies for MS." At the same time, the International Society for Stem Cell Research cautions the public to be wary of any clinic that offers some therapies that are now being offered by Okyanos.
I wonder whether the clinic has explicit approval from the expert oversight bodies charged with this responsibility in The Bahamas. Mr Gomez also had praise for an "unknown major philanthropist" who is offering to pay for the treatment of all Bahamian MS sufferers. I wonder who this might be.
As you may be aware, the former director of Okyanos has resigned and the clinic is now being administered by a financial backer of the operation.
Following are ICSSCR's specific warnings to the public
http://www.isscr.org/visitor-types/public/stem-cell-faq
"Be wary of clinics that offer treatments with stem cells that originate from a part of the body that is different from the part being treated.
"A major warning sign that a clinic may not be credible is when treatments are offered for a wide variety of conditions but rely on a single cell type.
"Be wary of clinics that measure or advertise their results primarily through patient testimonials.
"Be wary of claims that stem cells will somehow just know where to go and what to do to treat a specific condition.
"Beware of expensive treatments that have not passed successfully through clinical trials.
"The fact that a procedure is experimental does not automatically mean that it is part of a research study or clinical trial. A responsible clinical trial can be characterized by a number of key features. There is preclinical data supporting that the treatment being tested is likely to be safe and effective.
"Before starting, there is oversight by an independent group such as an Institutional Review Board or medical ethics committee that protect patients’ rights,…
the trial is assessed and approved by a national regulatory agency, such as the European Medicines Agency (EMA) or the U.S. Food and Drug Administration (FDA)."
My highlighting, incidentally.
Cheers
Ralph Deans
Posted by: tango | February 25, 2015 at 09:18 AM
Very interesting comment above. And scary to think things are NOT well regulated here anyway.
Larry, investigate further.
Posted by: Linda J Thomson | February 26, 2015 at 02:45 PM
The Bahamas does have robust regulations that license facilities for clinical use of stem cells and require all stem cell therapy approvals to be backed by substantial scientific evidence as to safety and efficacy. In comparison, Japan's stem cell legislation requires only safety – not efficacy – for cell therapy “biologics” to be approved. So the Bahamas is somewhat more rigorous.
The ISSCR is one of many patient advocacy groups. They are very focused on FDA approval. Other groups such as the International Stem Cell Society (STEMSO), the International Cell Medicine Society (ICMS), Pioneers for Stem Cells advocate “the right to try” and support technologies and biologics with international approvals such as those in use at Okyanos.
The cell processing technology in use at Okyanos is approved in Japan, Europe, Australia, Singapore, the Philippines, and New Zealand. In over 60 developed countries, in fact. The FDA tends to run approximately five years behind Europe in approving medical technology despite the fact that the safety record in the U.S. is no better than Europe.
An Okyanos spokesman responded to the management issue you raised: "Dr. Walpole was our Chief Medical Officer and unfortunately had a family conflict. Dr. Todd Malan is the Chief Cell Therapy Officer and he is supported by a world class team of doctors, nurses and advisors.
"Matt Feshbach is a co-founder and CEO of Okyanos and he leads the management team. He is not involved in medical practice or medical decisions of any kind. This has been consistent since day one and will remain so far into the future.
"There are many diverse perspectives on bringing stem cell therapy to patients. Okyanos chose the Bahamas as a desirable location for patients. With the adoption of legislation and regulations, and the due diligince done by the Bahamas National Stem Cell Ethics Committee, patients can be assured of the highest standard of safety and care in cell therapy."
Posted by: larry smith | February 26, 2015 at 03:50 PM