Minister Lee considers consumer-contribution

March 9, 2017

GREAT BAY – Reform of the healthcare system in a way that makes it financially sustainable is still a work in progress, but financial supervisor Cft has in the meantime reported to the Kingdom Council of Ministers that St. Maarten has “substantially complied” with all conditions of the 2015 instruction.
Minister Emil Lee (Public Health) is working on legislation to put a national health insurance in place. One of the components of this measure – though nothing is set in stone at this moment – is a possible contribution by health care consumers to the costs of treatments and medication. Previous governments have mentioned a 10 percent contribution as an option. But for Minister Lee that is too simple. He wants to put a mechanism in place that kills two birds with one stone: proper access to healthcare and a brake on costs.
We thought about a deductible of for instance a thousand guilders,” the minister told this newspaper yesterday. “That would mean that consumers would have to pay the first thousand guilders and that afterwards the insurance would kick in with a contribution of, say, ten percent.”
But that approach has a disadvantage, the minister says. “People who do not have that kind money could then decide not to go to a doctor at all. That’s not the purpose of the system.”
To avoid such situations, Minister Lee is thinking about turning things around: “We could cover the first one thousand guilders completely and ask for a contribution from consumers who incur higher costs,” he says. “Knowing that they will have to contribute after they have used up those first one thousand guilders will make people think twice before they go to a doctor.”
Healthcare reform, but also pension reform will have to be regulated through legislation that the Parliament still has to approve.
Healthcare legislation to be finished this year
Minister Gibson said that the government has the time until the end of this year to finalize such legislation. In the meantime, the Cft is satisfied with the preparatory steps the government has already undertaken in these fields, he said.’
Minister Lee pointed out at yesterday’s Council of Ministers press briefing that reform of the healthcare system is a complicated process. “We have to work with all stakeholders and there are many moving pieces. Therefore, we need time for the consultative process and make sure that we get national health insurance correctly.”
The financial viability of such a system is key. “If the system is underfunded it will result in a lack of proper health care,” the minister said. “But if it is overfunded, if it is generating too much money, that money is removed from the economy and that is destructive too. We are looking, as I have said before, for a Goldilocks solution that is not too expensive and not too cheap but just right.”