The minister of health and wellness is forging ahead with legislation for a National Health Insurance Plan (NHIP). The Caribbean Policy Research Institute (CAPRI) recently hosted a public forum to engage citizens on the matter.
The event highlighted some important considerations that are needed to flesh out this vision, including citizen partnership and acceptance, private sector buy-in and partnership, and a requirement for the involvement of technology at all levels of the system.
I am fully onboard with the development of the NHIP. It is needed and Jamaica is ready. It could lead to the desired universal health coverage, which will seek to equalise the population in terms of achieving an acceptable quality of life, healthcare and productivity. If we can achieve excellent health coverage, we can also achieve a more socially, economically and educationally wealthy population, which augurs well for the country’s development.
The Green Paper on NHIP gives a good overview of its intent. While I know it was not meant to provide any detail on the administration of the programme or all the technical moving parts required, I hope consideration has been given to the critical role of technology to its success.
PAHO states that “health technologies are essential for a functioning health system and medical devices … are crucial in the prevention, diagnosis and treatment of illness and disease as well as inpatient rehabilitation. An effective National Health Plan includes one (or more) sections on health technology with Government units enacting health technology policies”.
The basic benefits package outlined in the Green Paper include health promotion, diagnostics, immunisation, non-communicable disease (NCD) treatment and care, pharmaceutical services, primary healthcare, and laboratory and imaging services. All of these areas would be easier administered and have added value if technology formed the core of the system.
The NHIP comes at a time when Jamaica, like the rest of world, is faced with an ageing population and a continuous increase in the prevalence of NCDs. This means that advanced technologies such as telemedicine, e-health and remote care devices with interoperability support can play a critical role in healthcare delivery, especially where there is a need to broaden access. In our case, there are several underserved communities that can benefit from the use of technology in the public health system.
The no-user-fee policy has shown us that health-seeking behaviour is not necessarily improved simply by the removal of fees for services. Similarly, the NHIP, on its own, will not achieve the level of access to health that we need to make any significant difference.
Access is much broader than that. Access also includes whether persons have the capacity to achieve contact with where they are required to go to get assistance, as well as the knowledge that they can easily find what is required for them to stick to a wellness, as opposed to a reactive care, regime. Technology can, in no small measure, facilitate this contact, including through virtual means.
The health and wellness minister did indeed mention that the ministry is considering technology as part of the overall improvement of the public health sector, but by no means is this initiative anywhere near where it needs to be for us to properly implement an NHIP in the very near future.
While we give consideration to, and facilitate, discussion on the Green Paper, it behoves us to simultaneously begin to put in place systems towards a technological overhaul of the public health sector. I know there have been attempts in the past decade, but the UHWI seems to be getting it right and should be used to guide the direction of the other health facilities.
On more than one occasion, I’ve been surprised by relatives living abroad who mention access to healthcare, more so than crime, as their main consideration for not retiring here. This minister seems to be focusing his boundless energies on addressing this. Maybe he should also be sharing his good news with our diaspora.
Every citizen should take keen interest in this development. Read the Green Paper, which can be found on the ministry’s website, and comment by simply contacting the MOHW via email at JNHIPGreenPaper@moh.gov.jm, or snail mail at 10-16 Grenada Way, Kingston 5.
Published:Sunday | May 19, 2019 | 12:22 AM Doug Halsall