 Hello and welcome to HealthFocus, a production of the Ministry of Health and Wellness. I am Fenel Neptune. Today we have with us the Health Planner in the Ministry of Health and Wellness, Lauren James, who will provide us with some information on the National Health Insurance. Welcome to the program. Thank you Fenel. Great. Can you tell us what is the National Health Insurance? Okay before I could go into what is the National Health Insurance, I think it's pretend that we give persons a background with respect to where we're coming from with this. I recall back in 97 when the health sector reform was commissioned, that was checked by Dr Stephen King. They were looking at gaps in our health system and how ways of remedy in it. What they looked at was one of the gaps identified was that persons who needed care, they were not able to access care as needed because of financial constraints. So this is where our national health insurance is coming from. We're looking at giving persons access to health care without them having to pay out of pocket by preparing for health. Okay and what is the benefit of the National Health Insurance to the population in this first phase? Okay let me just say I'm sure persons could identify with other persons who have had health crisis, for example cancer. We are seeing persons going around with raffle sheets doing barbecue because they do not have the money to pay for treatment. What this will attempt to do is have persons be able to access health care when they need it, need it without thinking about hey do I have money to pay for this? Do I have money to pay for that? So in that way persons can be more proactive about their health by seeking care when they need it. In the first phase we are looking at a package of services where we are targeting more or less chronic diseases which have been affecting the the country at large. For example diabetes, hypertension, we have the screening for cancer and other care areas. Okay so you're saying that in the first phase of this program it will cater more to persons with what we say N-Series which is the non-comicable diseases? Yes for now but I should say that was the initial thinking but you can well appreciate that this is a process and that we have been in conversation with health insurance and what they are looking at is looking at more of a holistic manner where persons we do not want to confine it per se to chronic diseases but more or less on a general level where persons with different health conditions can access care. So we looked at a more general way. The initial thinking was a set of package but now given the conversations we have had with health insurance we are looking more of a general outlook where persons where everybody can see something in there for them. So for example if I don't suffer from diabetes, hypertension, any of those things and I have something like something let's say I get breast cancer, I need radiation therapy or whatever so that I can access my health insurance to provide care for me in that area. Okay and you mentioned of course we in the first phase of this national health insurance how soon do you think that the government will be able to actually roll out this first phase? We are looking for the end of the year right now we have been working assiduously in a ministry towards achieving that. We've had discussion with the private health insurance providers, we've had a stakeholder consultation, we've met with our stakeholders in terms of doctors and nurses to determine the package. We are looking at the different structures which are needed to implement national health insurance so we are looking by the end of the year to implement this. Okay so for now it doesn't just the first phase you said it caters to persons but later on I'm guessing that's where it would be moving to the second phase right? Right now as you know well you will kind of appreciate that the fiscal space of the government is very limited so while the package may not be that wide going forward into the future when we see a second phase it will be more online conversing probably including more services that's what that's what we speak when we talk about a first and a second phase. Okay and what are some of the social issues you would think that a factor person getting proper health services in St. Lucia? We have persons being poor, we have persons who do not have money to travel to a health centre to access the care, we have persons although they access their health care they do not have the money to do the lab works the diagnostic to buy the pharmaceuticals, we have persons who have to make sacrifices in terms of family do they access health care or do they pay for health care and they are and even the situation which people live in the environment affects their health so all of those factors impact their ability to access health care. Okay well we are due for a break so we will definitely continue this question after the break we'll be back in a moment. Do you know we can limit the spread of the COVID-19 virus? The Ministry of Health is your partner in achieving this solution introducing the Amber wristwatch. The amber wristwatch is designed for monitoring daily movements while in quarantine it provides an accurate location and a precise heart rate. The device is also waterproof and can be worn during all daily functions like washing the dishes or taking a shower. It's worn like a typical timepiece. The Ministry of Health can now better monitor people in home quarantine and receive alerts of those who do not stay in the confines of their home. A 14-day rental of the amber wristwatch is just 75 US dollars. Let us stop the breaches of home quarantine. Welcome back we will continue our discussion with Lauren Jeans on the National Health Insurance. Okay so a lot of solutions and all the people have been hearing of the tomb universal health care which means that okay I'm health care for all but can you tell us is it any different from the national health insurance? Okay universal health care is a tomb that has been used worldwide by World Health Organization. It really speaks to health care for persons, health care for everyone where they don't have to pay out of pockets but they could access it without suffering financial hardship. I must say every country has a different method for implementing UHC and national health insurance is basically just a vehicle for implementing UHC. For example the BVI they've had they've implemented UHC and they've done it through their social security board social health insurance. Some countries have a mix of both private health insurance and social health so NHI is really the vehicle for achieving universal health coverage for the country. Okay and that is done through the national health insurance but we know that work has been done as it relates to the implementation of the national health insurance where we're in the first phase. Can you tell us what work has been done right now with that in terms of do you all meet with insurance companies what exactly is happening? So what we've done we've identified a package of care and we've sent our proposals to private health insurance companies to for proposals. We've had to sit with them to provide clarity on our package and we are now in the process of refining our package to send back to them and then we are expecting a proposal from those insurance companies identifying what would be the premium what would be the coverage and how they would in terms of how they would go about because there are certain requests that we made in there in terms of persons not paying co-payments or persons not paying out of pocket and getting reimbursed by the company so they will come back to us with a proposal indicating all the areas that we've identified. Okay and who does NHI cater to? NHI caters to everyone. It does not discriminate against sex, male or female, rich or poor, healthy or sick. It caters to everyone. This is the right of everyone to receive health care and it caters to everyone. Okay but how exactly will NHI what is it that how is it expected to work? Okay what we envision is where persons would pay a premium every month or whether it be every year every month and they would access health care and they would not have to pay out of pocket. Normally right now as it stands for example I have an insurance insurance package and I would have to pay for the service out of pocket and then claim from my insurance company what we are looking for is to move away from that and to have the insurance companies reimburse the providers. So that is the method in which you pay your premium and then whenever you need the care you just access and don't pay. Okay but you say that persons would have to pay but there are some persons who or there are people who are unable to afford health insurance. What is in place for those persons? I'm happy you asked that question because we do recognize that there are persons who are poor, vulnerable. Government is committed to providing health care and providing packages to those persons and we are doing you may wonder how we are going to do that because I could be working at Ministry of Health and I tell the government I'm not working and I cannot afford but we are doing it from Minsteads where we identify based on your situation whether you can afford or cannot afford and then we will provide coverage for those persons. Okay so you would be working with other ministries or other organizations? Yes right now we are piggybacking on what the Ministry of Equity has been doing because they do have some minstesting for the vulnerable people that they provide support to so we will be piggybacking on that and we will be looking at their method and actually right now we are looking at the recruitment of someone to assist in that regard someone who has been working with Ministry of Equity on this so we are looking at that right now to recruit this person in the next few weeks. Okay so I'm guessing you would also be getting information from Ministry of Equity on persons who are actually probably on public assistance or something of that sort. We are looking we are working with them and then we will be using their information as well as well as going on a drive to identify more persons who may be vulnerable or poor. Also what we have to recognize through is that we also have what we call the working poor where probably I am working at Ministry of Health but because of my commitments I won't be able to afford health insurance it will just impoverish me more so we are also looking at those persons who are what we call the working poor where we provide coverage for those persons who may not be able to afford coverage. Wonderful and one of the things you mentioned you said the implementation you're trying to hire somebody in that area I'm guessing that government doesn't have the funds available for actually providing that service yet but I'm guessing funds are being provided from the World Bank for to help with the implementation can you speak on that? Yeah I know a lot of people might be saying we've been hearing of this national health insurance for since Jesus was a baby but what makes it different now is that we have dedicated funding for implementation I in a previous show we may have reported on the World Bank project where we looked at where we have funding of 25 million we have approximately 5.5 million US dollars dedicated to implementation of health insurance so that's what makes it different we actually have the funding now to coordinate all the activities to implement health insurance. Okay so right now it's focused more on the implementation so the funds are right now? I know people may be wondering what is the cost what is the cost because we have had consultation with stakeholders and they say we're not interested in that we more or less want to know what the cost is but that is a process we are now working with the insurance companies to determine what it will cost to cover one person or a person on one or person in their family so that is in progress and we should be getting that information sometime in the next few months. Okay so I'm guessing as time goes by and the program gets as the implementation goes that more information will be provided for the problem? Yes and that is why we've been having a stakeholder consultation with the different people the unions the SLMDA because we we'd not want to come where we just throw everything one time on everybody we want persons to be involved in the process what we are doing what is the model that we are looking at and that way when we come the final product person would have been consulted and they would have known what we're doing all along so in the next few months we will get the information on the financing in terms of what we are going to be. Wonderful well we have come to the end of our program for today I want to thank you so much for being part of this program and providing us with information on the national health insurance. Thank you for that. Thank you well that's how we come to the end of health focus on behalf of the entire production team I am Fernelle Neptune thanks for watching until next time