In the past two to three weeks the news has been rife with reports on the implementation of the NHI scheme for
St. Maarten. Though this is not new as the idea presented itself in the 2014 election without much information or sound reasoning. The minister of public health and labour Mr. Emil Lee said that haste is of essence and delaying the implementation might not be wise in his opinion. The minister said to have spoken to all stakeholders including the Netherlands, though SHTA and other organizations are not wholly on board, while the Netherlands being a stakeholder is not quite clear...
Then it hit me that the minister is himself interpreting advice from the CFT as coming from the Netherlands. But be that as it may here is why we need to slow down and put in place policies that would assure the local stakeholders that this scheme won’t result in unlimited taxation going forward.
We know today of the pressure exerted on our school system by an uncontrolled implementation of compulsory education. Of course as a society we were and still are convinced that every child should be guaranteed an education; we don’t understand why we should pay such for all who end up here. Because of open and uncontrolled immigration, people were literally able to walk from the airport and register their children in local schools. Persons applying for residence or work permits were allowed to lie on the forms and later inviting their families over, putting more pressure on an already heavily burdened system. Because of this free for all Schools, SMMC, public housing and many more institutions here suffer from lack of space, and payment which the tax payer ends up carrying the load for.
The minister also intimated that the civil servant and the labourer will all be the same in this new NHI, and since he claims the unions were part of the consulted stakeholders I wonder aloud if WICSU, ABVO and other organizations representing civil servants don’t see anything wrong with that picture. We have the (LAR) civil servants Regulation because we have recognized by law that the civil service should be different in their functioning and how they seek redress. Moreover, as has been the M.O. of past years when newly implemented systems or experiments don’t pan out to our expectations, the civil servants, because they are a captive work group in government, are the first to be forced to tighten their belts.
Furthermore, the civil service has always paid their contributions and the reason the system AZV/SZV is having problems is that government never turned in the withheld amounts, which now form part of our debt negotiations. So where are the guarantees or checks and balances; the same won’t be true in the future. It would also be interesting if we were told what would happen to private insurers when government by its very action becomes their primary competition. At this time I recall an adage that says, “The business of government is to stay out of government.”
How would it affect dependants oversees or illegals on the island. The minister himself has commented on the fact that too many permits are been extended to outsiders for jobs locals can fill, so maybe we can be told how this would be addressed and how this activity will impact the NHI. How is the abuse of the system, which today permits patients to be referred abroad for medical tests and not only emergency treatment? Can we not enforce a better way or make it possible for these tests to be done locally.
And of course, in the present system depending on your pay grade and your years of service and how much you contribute determines whether your internment is designated as 1st,2nd or 3rd class how would that be organized in our NHI.
We know certain things require speed but we would much more rather have sound and well thought out decisions than hasty kneejerk changes that aim solely to placate the CFT or the stakeholder the minister sees in the Dutch. So for the sake of a seven year old “country” still finding its feet with so much yet to be done let’s slow it down. In the trade-off between efficiency and time we would hope efficiency takes precedence. It would seem to be in our interest to slow it down.