The St. Maarten Hospitality and Trade Association (SHTA) again expressed serious concerns over the National Health Insurance (NHI) in Friday’s paper. Minister of Public Health, Social Development and Labour Emil Lee had said earlier that he hopes to table the draft legislation for such in Parliament by the end of this year.

One of the main complaints brought forward is that Social and Health Insurances SZV would be the sole provider, driving private insurers out of the market and creating a Government-owned monopoly. SHTA says that without proper representation on the Supervisory Board, employers have insufficient influence on the direction of the organisation and management of the funds they mostly generate along with their workers.

The association is worried about the lack of reliable population statistics that vary from 40,000 to 60,000 and the 50,000 number used in the NHI calculations. They also fear the estimated annual cost per person of NAf. 3,600 is too low compared to more than NAf. 4,400 in both Aruba and Curaçao.

While businesses and their personnel currently pay a joint 12.5 per cent ZV/OV premium, government does not contribute to the funds as an employer due to civil servants falling under a different OZR system whereby only the actual cost of medical care is covered. Government’s payment history does not exactly inspire confidence regarding future premiums for its employees either.

In addition, too much is left to be arranged further by National Decrees needing no prior legislative approval.

SHTA says it believes some concessions were made verbally based on prior comments and there had been a shift on a few important points, but its position is still not adequately reflected in the law proposal.

The overriding issue is that an NHI must be sustainable so that it’s not burdened by deficits running into the millions like with Aruba’s AZV that had to be covered from the national budget. This could in turn lead to an undesirable scenario of higher taxes in already difficult economic circumstances.

Of course, there is really no arguing against the idea that everyone ought to have access to affordable basic health care in a civilised society. However, considering the NHI’s widespread nature and possible impact, handling this matter with the necessary prudence certainly seems called for.

Haste makes waste.

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