After several months of trying to shift responsibility for the budget-breaking National Health Insurance Plan (NHIP) onto the interim government, the Progressive National Party (PNP) has finally begun to admit that the plan masterminded by current party leader Dr Rufus Ewing, then health minister Lillian Boyce and then finance minister Floyd Hall has problems. This admission came from an interview with the TCI Weekly News.
Progressive National Party (PNP) leader and former director of medical services Dr Rufus Ewing
The issues come at Ewing from several sources. First is the cost of the two hospitals. Planned originally by the Peoples Democratic Movement (PDM) to not exceed $50 to $60 million, the two buildings are mortgaged to the tune of $235 million. Also, seemingly at the last minute, the planned 20-bed Grand Turk facility was reduced to 10 beds and the Provo hospital downgraded from 40 to 20 beds. The mortgage has an astonishingly high 12% high mortgage at a time when mortgage rates were less than half this rate. The mortgage, which runs for 24 years, will cost the taxpayers nearly $500 million or ten times more than the PDM budgeted cost.
There is a $125 million cancellation clause in the over 7,000-page contract. The USA’s new health care plan to cover 350 million people known as Obamacare is by comparison only 2,000 pages long.
Another factor is the monthly cost of the contractor, Interhealth Canada. Opting not to operate the hospitals and provide secondary health care as part of the medical services for the country’s 33,000 people, the PNP decided to hire Interhealth Canada, which only operates in one other country in the oil rich Middle East. Now, as numerous issues with the level and quality of health care mount, Ewing has had to admit that, if his party if elected to lead the government in early November, they will have to deal with these issues.
The cost of paying off the hospitals, meeting the cost of Interhealth Canada’s services and covering overseas referrals has been costing the government between $60 and $80 million per year. Of this amount less than one out of every five dollars being paid for health care is coming from the 6% tax being paid by those employed or on National Insurance (pension). The government must make up between $50 and $60 million dollars a year from its general revenue.
This cost has resulted in a very difficult situation, as funds for schools, teachers, scholarships, roads and other important infrastructure are being consumed by NHIP.
Also embarrassing to Ewing is the lack of foresight in covering the entire population. Those not working or laid off are expelled from the plan. TCI citizens never working under NIB are also not covered, while foreign workers are covered.
Ewing has admitted that, after two years of operation, the costs experienced will form the basis for the ongoing costs. He now is saying that he, if elected, will audit those costs. What he has failed to admit is the two year period elapsed this year in April, after the government has paid Interhealth Canada, the mortgage lender, overseas providers and foreign and domestic primary care workers approximately $170 million as of April 2012. Taxes have had to rise to cover these costs and a value added tax (VAT) is scheduled to take effect in April 2013, which will raise taxes further.
Ewing is saying he will handle the health care problem and reduce taxation as well. He does not say how this can be accomplished, except that he and PNP candidate Royal Robinson are claiming they will improve development, which under their previous administration had numerous failures.
Also barely addressed is the current standard of primary care, which before his recent resignation as director of medical services, was Ewing’s sole responsibility. Primary care is no longer providing medications and people receiving care in the family islands must order their medications from Provo. The interim government, which contracted to build an expanded health clinic at Middle Caicos for $80,000 less than the estimated cost, is experiencing continuing delays. This, Governor Ric Todd says, is being investigated.
Both Ewing and Robinson have acknowledged receiving honoraria of up to $20,000 each for their efforts in building the hospitals and creating the deals establishing the NHIP. Former health minister Karen Delancy, in a sworn statement leaked to the press, indicated Ewing was a central player in creating the plan as early as the first quarter of 2004. This has been confirmed by CEO Patrick Boyle