February 6, 2010
By all accounts, Dr. Duane Sands is a brilliant and highly trained surgeon. Many wonder why he has chosen to enter the rough and tumble world of politics or why his party leader would even cajole him to do so, leaving a void in the local health community that begs for greater specialization and skills. But Dr. Sands has made his determination for a career in politics and as a result, he must subject himself to public scrutiny on his ideas, beliefs and philosophy and their impact on the public good.
In listening to him being questioned by Algernon Allen on issues of the Day, Love 97, Feb. 2, his responses on the implementation of National Health Insurance were vague, evasive and disingenuous at best. His political advisors obviously told him to say you support NHI (as the politically expedient answer). But Dr. Sand’s history as a medical practitioner and his real views on NHI, very closely parallel the objections and approach of American medical doctors on the implementation of a universal health plan (coverage for all) as defined in a NY Times article “Follow the money in the Health care debate”.
In the US, doctors, insurance and drug companies all fear that their revenues would drop significantly with the introduction of National Health Insurance. They therefore commit substantial resources to block its implementation. Since its creation in 1965, Medicare has evolved into the bedrock of health insurance for America’s elderly population. Anyone over 65 qualifies for coverage regardless of income or health status. What concerns doctors most about NHI is that like Medicare they will have to take a pay cut as Medicare pays doctors 80% of what an insurance company pays. Dr. Sand’s recent financial disclosure shows that the business of medicine has been good to him so he has a “lot of skin in the game”. There should be no wonder then that he fought so hard against the introduction of NHI, introduced by the PLP Government 2002-2007.
In the health care debate in the US and Bahamas, there has been a lot of double speak, or as Bahamians say “talking outa both sides of ya mouth”. In the US, the nation’s doctors say they wholeheartedly support health care reform, but the American Medical Association (AMA) has a long history of being opposed to legislation that threatens the status quo. The AMA opposed the creation of Medicare more than 30 years ago. Dr. Sands in his eloquent and forceful fight against NHI in Bahamas was the chief at double speak. In a March 17/06 address to the Rotary Club of East Nassau, Dr. Sands said that “the doctors (Medical Assoc. Bahamas) are not opposed to NHI, but we made it clear that we do not support the plan as currently presented”. What does that mean in real terms? Does anybody know?
Dr. Sands in his Rotary presentation also raised the question “Is health care a right or a privilege and how far should we go to guarantee this (healthcare)? In his presentation he openly questioned the cost/value of NHI. Since Dr. Sands wants to affect public policy via a switch in careers, I believe the good people of the Elizabeth constituency will answer his question on healthcare above as President Lyndon B. Johnson did in a phone conversation with his Vice President, Hubert Humphrey: “Don’t ever argue with me about healthcare. I’ll go a hundred million or a billion on health. I don’t argue about that anymore than I argue about Lady Bird (wife) buying flour. You got to have flour and sugar in your house. Healthcare, I’ll spend the goddamn money. I may cut back some tanks, but not on health”.
Dr. Sands has to be constantly reminded of his obstructionist stance on National Health Insurance for all Bahamians. His philosophy has hurt Bahamians and certainly the less fortunate who lack private insurance, in the Elizabeth constituency that he so badly wants to represent. When conservative American pundits were tearing down Britain’s National Health Service to discredit the Obama plan, Prime Minister Gordon Brown felt moved to state publically for the world to hear, that the NHS, “often makes the difference between pain and comfort, despair and hope, life and death.” Dr. Duane Sands told his Rotary audience that the debate on NHI is emotional and “requires a thorough evaluation of the core values of basic Bahamian humanity”. Yet when he had the opportunity to positively impact the implementation of NHI to achieve for the Bahamian people the noble values in an NHI plan similar to one espoused by PM Gordon Brown, Dr. Sands chose not to listen or even care. Like his medical counterparts in the United States, who characteristically block a universal health coverage plan, Dr. Sands in his objections to NHI, chose to “follow the money”. For that alone, Elizabeth must reject him on February 16, 2010.
Mr. Sands will not debate cause he scared he may be asked questions about court cases.Careful, malpractice Sands ….Ha !!!
“This is not a tax!” the words of Prime Minister Perry Christie as he attempts to put the Bahamian public mind at ease concerning the proposed Nation Health Insurance plan – but is this really not a tax?
The word tax would tend suggest that payment into this plan is mandatory so if it in not a tax then payment into it is not.
First looking at the word tax; this would be a sum of money levied on incomes, property etc. by a government for its support. So is this is something that is being levied on the Bahamian people? Let us see.
Section 12, subsection 2 states: “the failure to comply with sub-section 1 [to make regular payments into the plan as one does National Insurance] as regards the NHI contributions shall constitute an offence……” this would tend to suggest that this is taxation but looking at section 9, subsection 2c, and there is the term “voluntary insured persons”. This language here would tend to suggest that payment into the plan is not mandatory, which would further suggest that once a person has signed up (voluntarily) and upon not making regular payments then he/she has committed an offence. Someone needs to explain this to me like I am a five year old.
A “voluntary tax”? Hmmm! This would be a first for me and no doubt most of us. We all know that the whole idea of taxation is a very serious matter, even back to the times of the Romans. People traveled many miles just to pay them. Ask the man who took his pregnant wife all those miles and ended up having to accommodate her in a stable but I tend to digress.
This bill in its present form has too much contradiction which needs to be sorted out before it becomes law. No doubt, there are those among you that may feel that these ‘minor contradictions’ are nothing to worried about and they would, not doubt, be the very same ones that believe that the proposed budget of two hundred and fifty million dollars a year to run this program is nothing to worry about. I feel that the whole plan deserves a second look. In its present state, it sounds like it was concocted on a cocktail napkin, late one evening after a ‘stiff drink’. I would know this feeling of coming up with a ‘brilliant idea’ after a cocktail or two. Being an Architect, I have come up with plans in this very same situation – ‘The Next Great Idea’! But upon becoming sober and looking at the plans, it was found that they would just not work or needed ALOT of work to be made workable.
There is to much talk being put forth by the ‘Master minds’ of this plan against those that oppose this plan in its present form and it is distracting. To much talk critizing these people for not being compassionate towards the person that cannot afford health care. I have heard it said ‘shame on the persons that have for opposing this plan; being blessed with so much and not willing to give back to help their fellow brother’ – I have heard this talk before , it must be time for an election. All that I am hearing from those that have opposed this plan is that the plan in its present form will not work and should be given a second look.
This seems to be a war on the middle class because as section 9, subsection 4a states “NHI contributions shall paided by the Government on behalf of the following persons: “persons to whom paragraphs (b) and (c) and (d) of section 8 would apply;
Sections (b) and (c) are no problem under a plan with a viable budget but paragraph (d) allows for the Government to make payments on behalf of the “indigent”, who the bill describes as being “ a person who is recognized by the Commission to be exempt in accordance from paying the NHI contribution by reason of insufficiency of income”. Who is going to define this class of people and I ask again, is the proposed budget enough?
While the goals of the NHI plan seem to be noble and seem feasible on paper but let us bear in mind that Communism also did. I ask, would it be so difficult to give this plan a second look, or must we rush it into law,” The Great 2006 Christmas Gift”, one with potentially disastrous consequences? Then will we work out the ‘kinks’?
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