Ministry of Health & Social Development
Release Date:
Thursday, 3 September 2015 - 12:15pm


National Health Insurance Implementation

Madame Speaker in April of last year when the Social Security (Amendment) Act, 2014 was debated and passed I addressed this Honourable House on the subject of Universal Health Coverage.  This amendment laid the foundation for a National Health Insurance System in the Virgin Islands. 

On that occasion I described some of the health-related challenges confronting the Territory, and highlighted some social and economic benefits that would follow from implementing a National Health Insurance System.

I rise today with a keen sense of excitement and anticipation, on the heels of the historic launch of the long-awaited NHI registration process on Tuesday, 1st September 2015.

Madame Speaker, September 1st will be recorded in history as a date that the BVI took another bold step to transform its healthcare system and its economy, and to uplift the quality of life of its people for generations to come.

Madam Speaker, while we pause to celebrate our arrival at this pivotal point after years of vigorous research, analysis and debate – all in an effort to ensure that the NHI system would respond to the health needs of our population in a way that respects and upholds the human dignity of every person living in the Virgin Islands, we recognize that there is still important work to be done.

I wish to, again, place on record our deep gratitude to Dr. Karl Theodore, who graciously joined us for the launch ceremony, and the entire project team from the University of the West Indies Health Economics Unit whose research served as an excellent strategic foundation for the NHI design. Dr. Theodore, has pledged the full support of the University of the West Indies Health Economics Unit to us as we implement the NHI.

Madame Speaker, we have not been resting on our laurels.  Over the past 18 months since the enabling legislation was passed, the Social Security (National Health Insurance) Regulations has been approved by the Cabinet, and will shortly be tabled in this Honourable House.

The Implementation Team has also been hard at work finalising various policy documents, such as Operational Guidelines; a Medical Policy Manual; a Provider Payment Policy; a policy that covers Program Integrity; a Pharmaceutical Management Policy and Formulary, to give a few examples.

Arrangements have also been put in place to facilitate credentialing and contracting of local and overseas private providers; Reinsurance; and Third Party Administration.

The NHI information system has been developed, with software that offers real-time claims adjudication, checks and balances for fraud prevention, a drug formulary, International Classification of Diseases (ICD 10) diagnosis codes; and the CPT Billing Codes system. Using this information technology, online registration began on Tuesday, with 17 employers completing registration that first day.

Beginning in October a community-based registration drive will aim to capture all self-employed and unemployed individuals, and children of all ages. More details will be announced about the registration process in each community during this initial registration period. 

Staff recruitment and training are also underway as new jobs are being created in this exciting field.  Several new positions will be advertised in the local media over the next few weeks, and persons with relevant experience are encouraged to apply.

Madame Speaker, as we embark on this important work we recognize the need to continue to educate and inform the community of the system design, requirements, and benefits.  Madame Speaker, our public education campaign will continue to be rolled out over the next several months to provide more information and address new concerns.

Madame Speaker, I think it’s fair to say that some of the dissenting views being expressed about the specific design features of the NHI can be expected in any healthy democracy.  There are some who still hold to the belief that universal coverage could have been achieved by simply offering a Government plan to those without private insurance.

One can understand why that concept would seem appealing on the surface; but a deeper look reveals disturbing realities in several countries that have traveled this path.

Government plans were typically saddled with residents that had the highest disease burden and least ability to pay – a recipe for financial collapse.

When subsequent legislation was passed to prohibit private insurance companies from turning away recipients with pre-existing conditions, the premiums in this category were exorbitantly high.

Madame Speaker, after years of research and analysis, taking into consideration our size, population demographics, and economic structure, extensive studies have all concluded that full participation in a single pooled system is the only sustainable option for universal health insurance in the Virgin Islands.

Madame Speaker, ensuring access to quality healthcare and financial risk protection for all citizens are issues of concern to every responsible government and just society.   This Government is taking the right steps to address financial barriers to healthcare access with the implementation of National Health Insurance System.

But lack of financial resources is not the only barrier that people encounter.  There are also cultural barriers; structural barriers that inhibit physical access; and social barriers that affect groups such as adolescents, seniors, women and men differently.

Madame Speaker, I say this to emphasise the point that National Health Insurance System is just one component of a comprehensive strategy to steer our health system in a new direction: towards greater efficiency, improved quality, and financial sustainability.

Working in collaboration with several sectors, we at the Ministry of Health and Social Development continue to promote disease prevention and control; patient and community-centred primary health care; investments in health infrastructure and technology; strengthening the emergency medical services system; and building the health workforce along with regulatory and health financing reforms. Together, we can realise our vision and achieve our goal of a healthier, more prosperous and harmonious Virgin Islands.

I encourage the entire community to get on board and be a part of this change.  Let us focus our collective energy on building our great little nation. We may lose something that you think is good, but I guarantee you, we will gain something that is much better.

Thank you Madame Speaker.