One of the social services the Anguilla Government says it will be introducing in the near future is a National Health Insurance System which is certainly a good idea. However, in order for it to properly get off the ground and eventually satisfactorily succeed and serve its purpose, it must have a well-planned and carefully ordered foundation. One way of ensuring this is that all stakeholders and other key persons must be well informed and prepared for it. In the first case, the Government and the Committee tasked with implementing the system must be on the same wave length with clear and sound policies, objectives and safeguards on the table.

The introduction of Social Security a quarter century ago is so far the best conceived, implemented and administered social system for the people of Anguilla, and is a hard act to follow. The establishing of a National Health Insurance System cannot be haphazard or seen as just another undertaking to catch up with the services of the rest of the world. The price of failure is too great a risk for a small developing island like Anguilla and so the emphasis must be on the development and administration of a quality system.

The Government’s planned system will be different in some respects from the medical benefits provided by the normal insurance companies which do not provide coverage for certain high risk and terminally ill persons. In the case of a National Health Insurance plan, which the Government is thinking about, it will have to be non-discriminatory - covering everybody irrespective of their afflictions or other circumstances. This makes the system even more challenging and calls for some serious thinking about how to deal with the situation.

The fact that the people of the island will be required to contribute a percentage of their earnings to the system, matched by an equal amount from employers, means that there will be a great demand on the island’s health services to provide the type and level of local care expected as well as any additional care which may be required at other institutions abroad. If people are paying their hard earned money for this service, they will not settle for anything less than what they expect. Travel and immigration arrangements, particularly where visas will be necessary, are also matters for careful consideration. There will obviously be the need to ensure that a substantial amount of money is always available in the system and that the funds are not used for any other purpose than that for which they are being collected.

The road to a National Health Insurance System may not be a short or easy one without its attendant potholes and rough edges to avoid. The planned system needs to be given maximum publicity to attract well-meaning participation and feedback that will be necessary for it to properly take shape and work well. It is understood that the legislation to govern the administration of the system is at an advanced stage in its drafting. It is the right tool that must have the teeth and the built-in safeguards to ensure the flawless functioning of the service.

The National Health Insurance System, despite its plausible conception, must not be rushed on the society. All the players must be enlightened, their views respected and taken into account. Taking time on this matter may be just as good an idea as the one which conceived it. By doing so some of the unforeseen pitfalls may be avoided and all of us will be roundly prepared for the introduction of the system.

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