In a call last Friday morning to Nuri Muhammad, the host of XTV’s WuB Morning Show on Thursdays and Fridays, Public Service Union (PSU) president, Dean Flowers expressed serious reservations about the funding of the National Health Insurance (NHI) scheme. At the time of the call, Nuri had been commenting on statements PM Briceño made in a House Meeting last week, about the millions of dollars that were coming into government’s coffers, the near decupling of the profits since we tek bak di Boledo. The House Meeting had been called to discuss a US$34 million loan from the Caribbean Development Bank (CDB) to upgrade a section of the George Price Highway, and various bills; but as is usual at House Meetings these days, the PM used the opportunity to tout the government’s profit from the national lottery, and the noble use of the funds, mainly to sponsor the NHI program.
Flowers said funneling the Boledo funds into the NHI doesn’t mean it is being put to the best use, that the funds might just be going into different private hands. Flowers also said that the public health system is in crisis, with a shortage of supplies, while millions are being pumped into the pockets of the private providers of the NHI. He said the NHI is aimed at primary health care, an area that should be addressed mainly through preventative lifestyle.
The NHI was created during the era of privatization, the 1998-2003 PUP government. During that period a number of publicly owned utilities were sold into private hands, and most of them have since been returned to government control. Flowers is not alone in the suggestion that the NHI might be a cash cow for government favorites. On a number of occasions, the UDP’s Alfonso Noble has, on his Plain and Straight morning show on Color Blind Multimedia Productions television, hosted Carlos Perrera, an accountant who failed in a bid to become the standard bearer for the UDP in Port Loyola earlier this year. Their conversation often features the NHI, which Perrera lambasts as a scheme with much pork for favorites of the government.
The NHI website says the scheme, which was established in 2000, is “an integral part of the Health Sector Reform process” which aims for “universal health coverage for all Belizeans.” The website says the reform promotes “the separation of the key functions of the regulator, provider and purchaser of health services.” The Ministry of Health (MoH) is the regulator, responsible for “identifying the health needs of the population covered by NHI, defining the quality health service delivery standards, development of the clinical guidelines and facility regulations that providers must meet.” The NHI is “responsible for purchasing the defined package of services from pre-approved registered providers and ensuring that services rendered, meet the requirements stipulated in the contractual agreements”, and “registered providers are responsible for delivering the health services in accordance to the standards and Key Performance Indicators negotiated in the contractual process.”
In the healthcare systems in Canada, and many countries in Europe, everyone is insured. In those countries everyone has access to tertiary level healthcare at public hospitals, and that is complemented with a private system for those who have the cash and don’t want to wait in line. In Cuba, which is impoverished because of a cruel economic embargo placed on it by the US for over 60 years, everyone has access to medical care, to the highest level.
The healthcare system is a hot button issue in every presidential election in the US. Recently, the American government was shut down for 43 days, with the core issue causing the stalemate being their healthcare system. Ken Alltucker, in a story in USA Today titled, “Trump’s Obamacare fix: Send consumers money, not insurance companies”, said “Americans spend more on medical care than any other nation”, and “more than 150 million Americans who get coverage through their employer will see average costs in 2026 rise at the highest level in a decade [and] a half.” In an effort to reduce the cost of their healthcare system, US Secretary of State Marco Rubio announced around the middle of November that people wishing to visit the US might be denied visas if they have cancer, diabetes, or are obese. As it stands today, visitors to the USA have access to the US health system if they fall ill while over there.
Health was a major issue in only one general election in Belize, in 2008, and it was primarily about a hospital. The 2003-2008 PUP government gave a sovereign guarantee to the Belize Bank for a $33.5 million loan to the private Universal Health Services (UHS) hospital, and was daubed with the brush of corruption when the UHS defaulted on the debt.
Specifically in regard to the UDP, it is good politics for members of the party to attack NHI, especially since it is partly being funded with the millions in Boledo profits, profits that were obscenely going into private pockets when the UDP was in government. But their stance against NHI isn’t new. The UDP won the 2008 general elections, and where they inherited the NHI is where it stopped. It was not until 2020 when the UDP was booted out of office that expansion of the NHI continued, with the present PUP government aiming for full NHI coverage for Belize by the end of 2025.
For Belizeans, it is all about getting the best results from our dollars. Scrutiny of the NHI must be intense; it is our money that is being spent.
Two and a half years ago, in May 2023, the PM announced the signing of a US$45 million loan from the Saudi Fund for Development for the construction of a tertiary level hospital in Belmopan, and about a year and a half ago the government acquired land, which it said was suitable to locate the hospital, for BZ$6.9 million. There are no reports that construction of the hospital has begun. Belizeans want the new hospital, presently called University Hospital, to be the best in the country. Belizeans who seek care at private hospitals must go there because they have cash and cannot wait for their turn, not because they don’t trust what the public facility has to offer.
How is NHI better than the system that was in place during the UDP’s years in government, 2008 to 2020? Belizeans don’t like that families who have children and young adults who need specialist care, have to seek charity to cover medical expenses. They should have an open check to go to Cuba if the attention they need isn’t provided here. The MoH needs to answer the queries of the PSU president about the spending of our Boledo money on the NHI, and the UDP, which hopes to form the next government when we go to the polls in 2030, has to properly articulate its alternative vision for health care. At the end of the day it is what works best for Belizeans, with our primary focus being on the less well-off citizens in our country.
