Three islands in the Caribbean make up Antigua and Barbuda. It ranks as a high-income country, has a population of 93,200 and is a member of the Commonwealth. Originally, the health system was principally funded by a combination of public funds and out-of-pocket (OOP) expenditure. The 2010 Medical Benefits Act established the Medical Benefits Board to administer the funds collected regarding the health benefits scheme. The scheme is directed at formal sector employees and financed through payroll taxes, but voluntary subscribers are permitted. Specific benefits are described under the 2011 regulations.
Financing the health system
In the 10 years between 2011 and 2021, as a percent of current health expenditure, OOP expenditure decreased from 25.77% to 19.16%, and domestic general government expenditure increased from 56.95% to 67.2%.[1] These financing sources are complemented by voluntary prepayments of 13.62% in 2021.[1] However, in that year, public health expenditure accounted for 3.9% of gross domestic product[2], less than the 6% recommended by the Pan American Health Organization.
Remaining challenges and potential responses
Despite clear improvements in financial protection or health over the past two decades, the Medical Benefits Scheme acknowledges challenges with the current national health system.[3] These are related to the growing financial burden (cost of health services) and limited access to essential health services that go along with the population’s increasing needs and demand for health care. One of the options being explored is the national health insurance scheme.[4]
[1] World Health Organization, Global Health Expenditure Database
[2] Pan American Health Organization (PAHO), Antigua and Barbuda – Country Profile
[3] Medical Benefits Scheme (MBS), The Proposed National Health Insurance and what it means for Antigua and Barbuda
[4] Medical Benefits Scheme (MBS), The Proposed National Health Insurance Stakeholder Briefing: A transition for MBS
