Bahamas



Latin America and the Caribbean

7.1%CHE/GDP

24.5%OOP/CHE

13.8%GGHE-D/GGE

11BGDP (USD)

407.9KPopulation

The Bahamas consists of an archipelago of islands in the Caribbean with a population of 407,900.¹ A former British colony, the country obtained independence in 1973. To complement public health efforts financed by the national budget, national health insurance was established. The National Health Insurance Authority (NHIA) has undergone a range of legal and technical evolutions since the National Health Insurance Act 2006, followed by the National Health Insurance Bill 2017, and most recently the National Health Insurance Bill 2022. The latest bill makes the Standard Health Benefit available for anyone who enrols with NHIA and does not require any premiums or additional user fees. By 2023, 161,647 people were enrolled as beneficiaries of the National Health Insurance.

Low levels of catastrophic expenditure

In 2016, the Organisation for Economic Co-operation and Development reports that just 2.7% of the population was spending more than 10% budget on out of pocket (OOP) expenditure for health care^[2] and 0.1% was at risk of catastrophic spending. In 2021, public expenditure on health accounted for 3.98% of GDP, and 13.75% of total public expenditure.^[3] Current health expenditure (CHE) in 2021 was 7.1% of GDP while OOP made up 24.5% of CHE, which is slightly down from 28% in 2016.^[4]

Challenges and way forwards

Prior to the adoption of the 2022 bill, through national consultation, the NHIA identified multiple challenges⁵, including too many uninsured people, a population that is increasingly unhealthy and insufficient public dollars to fill the gap. Indeed, the consultation document describes an inefficient and expensive system with poor health outcomes.

The National Health Insurance Bill 2022 attempts to address these challenges by bringing together public and private clinical practices under a common financing structure and establishing a standard health benefit package. In October of 2022, the minister of health of the Bahamas stated that the NHIA will assume the role of the insurer of last resort and will protect the poorest and most underserved communities.⁶

References

[1] World Health Organization, Global Health Expenditure Database

[2] OECD, “Health at a Glance: Latin America and the Caribbean 2020”

[3] PAHO, The Bahamas country profile

[4] World Health Organization, Global Health Expenditure Database

[5] National Health Insurance Authority, National Health Insurance, A Shared Responsibility, A Modern Framework for Increasing Health Insurance Coverage in The Bahamas

[6] The Government of the Bahamas, Press Release