Gov’t to take closer look at healthcare financing, says Tufton

As surging costs facing the public health sector create an increasing funding challenge for the Government, Health and Wellness Minister Dr Christopher Tufton says in the months and years ahead, the country will have to engage in a serious conversation on healthcare financing.

Tufton said that he will be unveiling a ministry paper on sustainable financing for the country’s healthcare system, adding that the ministry will also embark on a series of consultations within the Government and with Jamaicans as well as multilateral partners.

He said that this was a follow-up on to the Green Paper on a national health insurance plan that was tabled in 2019, but was not pursued as priority was shifted to treating with the pandemic.

In his contribution to the Sectoral Debate in Gordon House on Tuesday, Tufton said it was time to restructure the health system to achieve a more sustainable financing mechanism, even as he noted that the country has a sick profile that is alarming and getting worse.

“A large percentage of Jamaicans have a non-communicable disease or a significant risk factor, such as obesity, high cholesterol or physical inactivity,” said Tufton.

He argued that many Jamaicans were unaware of their health status and that some might not even care, adding that in the end, it would have an effect on the entire country as the burden of healthcare costs is shared.

The 2016/2017 Jamaica Health and Lifestyle Survey indicated that one in three persons aged 15 years and older was hypertensive; one in eight had diabetes, and one in two persons was obese or overweight. Approximately eight out of 10 Jamaicans had low levels of physical activity.

“These are trends borne primarily out of historical lifestyle practices, and it will take time and a number of policy prescriptions to curb these trends,” the minister noted.

Data from the health ministry showed that at least 684,900 Jamaicans have hypertension and another 688,800 have pre-hypertension.

At least 577,300 Jamaicans are obese with the highest prevalence of obesity being among the 35 to 44 age group, with women accounting for 55.1 per cent and men 20.6 per cent.

In the 55 to 64 age group, women again outstrip men in terms of obesity with 54.1 per cent of females in this category being obese compared to 13.8 per cent of their male counterparts.

The ministry is also reporting that 236,200 Jamaicans have diabetes. It also highlights a 42 per cent increase in the prevalence of diabetes mellitus in Jamaica over the last 17 to 18 years.

Tufton argued that the country was facing few options on financing healthcare, noting, “We either reduce the benefits to over 720,000 Jamaicans who are likely to need medicines or curative services and cannot afford to pay in the private sector, change our funding model to reflect a more sustainable approach to financing the health sector, or use policies and laws to change our lifestyle to improve our health profile and ultimately reduce costs.”

He said the answer was likely to be a combination of approaches, stressing that access could only be granted if financing was available.

Reviewing spending by the National Health Fund (NHF), Tufton said that the entity’s budget has skyrocketed by 139 per cent from $4.6 billion in financial year 2015-2016 to $11 billion in fiscal year 2021-2022.

He said that projections for the next three years indicate further increases of approximately 30 per cent, moving spending to about $14 billion in 2025.

“At this rate of demand and cost increases to treat over 720,000 Jamaicans, served by the NHF, this critical entity will need approximately $40 billion over the next three years or risk being unable to address the needs of Jamaicans suffering from some sort of illness.”

He pointed out that Jamaicans who become ill as a result of lifestyle practices feature prominently in these escalating costs.

In 2020-2021, the NHF spent $1.3 billion on hypertension compared to $940.4 million over the 2014-2015 period. In 2020-2021, the organisation spent $1.4 billion on diabetes compared to $887.3 million in 2014-2015. This is a 59 per cent increase.

Over the 2020-2021 period, Jamaicans spent $2.4 billion in NHF co-payments on drugs to treat high blood pressure, compared to $1.5 billion for the 2014-2015 period – a 62 per cent increase.

Jamaicans also spent a staggering $1.6 billion on drugs for diabetes for the 2020-2021 period, when compared to $862.8 million for the 2014-2015 period – a jump of 82.6 per cent.

The health and wellness minister announced that he has appointed economist Dr Damien King to conduct a review of healthcare financing in Jamaica.

He said that King, who is also executive director of CAPRI, will lead the national discussion on the current challenges the country faces with health financing and the implications for poverty and the economic and social advancement of Jamaicans.

King will also consult with local and multilateral stakeholders to explore health financing options and to assist in the advocacy that is necessary to ensure a more sustainable health financing model.