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CARICOM’s health care challenge

Rickey Singh

CARICOM’s health care challenge

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BARBADOS HAS begun implementation of a new health care policy that restricts access to free drugs/medical care to non-nationals who have neither citizenship nor permanent residency status.
And it has come as a reminder why CARICOM governments should collectively and speedily move towards a common strategy for shared medical benefits by all nationals of member states that have signed on to the Community’s Single Market and Economy (CSME) project.
In the Barbados scenario, unless proof of citizenship or permanent residency status could be established when seeking medical care, then non-nationals could be denied health benefits previously freely accessed. 
The ministry of health has advised people with work permits that when applying, they should consider getting health insurance or ensure that their salaries made provision for acquiring health care here. It said exceptions to the new policy would only be made in cases where it was deemed to be an emergency or where there was a communicable disease involved.
From inquiries made of some governments including Guyana, Jamaica, St Kitts and Nevis and St Vincent and the Grenadines, there are concerns about the application of the new policy that would require clarifications.
It has been noted that implementation of the Barbados health care policy is taking place while CARICOM is still striving to establish appropriate mechanisms consistent with arrangements for the CSME.
These arrangements, which would facilitate more than the estimated nine categories of skilled nationals to have freedom to live and work in any of the participating CSME member states, relate to outstanding issues like contingent rights and creation of a health insurance scheme that’s applicable across the region. 
Prime Minister Dr Denzil Douglas, of St Kitts and Nevis, who has lead responsibility among CARICOM Heads of Government for Health and Human Resource Development, said the community should prioritise arrangements for “an enlightened common approach” in the provision of health care for all nationals of the community.
As chairman of the Organisation of Eastern Caribbean States, Douglas observed – as did his Vincentian counterpart, Dr Ralph Gonsalves, that the OECS subregion had already made “significant strides” towards the evolution of a common health care programme for community nationals, including non-citizens who live and work there. 
Both prime ministers felt that access to health care for CARICOM nationals should be discussed at the inter-sessional meeting in Grenada later this week, not only in relation to common health care benefits, but also bearing in mind the wide-ranging recommendations for action outlined in the report from the Caribbean Commission on Health and Development.
As observed by Guyana’s Minister of Health Dr Leslie Ramsammy, there was “general understanding” that a member state of the community “is free to pursue policies and programmes it considers to be in its national interest” while, at the same time, “we can hope for consistency in fulfilling the broader goals of the regional integration movement . . . . “
Ramsammy said the goverment was “fully committed” to honouring its obligations in providing free access to approved drugs and basic medical care to “all of our citizens as well as nationals of CARICOM who either live and work here, as long as they deal with the state sector health system.”            
In Jamaica, as explained by its health ministry, no one, national or non-national, would be denied access to urgent medical attention but a payment arrangement is normally discussed for non-nationals. 
Jamaica is also keen for a “common approach” by CARICOM for nationals to access free drug/medical care. It also shares the concern for progress to be hastened in CSME-readiness arrangements that include issues such as contingent rights and the creation of a regional health insurance mechanism to benefit nationals across the community.
Part of Barbados’ problem seems to reside in the Government’s failure, to date, to have preceded its implementation of the new policy with a public education campaign on relevant provisions –in particular, those applicable to immigrants – CARICOM or else.