Feature Address by Dr. the Hon. Timothy Harris, Prime Minister, at the Launching Ceremony of the Universal Health Insurance Coverage on February 23, 2018 at the St. Kitts Marriott Hotel  

This is a proud and momentous time for our nation.  Today’s launching ceremony represents significant progress in my Government’s mission to ensure full and affordable access to healthcare for all of the people.

This is an important manifesto promise of our Team Unity Government, and today my Cabinet colleagues and I signal that National Health Insurance remains a top priority. Today, with this launching ceremony, we move one step closer to providing dignified care for our citizens and residents throughout our lives.

Today’s watershed ceremony comes at a time when our Team Unity Government is celebrating our 3rd Anniversary with an extended week of activities under the themeOpening Doors and Creating Opportunities Through Service and Empowerment.

My Government’s efforts to open doors to healthcare for the people of St. Kitts and Nevis will close the gap on health disparities, marking a landmark achievement for our nation, and further advancing St Kitts and Nevis’ stellar leadership in healthcare delivery.

Significantly, my administration’s historic, unprecedented move to open doors to universal health insurance coverage will close the life expectancy gap between the poor and the middle and upper classes. Our national health insurance will help our people, particularly the poor in our federation, access care on a timely basis.

For our Team Unity Government, opening doors and creating opportunities mean empowering the people to make a difference by bringing their passions, talents, interests and skills to bear in building our nation’s future.

In order for us to accomplish this very important mandate, appropriate safeguard measures are needed.  These measures include a strong social safety net system, to assist poor, vulnerable and at-risk families that are just one health crisis away from financial ruin.  It is therefore necessary to introduce a financial risk protection mechanism in our health system.

The sad fact is that way too many people in St. Kitts and Nevis do not have private health insurance coverage.  Many of the uninsured cite the high cost of insurance as the main reason.  Unlike civil service professionals and some private sector employees, many people do not have access to insurance coverage through a job.  We want to change this situation by encouraging more people to get insured early.  We invite all employers to add insurance protection to the milieu of benefits available to their employees.

I grieve when hearing heart-wrenching stories of the lengths that some people have to go when an unexpected health crisis befalls them.  Some uninsured have had to depend on their elderly parents and grandparents to take money from their savings in order to assist in an emergency.  Many of our people who lack private health insurance have also had to depend on the charity of others to cover high medical costs at home and abroad, including airfare.

Sadly, emergencies often develop after an uninsured person gets sick or, as we say colloquially, “take in” after years of ignoring health symptoms and going without routine checkups and basic preventative care.  These are needless tragedies, seeing that such care can often avoid worse health outcomes and prevent larger costs from happening down the line.  We as intelligent people must elevate our commitment to safeguard our health by doing all we can to keep ourselves in the best health condition.

We are a caring government and for us the health of our people must come first.

A single mother must not be placed in the position of having to choose between buying groceries and scheduling a mammogram the same day she feels a small lump in her breast.

Her children will find no solace in knowing that she chose their comfort over her own future, especially during significant life events such as graduations, weddings, births and christenings, when she is not there to share in the joy that she had always dreamed for them.

We believe that no one should have to skip taking a potentially life-saving scan or other procedure because of the cost, neither should they have to declare bankruptcy because of an expensive illness; and above all, we believe that equal access to healthcare is a basic human right.  We applaud the efforts of a young doctor, Dr Andy Redmond, a neurosurgeon, in giving back to his community by investing in the first MRI service here in St Kitts in 2016.  We applaud the 450 persons who were able to use the facility right here and save themselves the costs of travelling and getting accommodation overseas.  We encourage more persons to follow Dr Redmond’s lead to set up entities to provide specialist health support to our people right here in our federation, thereby bringing efficiency, effectiveness and efficacy in healthcare delivery in beautiful St Kitts and Nevis.

It was Winston Churchill who said, “Healthy citizens are the greatest asset any country can have.”  It is therefore unsettling that the prevalence of non-communicable diseases (NCDs) has increasingly become a liability on the national ledger, with NCDs accounting for approximately eighty-three (83) percent of all deaths in the federation.  What’s more, NCDs – which include cancers, cardiovascular diseases, diabetes and chronic respiratory diseases – continue to gain strength as the leading cause of death and disability among our people.

These are preventable, premature deaths and disabilities that disrupt economic productivity, devastate families and debilitate the country’s human capital and development. These are preventable, premature deaths and disabilities that occur especially among the poor, and whose impact is felt hardest in the CARICOM region.

Concerned about the troubling trajectory of global NCD statistics, then-Secretary-General of the United Nations, Ban Ki-moon prepared a report back in 2011 titledPrevention and control of non-communicable diseases in which he said: “The ultimate protection for people at high risk or who already have non-communicable diseases is universal health insurance coverage.  A significant factor in the unequal distribution of such diseases among low- and middle-income countries is the lack of public or private health insurance.  Universal social protections must be the goal.”

According to the World Health Organization’s data, in 2015, non-communicable diseases were responsible for seventy (70) percent of global deaths, i.e., 39.5 million deaths – and over three quarters of NCD deaths (30.7 million) in 2015 occurred in low- and middle-income countries with about forty-eight (48) percent of all deaths occurring before the age of 70 in these countries.  Even more disturbing, the World Health Organization’s 2010 Global Status Report on NCDs notes that nearly 30 percent of NCD-related deaths occur under the age of 60.

Additionally, a 2011 World Economic Forum study by Harvard School of Public Health Economist David Bloom states that the cumulative cost of NCDs in low and medium-income countries during the period 2011-2025 will reach nearly US$500 billion per year – largely due to lost productivity from affected people who were in the peak of their work lives.

Two of the five key messages that emerge from this World Economic Forum study titled The Global Economic Burden of Non-communicable Diseases are that middle-income countries (like St. Kitts and Nevis) are expected to assume an even larger share of the economic burden of NCDs as their economies and populations grow, and “cardiovascular disease and mental health conditions are the dominant contributors to the global economic burden of NCDs.”

That is why on Tuesday, at the renaming of the mental health day treatment centre to reflect Dr. Arthur W. Lake’s contribution to the psychiatric field, I pledged that my Government will work to ensure that our universal health insurance plan considers our mentally ill by forbidding the exclusion of people with pre-existing illness from gaining medical coverage.

Indeed, under our National Health Insurance System, health coverage will be provided from the cradle to the grave and will cover all persons regardless of age, employment, income or pre-existing conditions.  My government has taken this progressive step forward, more than this, it is a bold step and we do so because people matter most to Team Unity.  We understand the pain of our people often times traumatized by sheer cost of healthcare.  Hon Eugene Hamilton outlined several cases of real people from Keys and elsewhere whose circumstances would have been different, had health insurance been available.  Twenty years before Team Unity, the government denied itself the opportunity to help our people.  It is now the responsibility of Team Unity to step into the breach and we will succeed where others before us failed to do the right thing, for the right reason.  For us this is an urgent matter and we are making steady progress on our health commitment.

For its part, the Ministry of Health will ensure the delivery of quality health services in the public and private sectors.  At this juncture, I wish to thank the Ministers of Health: the Honourable Eugene Hamilton, for providing leadership – in regard to planning the delivery of universal health insurance coverage – buttressed by his many years of experience in the insurance industry.  The Senator with responsibility for Health, the Honourable Wendy Phipps, ably provides leadership support, and they are backed up by our Chief Medical Officer Dr. Hazel Laws and her incredibly talented and hardworking staff in the Ministry of Health.  Most importantly, there is incredible support across the public and private sectors to work together to achieve the best offering for our people.

We are encouraged by the involvement of the experts at the Centre for Health Economics at the University of the West Indies in assisting us in finding viable options to achieve our goal of universal national health insurance.

May God bless our collective efforts and may our people be persuaded to live healthy lives, remembering the adage: Prevention is better than cure.  Our health is our wealth.  Indeed financial costs of ill health can be ruinous.  Today we are working to consecrate the future of our people and our beautiful Country.  Onward and Forward with a Healthy Nation.

May God Bless Us All.

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