Sept / Oct 2016 | Business View Caribbean

94 September 2016 - Business View Caribbean Business View Caribbean - September 2016 95 terms of management of patients.” Dr. James believes that while the healthcare system in Barbados is capable of providing excellent services for its population, the taxation model may not, in the long- run, be the best way to keep up with increased health- care costs and continuing changes in the healthcare landscape. “On the financing side, we are having a con- versation about changing the model more along the line of social health insurance,” he says, “because the monies that are appropriated every year by Parliament to meet the recurrent expenditures of the hospital is inadequate for several reasons: you have changes in consumer taste and preference; you have changes in the demographics of patients – Barbadians are living longer, but, unfortunately, they are not living healthier; and there are changes in technology. So when you look at all the drivers of healthcare costs, the taxation model cannot keep pace with the demands of the sys- tem. So, the government has to find a new model.” “Under the taxation model, everybody pays taxes; it goes into a consolidated fund, and then the Ministry of Finance decides how those funds are to be allocat- ed across the various government ministries,” James continues. “Under socialized insurance, every citizen will pay a certain amount of their salary, or it can be employer, or employer/employee funded; it goes into a fund and those funds are then used to meet the expenses of the healthcare providers. And that is the model that most countries that have tax-based mod- els are moving toward - a model that is more along socialized insurance. And so we’ve had financing con- ferences over the last three years and I’m happy to