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94 September 2016 - Business View Caribbean
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