Just two diseases cost taxpayer $35m

It was revealed yesterday that just two diseases use more than one out of every six dollars of the government's annual health budget, and that the government's public clinics have a "extraordinary need to improve."

Documents related to the $60 million loan from the Inter-American Development Bank (IDB) to improve primary health care in the Bahamas show that treating diabetes and high blood pressure alone costs Bahamian taxpayers close to $35 million per year, or almost 18 percent of all public health spending. This is because the government is trying harder to fight chronic non-communicable diseases like diabetes and high blood pressure (NCDs).

One IDB paper bluntly said, "NCDs are very common." It went on to talk about the rising costs and consequences of a Bahamian population that is getting sicker and sicker. One in ten adults has diabetes, and four in ten have high blood pressure.

"There is a health gap between men and women because of NCDs. More women are obese (54.8% of women and 31.8% of men), have high blood pressure (77.5% of women and 66.25% of men), and have cancerous tumors (women 66.2 percent, men 47.9 percent). Prostate, breast, colon, and cervical cancer are the most common types.

"NCDs are also the leading causes of ambulatory and hospital care, and 63 percent of disability-adjusted life years are caused by them. Ischemic heart disease (52.5), cerebrovascular disease (39.8), prostate cancer (31.9), breast cancer (28.8), and diabetes are the top five causes of death per 100,000 people (27.1). Estimates show that between 2000 and 2030, the chance of dying too soon from cancer will rise from 7.9 percent to 9.23 percent per year.

With the help of IDB money and technical support, the government is trying to find and treat these diseases sooner by improving primary healthcare infrastructure and making services more efficient. And by doing this, it hopes to give Bahamian taxpayers more for their money while also lowering the cost of health care.

"Appropriate preventive and curative care in primary care facilities and hospitals can lower health costs and cut death rates from NCDs by up to 25%," the IDB paper said. "For example, more than 70% of women with breast cancer are diagnosed at a late stage, which makes treatment less effective and decreases their life expectancy.

"NCDs have a big effect on how much money is spent on health care. Diabetes and high blood pressure have direct costs of $34.8 million per year, which is 17.6% of all public health spending. It also costs a lot to treat cancer. In The Bahamas, it can cost up to $23,059 per case."

The IDB paper also said that primary healthcare providers and facilities need to be better prepared "to provide preventive and curative care" for Bahamians and residents with NCDs. This will cut down on the number of people who need emergency or hospital care, which will lower healthcare costs.

But the government has said that the primary health care system and infrastructure in The Bahamas, especially in the Family Islands, are in "dire condition" and need a lot of work. Colin Higgs, the permanent secretary for the Ministry of Health and Wellness, wrote to the IDB on April 20, 2022, to let them know about this.

Confirming that the ministry "had to change its activities to fit with the new mandate of government" after the general election on September 16, 2021, Mr. Higgs told IDB officials that the original $20 million needed to upgrade the clinics had to be raised to $26 million because the Davis administration wanted to double the number of new or renovated locations from 9 to 18.

#A $5 million grant from the European Union (EU) brought the total investment in the clinic to around $31 million. Mr. Higgs wrote, "The Ministry of Health and Wellness was told to do more with the money given, given the terrible state of health infrastructure and the urgent need for improvement."

"The buildings chosen to have their air conditioning systems updated were not ready for that. Works that are important for the health system to work are now being proposed." The previous government led by Minnis had tried to improve primary healthcare infrastructure on the first seven Family Islands.

But Mr. Higgs wrote: "The Ministry of Health later put the building of five new clinics and the renovation of 12 others at the top of its list." Each building would be built to be safe from natural disasters and the effects of climate change. It would also be built in a way that is sustainable and uses less energy, as required by the EDGE certification, and it would be built in a way that makes it easy to care for and stop the spread of diseases like COVID-19 and other infectious diseases.

#New clinics will be built in Fresh Creek and Mangrove Cay, Andros; Smith's Bay, Cat Island; Staniel Cay, Exuma; Long Cay; and Rock Sound and Palmetto Point, Eleuthera. The primary health care clinics that will be upgraded and remodeled are in Matthew Town, Inagua; Marsh Harbour and Fox Town, Abaco; Mastic Point, Andros; Simms and Deadman's, Long Island; Alice Town, Bimini; and Fox Hill Clinic, New Providence.

An IDB cost-benefit analysis of the healthcare improvements showed that they will have a net return of about $37.141m, with the benefits of the project totaling $249.863m and the costs of the project totaling $212.722m.

The IDB said, "The main goal is to improve the health status of the population by strengthening The Bahamas health system to meet the priority health needs." The IDB also said that the Bahamian public healthcare system is broken up, which makes the quality of care vary.

"The Ministry of Health and Wellness is updating its health information system to reduce the fragmentation of the public health care sector and close the gaps in their uneven growth. The National Health Insurance Authority has an electronic health record system for primary care that 43,000 people can use to access their health information through a digital patient portal.

"On the other hand, the Ministry of Health and Wellness is getting ready to switch from a paper-based health information system to a digital one. At the moment, most of the data management in health care facilities run by the Ministry of Health and Wellness is done on paper, with manual data entry and reporting.

Palmetto primary patient portal login