NHIP is not the problem
Friends, as a former chairman of National Health Insurance Board and a current client of National Health, I feel it is my right to address the financial situation at NHIB. I know I have already made some comments under someone else page but this is my page and so I can elaborate.
First of all, when the National Health Insurance Bill was introduced to us in 2009, I was totally against the implementation because I like most people who opposed at that time suggested that the TCIG should make it mandatory that all persons have private medical insurance through their companies. However, when I became a member of the Board, only then did I realize the importance of this institution. BVI has recently implemented NHIB and the Bahamas is on the verge of doing the same. Both of these countries came to TCI on a fact finding mission and using our institution as a model.
Once you are covered by the National Health Insurance Board, there are no restrictions on your medical costs. NHIB covers all of your overseas medical costs. NHIB pays for your fight and provides you with subsistence during your time away. In addition NHIB covers your pre-existing conditions. Any pharmaceuticals over $25 is absorb by NHIB. Eg. If your pharmaceutical cost you $100, you pay $25 and NHIB pays $75. If you go to private doctor locally, NHIB pays $35 to that doctor/medical facility. One will not get half of these benefits from a private insurance company.
I am quite aware that there are issues among management and staff at NHIB which must be resolved in order for the organization to move forward. This article however is not to address this but to address the financial situation at NHIB. I will go on record and say that the financial situation at NHIB has nothing to do with the management personnel or style of NHIB. The situation we have on hand is that there is increase in the number of medical cases in TCI and therefore the Board is underfunded.
When management and the board of Directors presented the budget last year to TCIG, we knew the budget was not workable. However, as a statutory body, NHIB could not submit a budget showing a loss as it is against the guidelines of Govt. NHIB was asked to find ways to reduce its costs and they did put measurements in place to reduce costs including negotiating cost reductions with the main overseas providers. Unfortunately when it comes to the number of persons who are sick, it is beyond the control of NHIB. For the first half of 2016, there has been 18% increase in the number of patients referred abroad. Imagine if this trend continues, then the increase can be as much as 36% by the end of the year and I can assure you the budget does not reflect the cost to cover these unexpected increases in overseas treatment abroad cases. One also has to consider not only the medical costs, but also the subsistence cost, the travel costs and the pharmaceutical costs associated with these increases in the overseas treatment cases.
I know the first thing critics may say is that we should ban the NHIP plan. If we ban the NHIB plan, then it becomes more of burden for the TCIG and then TCIG will have to find other ways to increase its revenue (through a tax) should it decide to fully absorb all medical costs.
Before I go any further, I should note that NHIB is audited annually by PWC, a leading international company, and the audited financial statements are in the public domain. I should also add that NHIB has monthly board meetings and is attended by PS Finance and PS Health. If they are unable to attend, they send a representative. At every meeting, the financial performance of NHIB is discussed and furthermore NHIB like all statutory bodies must present quarterly report to the Ministry of Finance. For 2016 , I do not know the frequency or the format of the meetings as I was no longer on the Board. I can only speak to what happened when I was there in 2015.
Speaking about finance and since this information is in the public domain, I will share with you a synopsis of the finances for 2015. In 2015, NHIB collected more than $26.9 million in contribution income from their clients. In addition to the above the TCIG contributed a further $17.4 million to NHIB to cover overseas medical treatment, registered unemployed workers (up to 90 days I think) and indigents (persons who are sick really badly and not in a position to work). Now imagine if the TCIG had to fund the entire $44.3 million ($26.9 +17.4), do you really think we should ban NHIB.
On the cost side for 2015, there was a total of $39.6 million in health costs. This includes local medical costs, overseas medical costs, pharmaceutical costs, local and overseas travel and subsistence and reinsurance costs. Another $3.1 is on administrative costs which is minute compare to the overall scope of things.
I hope by now you have a better appreciation of the NHIB. We are now in 2016 whereby the number of cases has increased significantly but medical costs have also increased and so yes NHIB will have a financial crisis especially if the budget is not a true representation.
Here are my recommendations
Before I start with my recommendations, I believe most politicians are afraid to admit this. It is a sensitive issue and it has already happened. I am not a politician so I can say this. We should have never build two fully fledge hospitals. We should have one major hospital in TCI and all other islands have a medical facility along with family clinics in populated settlements.
1) Having one hospital would have eliminated some of the local medical costs. However, I know we cannot do anything about that but I wanted to list that anyway.
2) As a community, we must focus on preventative healthcare. At the moment, all of our funds are being used to treat diseases. We need to institute preventative healthcare platforms in our schools, our churches and homes. Perhaps NBIB can partner with someone and take this as project. There are far too many cases of sicknesses and diseases taking place in our small country. We need to educate our public on healthcare: eating and living healthy. If we do not address this, we will continue to spend more money than we budgeted for medical care. It is very challenging to budget for medical costs. The key for cutting medical costs is the prevention of diseases and sicknesses. Unfortunately, some of us do not get routine medical care or check up and we find ourselves in late stages of the diseases and then we end up blaming the hospitals.
3) Everyone who lives and works here should contribute to the plan and be honest in their contribution. When one of our family members get sick, we get upset with the plan when sometimes we do not even contribute to the plan. However, because we are a small island and we know everybody, we called the minister or the premier for help. Is it fair to those who are paying?
4) Everyone should be treated equally. Currently the plan refers persons to DR, Jamaica, Bahamas and sometime Puerto Rico for overseas treatment. However, there are some who refuse to go to these places and want to go the USA or they want to choose where they want to go. Don’t you know that some of those same doctors you deal with in the USA are from Jamaica, Bahamas etc
5) NHIB along with the TCIG need to review the benefits including the coverage of the pharmaceutical costs. Perhaps the TCIG really needs to rethink about the establishment of their own pharmacy. Something has to be done because some pharmaceutical costs can be as high as $7000 for one patient.
6) For those persons that have private insurance, perhaps the insurance can cover the 80% and NHIB can cover the remaining 20%. Of course the issue will be the referral country as NHIB does not send patients to USA.
7) Another option is to increase the current rate from 6%. A study will have to be done to determine the best viable rate.
8) Given that we have two modern hospitals in Turks and Caicos, we need to find ways and means to treat patients locally rather than sending abroad. It will cost us but I believe it will still be cheaper to do it locally. I know efforts have been made already as some doctors and consultants visit TCI often at the hospitals and are able to administer some of the procedures locally.
Before I close, it is important that I explain the difference between NHIB and IHC as there seems to be a lot of confusion.
In my opinion the National Health Insurance Board serves three primary purposes, 1) the registration of individuals so that they can access medical care locally through the main local provider and the selected overseas providers, 2) the collection and payment of funds. NHIB collects funds from employers for their employees and then use those funds to pay for medical costs locally and overseas and 3) the management of overseas treatment abroad.
Interhealth Canada on the other hand is the local provider of medical services to the people of the Turks and Caicos Islands. NHIB and IHC are two separate institutions and are managed separately.
I wish to stress that NHIB is not the problem, the cost of providing health care locally and overseas is the problem. The challenge for the new Government of TCI, is how much are they willing to fund the cost locally and overseas and are they willing to reduce the benefits offered to patients.
NHIB is helping to pay for the local and overseas medical costs and so NHIB is not the problem. The only new cost that has occurred as result of the introduction of NHIB is the administrative cost that I have already mentioned above.
Politicians should not interfere in the running of statutory bodies. Even Board members should not be responsible for the day to day activity of a board. The role of the politician with respect to the Board should be to implement policies and providing funding.
I have provided you with facts, not hearsay.
Drex Seymour
UNITED AIRLINES INTRODUCES NEW ROUTE TO PROVIDENCIALES FROM WASHINGTON D.C.
United Airlines will introduce a nonstop flight on Saturdays from Washington D.C. to Providenciales, starting December 17th, 2016. Originating via the Washington Dulles International Airport (IAD), the seasonal flight is expected to be offered until April 29th, 2017.
The Washington Dulles International Airport (IAD) is one of the three major airports in the Baltimore-Washington metropolitan area, serving more than 21 million passengers a year. The new service now totals four United gateways to the Turks and Caicos, providing easy access for potential visitors and adding further convenience with more space, more comfort and more service.
Anticipating the new service, the Turks and Caicos Tourist Board recently partnered with United Airlines on a familiarization trip to the destination, “In an effort to ensure maximum exposure for the destination, we invited United to provide us with 20 of their top producing travel agents to experience the Turks and Caicos with hopes that the selected agents would better sell the destination and our many attributes to their clients,” said Pamela Ewing, Regional Marketing Manager.
Ewing continued, “The agents experienced not only Providenciales, but also North and Middle Caicos and our many wonderful natural and historical sites. The agents had a wonderful time and are better equipped to promote the Turks and Caicos.”
United Airlines also commenced their seasonal nonstop flight from Chicago (ORD) to Providenciales, as of mid November. United Airlines currently offers nonstop flights from Newark (EWR) and Houston (IAH) to Providenciales as well.
VW prepares a blitz of trucks and EVs in North America
Volkswagen AG is going on the offensive in North America, challenging the likes of General Motors and Ford Motor Co. with a wave of new light trucks and battery-powered cars.
VW’s namesake marque will expand its range of SUVs, crossovers and sedans and start making electric autos in North America in 2021 in a bid to “evolve from a niche supplier” into a successful mainstream carmaker in the region, the company said today.
“We will be significantly stepping up our activities in the U.S.A.,” VW brand chief Herbert Diess said. “Our goals are high and our strategy is very ambitious.”
Even before the diesel scandal, Volkswagen struggled to extend its dominance in Europe and China to the U.S., misreading American tastes for large, affordable cars. VW’s rollout of SUVs that appeal to American consumers came late, and the company was slow to follow up a bigger, cheaper version of the Passat sedan with other models. Now, VW plans to increase its global SUV/crossover lineup to 19 by 2020 from two currently and become profitable in North and South America by then.
The North American push is part of a sweeping overhaul to improve profitability at VW, one of the auto industry’s least efficient brands. Under the new strategy, the German carmaker’s biggest unit plans to more than triple its profit margin to 6 percent and increase sales of electric cars to 1 million vehicles per year by 2025. Efforts to boost the margin are critical as Volkswagen faces at least 18.2 billion euros of fines and repairs in the wake of the emissions crisis.
To help cover those damages and the cost of developing battery-powered and self-driving technologies, VW reached a landmark agreement with workers last week, to cut as many as 30,000 jobs worldwide and slash 3.7 billion euros of expenses. The electric-car transition will be funded in part by eliminating more than 2.5 billion euros of costs by scrapping underperforming conventional models, while the annual investment budget will remain stable at about 4.5 billion euros, the company said.
Volkswagen shares were little changed at 120.40 euros at 1:11 p.m. in Frankfurt trading, bringing the loss since the emissions cheating was revealed in September of last year to about 25 percent.
VW’s main marque, which accounts for nearly half of the group’s sales, was already struggling with bloated production costs and convoluted management before the diesel scandal came to light. Burdened by its free-spending past, productivity at VW is 30 percent below its peers and the carmaker spent 60 percent more per vehicle than Toyota Motor Corp. over the past three years, Exane BNP Paribas estimates.
VW currently assembles the Jetta sedan, the Golf hatchback and the Beetle in a factory in Puebla, Mexico. Its only factory in the U.S. is in Chattanooga. Globally, Volkswagen plans to sell as many as 3 million electric vehicles per year across all its divisions.
“Over the next few years, Volkswagen will change radically. Very few things will stay as they are,” Diess said. “The electric car will become the strategic core of the VW brand.”
Kanye West taken to LA hospital following disturbance call
Kanye West has been taken to hospital following an emergency services call, media reports say.
A police spokesperson told the BBC they had received a "disturbance call" on Monday afternoon, but did not name the singer.
The disturbance was later deemed a medical incident, he said, and the fire department responded.
A spokesman for the LA Fire Department said an unnamed man had been taken to hospital for "further assessment".
"At 13:20 Pacific Time, the Los Angeles Fire Department responded to an unspecified medical aid request," a spokesperson for the service said.
"An adult male described as medically stable was taken to an area hospital for further assessment."
West's wife Kim Kardashian West was photographed getting off a private jet at Van Nuys Airport in Los Angeles a few hours after he was taken to hospital.
Further details of the incident naming West varied in conflicting reports from multiple news sources.
NBC News said officers had been responding to a "medical welfare call" and the decision to hospitalise West was for his own health and safety, citing "multiple authorities familiar with the case".
Gossip website TMZ said that West was taken to hospital for "psychiatric evaluation" and had been seeking treatment for "severe sleep deprivation".
The Los Angeles Times reported that there had been a 911 call from the address, citing a fire department source.
Neither West nor his representatives have made an official statement about the incident.
Source-BBC
Malware is making ATMs 'spit cash'
A Russian cybersecurity firm has issued a warning about a spate of remotely coordinated attacks on cash machines.
Hacks of banks' centralised systems had made groups of machines issue cash simultaneously, a process known as "touchless jackpotting", said Group IB.
The machines had not been physically tampered with, it said, but "money mules" had waited to grab the cash.
Affected countries are said to include Armenia, Estonia, the Netherlands, Poland, Russia, Spain and the UK.
But the company declined to name any specific banks.
Dmitriy Volkov from Group IB told the BBC a successful attack could net its perpetrators up to $400,000 (£320,000) at a time.
"We have seen such attacks in Russia since 2013," he said.
"The threat is critical. Attackers get access to an internal bank's network and critical information systems. That allows them to rob the bank."
Two cash machine manufacturers, Diebold Nixdorf and NCR Corp, told Reuters they were aware of the threat.
"They are taking this to the next level in being able to attack a large number of machines at once," said senior director Nicholas Billett, from Diebold Nixdorf.
"They know they will be caught fairly quickly, so they stage it in such a way that they can get cash from as many ATMs as they can before they get shut down."
A recent report by Europol warned of the rise of cash-machine-related malware, although it said "skimming" - using hardware to steal card information at the machine itself - was still more common.
"The new method is being done by somehow gaining access to the banks' central systems and infecting whole communities of ATMs simultaneously, hence multiplying the amount of money that can be stolen in a short time," said Surrey University's cybersecurity expert Prof Alan Woodward.
Because criminals were collecting the cash in person, it made the crime more difficult to trace, he added.
"The classic way of solving online financial crime is to 'follow the money' - but when you can no longer do this, it is very hard to find out who is behind it, even though the evidence suggests it is a very limited number of groups that have started perpetrating this type of crime."
Source-
French heir finds $3.7m gold hoard underneath furniture in house
A Frenchman who inherited a large house from a relative has found an astonishing 100kg (220lb) haul of gold hidden under the furniture.
The unnamed heir discovered the glittering hoard in a variety of inventive locations, including under piles of linen and in the bathroom.
"There were 5,000 gold pieces, two bars of 12kg and 37 ingots of 1kg," auctioneer Nicolas Fierfort told AFP.
The treasure is worth an estimated €3.5m ($3.7m; £3m).
Mr Fierfort said he had visited the house in Evreux, Normandy, to value furniture the new owner was selling.
He said he totally overlooked the gold, which was "extremely well hidden".
The coins and gold bars only came to light when the house's new owner started moving things around.
First, he found a tin box of coins screwed to the underside of some furniture.
Then came more, carefully concealed in a box meant for a bottle of whisky.
Finally, the man unearthed a staggering pile of gold bars and ingots.
"At that point he called his solicitor to make an inventory," Mr Fierfort said.
According to certificates found in the deceased's estate, the gold was legally purchased in the 1950s and 1960s.
It has already been sold on to buyers in France and overseas.
However, local newspaper La Depeche, which first reported the story, said the golden hello may come with a sting.
The finder will be liable for 45% inheritance tax and, if the original owner did not declare his or her assets, a further three years of back taxes.
Source-BBC
Trump Opposes Clinton Prosecution, Reversing His Campaign Taunts
U.S. President-elect Donald Trump said Tuesday he has no intention of pursuing more investigations of Democrat Hillary Clinton and her use of a private email server while she was the country's top diplomat, despite his vow during their lengthy race for the White House to put her "in jail."
"I think it would be very, very divisive for the country," Trump told reporters and editors at The New York Times. "My inclination would be for whatever power I have on the matter is to say let's go forward. This has been looked at for so long, ad nauseam."
Pressed whether he had definitively ruled out prosecution of Clinton for her handling of national security material in her emails when she was secretary of state, Trump said, "It's just not something that I feel very strongly about. I don't want to hurt the Clintons, I really don't," referring to his defeated presidential foe and her husband, former President Bill Clinton. "She went through a lot and suffered greatly in many different ways."
Some U.S. investigators have sought to continue their probe of the Clintons' foundation and allegations that foreign donors made large contributions to the international charity in hopes of currying favor with Clinton while she headed the U.S. State Department from 2009 to 2013. Trump said some people could argue that the foundation did "good work."
In months of campaign appearances, the Republican Trump attacked Clinton's handling of national security material in her emails, with his cheering supporters shouting, "Lock her up!" Trump repeatedly referred to her as "Crooked Hillary" and, at one point, said that if he were elected, he would name a special prosecutor to investigate her.
Hours before the president-elect offered his views at the newspaper, Kellyanne Conway, now an adviser to Trump after serving as his campaign manager, told the MSNBC network that "he doesn't wish to pursue these charges."
In her interview, however, Conway said, "I think Hillary Clinton still has to face the fact that a majority of Americans don't find her to be honest or trustworthy, but if Donald Trump can help her heal, then perhaps that's a good thing."
A directive from Trump to U.S. law enforcement officials that he does not want to pursue another investigation of Clinton would be unusual. In the United States, federal law enforcement officials are considered to be independent of political interference from the White House.
Conway, however, said, "I think when the president-elect, who's also the head of your party, tells you before he's even inaugurated that he doesn't wish to pursue these charges, it sends a very strong message, tone and content" to fellow Republicans.
"Look, I think he's thinking of many different things as he prepares to become the president of the United States," she said, "and things that sound like the campaign are not among them."
Clinton's use of the private server based in her New York home played a central role in the election. Surveys showed that many voters doubted Clinton's explanations about the tens of thousands of emails she sent or received while she was the country's top diplomat and questioned her trustworthiness and honesty.
Clinton said she used the unsecured server on a single mobile device, rather than a more secure government server, for her convenience. Clinton said it was a mistake, but that she had not knowingly sent or received classified material in the emails.
Source-VOA
3 dead in Panama rains linked to Tropical Storm Otto
Civil defense officials in Panama say the country has already seen three deaths blamed on late-season Tropical Storm Otto.
The agency says two people died in landslides, and a child was killed when a tree fell on a car outside a school in Panama City.
Panama announced Tuesday it was cancelling classes it began to release water from locks and lakes feeding the Panama Canal.
Otto is gained strength in the Caribbean and could become a hurricane soon as it heads for a possible Thursday landfall in Costa Rica or Nicaragua.
The US National Hurricane Center in Miami says the storm has top sustained winds of 70 mph (110 kph) and is stationary about 260 miles (420 kilometres) east of Limon, Costa Rica.
Source-AP
Panic behind Windies meltdown
Batting coach Toby Radford said West Indies were guilty of panicking in the late stages of their Tri-Nations Series clash with Zimbabwe last Saturday, which resulted in the tied game at Queens Sports Club.
West Indies seemed en route to an uncomplicated victory in pursuit of 258 in their second game of the tournament when they reached 220 for two in the 45th over.
However, they lost six wickets for 37 runs in the space of 32 balls — including three wickets in the last over with four runs required — as Zimbabwe forced their way back into the contest to earn a share of the points.
“We needed 60 runs with eight wickets in hand [at one stage], and nine times out of ten you’d expect the batting side to do that,” Radford said.
“I think a little bit of panic set in, which is easy when you’re away from home and there’s a noisy crowd. To be fair, they (Zimbabwe) actually bowled well and took the pace off on what was a slow-ish wicket.”
He added: “There were big boundaries and we made a made a couple of good strikes to keep us in with a chance of winning, and I think after we got into that position it was just a case of knocking the ball around, but one or two [players] sort of panicked under the pressure and then we ended up with the tie rather than the win which we probably deserved.”
The run chase had been expertly guided by novice Shai Hope who carved out 101 off 120 balls in only his second One-Day International, and opener Kraigg Brathwaite who struck 78 from 117 deliveries.
Together they put on 162 for the third wicket, a stand which put the Caribbean side in pole position to take victory.
“I thought it was outstanding. [They were] both great innings in a wonderful partnership… to set up the potential win,” Radford noted.
“We’ve talked about seeing the 50 overs in blocks of 10 and that there were certain rates we wanted to go at to keep up with Duckworth/Lewis. There were a bit of rain clouds around and we thought it could come down to Duckworth/Lewis, and also we just wanted to break it up so players knew what kind of rate to bat at.
“I thought both were exceptional; they rotated the strike really well. When bad balls were there, they put them away. There are two really talented young players who played as well as they could play.”
Despite the result, Radford said West Indies were doing all the right things and needed to remain consistent for the remainder of the tournament.
“I think we’re playing good cricket. There are a lot of positives to be taken from [the game] as disappointed as we were not to cross the line, having played so well,” the Englishman said.
“We know we are playing good cricket; we had a good win against Sri Lanka a couple of days ago … We have to keep doing these things, keep doing the basics well, keep pinning sides down in the field, and making it tough for them to score.”
He continued: “And in terms of batting, [we have to] set up the innings. I thought what was very good with those young batters (Hope and Brathwaite) was that they paced it well, didn’t go too rash early on, and got us into a situation where, to be honest we should have won.”
West Indies face Sri Lanka here tomorrow in their next game.
Source-CMC
TCI Shines Schools’ Big Bin Competition
Look out litter critters! The TCI will soon be scattered with beautifully decorated bins to keep our islands Beautiful by Nature. The Ministry of Tourism, Environment, Gaming, Heritage and Culture, in collaboration with TC Crystal Pure, Karam & Missick Attorneys at Law, the Turks & Caicos Islands Tourist Board, the Turks & Caicos Hotel and Tourism Association (TCHTA) and the Department of Environmental Health will be initiating the TCI Shines Schools' Big Bin Competition on 21 November, 2016.
The initiative, which will see every school on every island decorate a large plastic drum to be used as a garbage bin, is part of Tourism Environment Awareness Month, and hopes to create awareness, at schools and within the local community, to ensuring a cleaner, healthier environment for us all.
"I am excited for the Big Bin competition, as I am certain our students' talent will shine bright. This is a wonderful initiative and one that should continue as we promote cleanliness for a healthier environment, not only for our tourism industry but for generations to come," said Hon. Porsha Stubbs-Smith, Minister of Tourism, Environment, Gaming, Heritage and Culture.
Every school on every island will receive one, TC Crystal-sponsored plastic drum and a set of criteria. The three most creative drums in each category, namely Primary and High school, will stand a chance to win some exciting prizes for their school! The competition will kick-off with eight Provo schools, who will display their completed bins at the annual TCI Shines Clean-up, at the Bight Park on December 3rd, 2016.
"We are excited to have TCHTA's TCI Shine develop to include this year's Big Bin competition, making it more accessible and easier for individuals to dispose of their litter. We look forward to the support of each individual to take advantage of the bins that will be strategically placed around the Island in an effort to keep our Island "Beautiful by Nature".......as we all remember "Tourism is Key....it starts with ME!!," said Stacy Cox, TCHTA's Executive Director.
No entry fee is required, however all schools are to participate and will be required to submit three photographs of their drum, including a photograph of the location where the drum has been placed, by the closing date on March 1st, 2017.
The Ministry would like to thank Mrs Johanne Karam and Mr Lorell Ewing for their volunteerism and collaboration. Mrs Karam has, over the last year, tirelessly collected and stored enough drums to ensure that all schools can participate in this exciting initiative. Mr Lorell Ewing, owner of Perfect2Us Arts, and a son of the soil, artfully decorated a drum to provide students with inspiration for their entries.