Bahamas Cancer Patients Deal - Public Hospital Authority Accused Of Conflict
The Public Hospitals Authority is being accused of involvement in a questionable arrangement with local insurance companies that could put a Bahaman facility out of business.
Some medical professionals are also criticizing the Authority for what appears to be a conflict of interest situation.
The PHA has offered local insurance companies a special deal whereby it will pass on the 50 percent discount it gets from Mount Sinai Hospital in Miami, Florida if those companies agree to pay in full the treatment cost of private cancer patients.
For many years, Princess Margaret Hospital and the government have been referring indigent cancer patients to the Miami hospital for radiation and chemotherapy treatments.
The cost of these treatments per patient varies from $20,000 to $50,000, but Mount Sinai has an agreement with the PMH and the government to provide the treatment at a discounted rate for public patients who have no insurance.
The PHA wants private patients to also benefit from the same arrangement, which is expected to result in savings to local insurance companies.
One medical professional said Monday that what the PHA was doing was "collusion, unethical and wrong."
But a PHA official said, to the contrary, the Authority was seeking to protect patients in desperate need of care.
Philip Greenslade, financial controller of the PHA, said the intention is to ensure that private patients who are burdened with making co-payments still have access to high-quality health care. He said private patients who may not be able to come up with these co-payments could face an early death.
"There was nothing bad or fraudulent on our behalf," Mr. Greenslade stressed.
In a letter to Imperial Life Financial dated January 21, 2004, PHA's Chief Cashier wrote, "As a primary insurance carrier, we are hereby proposing that you cover the cost of private insured patients in full."
She continued that, "This will be both beneficial to Princess Margaret Hospital and the patient. For example, if a private patient covered under your insurance attends Mount Sinai for radiation and chemotherapy, [he or she] will be charged an average of $40,000."
The PHA proposes that Mount Sinai bill Princess Margaret Hospital for the private patients. PMH in turn will bill the insurance company, which will in turn pay 100 percent of the bill. PMH will then pay Mount Sinai.
Mr. Greenslade explained that by using the PMH arrangement to pass on the savings to insurance companies, PMH would in fact be fulfilling its mandate to look out for the best interest of all Bahamians in need of healthcare. As mentioned, the private patient would no longer have to come up with the co-payment, which is usually 20 percent of the bill.
"We will ensure that patients are able to receive service that will add years to their life," Mr. Greenslade told the Journal on Monday.
He said that it would also make "a lot of economic sense" for insurance companies to agree to this arrangement.
He also said that in putting forth the arrangement, the PHA was unaware that Radiation Therapy Services Limited had secured a license from the Bahamas government to provide radiation therapy for cancer patients.
The medical facility, located on Collins Avenue, was actually licensed the day before the letter to Imperial Life was written. The Journal has learnt that the Radiation Therapy Services has offered to give the PMH a 50 percent discount on radiation treatment for public patients, but has not yet been able to seal this deal.
The centre went into operation more than five years after the government closed down Oncology Associates Limited after it was found that deaths occurred among patients with curative diseases who were treated at that facility.
In a Bahama Journal story published February 20 on Radiation Therapy Services, Dr. Conville Brown, who heads the local team of professionals operating the facility, said, "The centre can be viewed as bringing first-rate American level medicine to The Bahamas while at the same time alleviating the need for most Bahamians to travel to the United States."
On Monday night, Dr. Brown said he was "too upset and frustrated to comment" on the situation at hand.