RESUMEN
In the Bahamas, a group of staff physicians, the Physician Alliance, proposed the privatization of selective health services in the public hospital, to provide universal access and availabiltiy of "modern" health care services at an affordable cost. The initial project outlined for the physician group to provide capital funds to establish and manage an Ultrasonic diganostic facility. Charges for procedures would reflect the government's subsidy of its public institution; reduced costs for procedures, differential fees for public patients and procedures, to be performed at no charge to the indigent patient. The hospital would provide the physical site, utilities and excise duties in the purchased equipment. Net profits were to be shared equally between the Hospital and the Physician group. The Physician Alliance provided an initial capital fund of US$86,000. The first year financial audit revealed fixed assets of $300,000. The one-year revenue of $270,000 yielded a 20 percent return to the physician share holders. The cost providing diagnostic services to indigent patients accounted for 7.4 percent of total revenues. The hospital, in addition to its profit share, collects 7 percent in management fees. Funds were allocated also for physicians to attend training courses in relevant diagnostic procedures and non-physicians to pursue certification courses to become ultrasound technicians. The privatization project is being expanded to include endoscopic equipment and an operating room surgical suite; capitalization projected - $800,000. We believe that selective privatization has advanced health care delivery in the public institution; simultaneously it has fostered physician involvement in the hospital's strategic planning and implementation of patient-related heath care services (AU)