Medical care insurance: the approach in developing a health insurance plan in the Caribbean - Part 11

ABSTRACT

For the effective financing of private and government medical services in the Caribbean, the basic needs are a prepayment scheme with a comprehensive health service for all persons, adequately trained personnel, satisfactory hospital, health centre, clinic and office facilities. In order to determine the magnitude of the financial problem involved it will be necessary to carry out income, welfare and hospital utilization surveys. The service to be provided would include general practioner and specialized care in office, home or hospital with laboratory and X-ray diagnostic services, hospital costs in ward or semi-private beds, half the cost of medicines, preventive medical care, nursing maternity and rehabilitation service. There would be a free choice of physician but group practice in clinics would be encouraged. The administrative control would be shared equally by the users and providers of the service and the scheme would be organized by a voluntary non-profit organization approved by the Government. Large industrial, agricultural and commercial organizations would be expected to co-operate by paying half of the health insurance contributions of their employees. To provide an incentive to subscribe for those already receiving free medical care from Government clinics and hospitals, cash benefits for accidents and sickness, old age pensions and death benefits would be introduced. (AU)