The On-going Debate over Healthcare Reform The public debate over healthcare reform. which the Nassau Guardian alone stirred up several weeks ago is at a curious point. It seems that the government's so-called Blue Ribbon Commission has already decided what plan it will propose without undertaking any public consultation and is now merely engaged in a PR campaign to convince us they have the answer. This seems a little head over heels to us. Since it is our money and our health that is in question, shouldn't we have been consulted at the break about which way we want to go? There are several models to achieve healthcare reform, and not all of them require us to hand more money over to keep government bureaucrats in big offices. Purely private healthcare may have big problems—but so does the socialised medicine the commission is recommending. For example, Canada's universal system of socialised medicine is now busily engaged in transferring costs from the public to the private sector… by reducing covered expenses, by deinsuring some expenses and so on. Medical authorities are on record as saying that in an effort to manage costs, hospital stays are being shortened (or even dispensed with altogether). So while we in the Bahamas are citing universal 'free' health care as the answer to our problems, in Canada there is an uncoordinated scramble by the public system to reduce and offioad the effects of rising health care costs. And we won't even mention the litany of complaints from users who have to wait for poor service. But what mostly concerns us about the Blue Ribbon Commission is that they have plumped for social health insurance without determining the cost of their recommended programme, or of the alternatives. And they do not seem to have taken into account the impact this plan will have on the fiscal deficit or on our individual pockets. Apparently, the position is that whatever the cost, this is the plan that will be presented to parliament. An initiative so far-reaching and so potentially damaging to our economy, should require more careful assessment of the alternatives in public. There is always more than one way to skin a cat. And we do not believe that a small group of consultants constitutes 'the public'