Health insurers have agreed that most Jamaicans do not know enough about the health benefits offered under the insurance policies they hold, and that more needs to be done to improve awareness on these matters as a way of upholding citizens’ rights to accessing the best public healthcare possible, especially among expectant mothers.
This was the consensus coming out of a recent meeting between representatives from the ‘Partnership for the Promotion of Patients’ Rights in Maternal, Neonatal and Infant Health (MNIH) in Jamaica’ project, and representatives from the nation’s two biggest health insurance providers, Sagicor Group and Guardian Group, as well as the Insurance Association of Jamaica (IAJ).
Convened by the Women’s Resource Outreach Centre (WROC) and University of the West Indies (UWI) – both responsible for implementing the European Union-funded MNIH project – the meeting was in response to complaints that pregnant women face tremendous pressure from having to make upfront payments for treatment and then reclaim the sum from insurance companies.
MNIH project team leader Professor Wendel Abel had noted that the upfront payment policy could possibly jeopardise women’s rights to the highest attainable standard of health, and expose them to the risk of less-than-favourable pregnancy outcomes.
NOT A BURNING ISSUE
However, sharing the findings of a small indicative study conducted by WROC, he noted that respondent females seeking prenatal care did not consider prepayment to be a burning issue.
Supporting this point, findings from investigations carried out by the IAJ highlighted that many pregnant women see paying out of pocket for prenatal care as a way of saving their insurance allotment to help with the more burdensome costs related to actual delivery, explained Orville Johnson, IAJ executive director.
He also revealed that only a quarter of Jamaica’s population and a third of the workforce have health insurance.
In 2017, health insurers paid out $154.7 million for maternity benefits, and between 2014 and 2016, one per cent of overall benefits were paid out for maternal care.
Johnson said that already, work is being done to build awareness around health benefits, especially those relating to maternal health. He noted that some health insurers have already begun to implement strategies for policyholders and providers to have a better understanding of their plans and how to make claims. It was also noted that one of the major players in Jamaica’s health insurance sector was in the preliminary stages of examining the feasibility of switching from the upfront payment system.