By Trudy Simpson, Staff Reporter
SEVERAL DOCTORS in Kingston, St. Andrew and St. Catherine are angry over their exclusion from the list of health insurance providers mandated by local insurance companies to accept health cards from patients.
They have written to the Fair Trading Commission (FTC), calling on the regulatory agency to investigate the issue of provider selection, the criteria for which have not been disclosed.
The FTC is now probing the issue, but is holding back on comment, pending completion of investigations.
According to the doctors, who are backed by the Medical Association of Jamaica (MAJ), all medical practitioners should be included as health insurance providers once they have been duly registered by the Medical Council of Jamaica. But only a handful of registered medical practitioners islandwide is included, they complained.
The FTC had written to the MAJ on November 5, advising of the complaints and asking the association to provide information to help its investigation.
In response, the MAJ, while unable to verify how many of the 2,000 local doctors were health insurance providers, suggested that the doctors' non-inclusion and the failure to declare the criteria, could be considered "arbitrary."
Evona Channer, FTC economist, confirmed the complaints on Friday, but is awaiting completion of the investigations to say whether the doctors' claim is valid.
The Gleaner requested a copy of the requirements from Blue Cross of Jamaica, the largest health insurance provider, but was told that officials would not feel comfortable handing it over until the vice president in charge of that area returns to office.
Dr. Henry Lowe, president and chief executive officer of Blue Cross, denied that selection of providers was "arbitrary", stating that Blue Cross sets international standards, and that there were reasons for the exclusion of some providers.
"We send out to inspect facilities making sure they are up-to-date. We (also) make sure that people are properly qualified and so on. Then we have a medical relations council, where all the health care officials sit and they assist us in assessing individuals," he explained.
Dr. Lowe added that some providers could have been rejected "because of qualifications, malpractice or some people at the time were not on (our system) because we couldn't cope with any new people. We had reached saturation point because of the manual-to-manual programme, but now that we have the automated (electronic card-swiping) system, we have opened it up and everybody who is qualified, meeting the criteria in a variety of ways will be looked at. So we are not leaving out people again, now that the capacity is here to deal with them."
Blue Cross of Jamaica, which has 1,100 providers islandwide, 500 of which are doctors, is at loggerheads with many doctors and other providers over its introduction of the Provider Access System (PAS), an electronic card-swiping system to replace paper health cards.
Only 20 doctors have gone on board so far, with the others, among them some of the MAJ's 650 members, resisting the move.
Dr. Errol Daley, MAJ president, said the doctors felt the system would burden them with additional investment of more than $100,000 to install a computer and card-swiping machine.
In February they complained that they would be forced to also pay a licence fee on each renewal of the contract with Blue Cross and Advanced Integrated Systems (AIS), the suppliers of the computer software.
Also, each time a patient pays a medical bill using the swipe card, the health professional will have to pay to AIS a 1.75 per cent processing or transaction fee.
Victor Anderson, the Blue Cross vice president in charge of PAS, says that more practitioners would accept the system as dialogue continued and Blue Cross addressed the concerns.
