Eulalee Thompson, Health Editor
A concern is that after grade eight, PE (physical education) is not on the curriculum. We want to get back PE in schools. - Barrett
Today, we continue to spotlight those who have been nominated to receive the 2008 Gleaner Honour Award early next month at The Jamaica Pegasus hotel, New Kingston. In the category health and wellness, the nominee is the National Health Fund (NHF).
Rae Barrett had just ended a meeting when the usually urbane Rosemarie Lee, his public relations manager, ushered me into his New Kingston office.
"You are a very busy man," I said primarily to break the ice and to get the interview started amicably. He shook my hand, chuckled and showed me to the round, dark-stained wooden table in the corner of the office where all three of us sat for the interview. Large glass windows allowed in the gentle rays of the mid-morning sun, creating a pleasant space for the interview.
Barrett, the chief executive officer of the National Health Fund (NHF), has occupied the top job since the establishment of the health insurance scheme just over five years ago. Over that period, the NHF has enrolled about 380,000 residents with chronic diseases for big discounts on prescription drugs. The organisation also rolls out an intensive and engaging health promotion and disease-prevention programme urging Jamaicans to take responsibility for their health by eating properly, exercising regularly and doing frequent health checks.
With the accumulation of a large data base of health issues peculiar to Jamaica's population because of its enrolment reach, Barrett said that one of his dreams is to start facilitating the generation of local health information and statistics.
"We are hoping to do research using data on our population and to stop (quoting) this World Health Organisation," he said.
No doubt, it is the NHF's reach into the community which earned it a nomination for a Gleaner Honour Award in the health and wellness category. Fifteen chronic conditions (including cancer, diabetes, hypertension and other cardiovascular diseases, epilepsy, depression, psychosis, glaucoma, asthma, arthritis and prostate enlargement) are covered by the NHF which is financed through a tobacco tax, an NHF deduction and the Government's consolidated fund. The NHF makes a fixed payment towards approved prescription drugs. The beneficiary pays the difference.
Pillars of benefits
Barrett said that the organisation operates on three pillars of benefits. They are:
1) Individual benefits which assist individuals to meet prescription costs for specific illnesses. Every individual living in Jamaica, regardless of age or socio-economic standing, diagnosed with any of the chronic illness covered by the NHF, is eligible for coverage.
2) Institutional benefits provide grant funding for health projects to improve infrastructure, purchase equipment, for building and research.
3) Public information - The NHF channels a significant portion of its effort into health promotional activities such as the NHF's community days, health fairs and other sponsored events supported by its advertising and public relations programme. This focus on health promotion, with the aim of getting Jamaicans to take more responsibility for their health, takes on greater significance at this time in the country's health history when epidemiological studies show a shift in disease profile to the chronic lifestyle conditions such as cardiovascular conditions, diabetes and obesity.
Barrett pointed out that the organisation now participates in over 400 community-based activities each year and provides more than 40,000 screening tests, including checks for blood cholesterol levels, diabetes, heart checks (ECGs), mammograms, Pap smears, vision and hearing tests.
Concerns of special groups
In spite of NHF's sterling service to Jamaica, hardly anything can claim perfection. The stipulation that eligible residents have a tax registration number (TRN) to be enrolled have not gone down well with some subsectors such as the mental health community. Some mental-health professionals have always complained that patients who are psychotic, cognitively impaired, displaced and without identifications and other personal documents are in no state to apply for a TRN. Advocates like Dr Wendel Abel, head, University of the West Indies' Department of Psychiatry, have called for some relaxing of the stipulation for this group so that they can access the medication they need to get better.
Barrett, while familiar with the concern, was adamant that the NHF cards cannot be issued to residents who do not hold TRNs.
"Tax registration personnel have worked with (group) homes to help them get the TRN and institutional caregivers can do it for them (the patients)," he said.
Other groups and advocates such as those caring for patients with Alzheimer's disease, Parkinson's and lupus have also been outspoken in the past for not being included in the 15 conditions covered by the NHF. But, Barrett said that unfortunately, the NHF is not planning to do anything for these groups right now.
"We only cover 15 conditions. We do what we can afford to do. If we could afford to do everything, we would. It is about affordability. The conditions that we cover are the most prevalent ones. The mission of NHF is to reduce the burden of health care (and) the most significant (burden) are the chronic conditions. We looked at about 40 diseases and came down to 15, so it is not that we have anything against anybody, we can't do more than what the funds allow," said Barrett, while emphasising that the NHF is indeed a caring organisation and that the list of conditions covered will expand at some time in the future.
Expansion of coverage isn't the only future agenda item. The NHF has its eyes set on reaching out to young people in schools.
"A concern is that after grade eight, PE (physical education) is not on the curriculum. We want to get back PE in schools," Barrett said. He said also that the NHF would like to increase its focus on health screening for children, especially since chronic diseases are becoming more prevalent among children.
eulalee.thompson@gleanerjm.com.
How to apply for an NHF card
1. Collect an NHF application form from your doctor, hospital, health clinic, pharmacy or NHF head office.
2. Have your doctor fill in the applicant's illnesses and sign the card, including his or her doctor's registration number.
3. Fill out all the relevant sections of the card - name, address, date of birth, gender and your Tax Registration Number (TRN). If you do not have a TRN card, apply to your nearest tax office.
4. Mail or take the completed application form to the NHF's office.
5. An adult or a legal guardian must sign the application card for children under the age of 18.
