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The National Health Insurance scheme (or NHI) is a proposed form of National health insurance established by the Government of the British Virgin Islands through the Ministry of Health, with a goal to provide access to and financial coverage for health care services to British Virgin Islands residents. The scheme is based on two fundamental principles:〔 # payments are shared based on ability to pay, without worrying about health risks such as age, occupation or pre-existing health conditions; and # healthcare benefits are equally available to everyone. The scheme is to be administered by the Social Security Board of the British Virgin Islands. The Deputy Director with responsibility for the scheme is Mr Roy Barry.〔(【引用サイトリンク】title=The National Health Insurance Team )〕 The primary legislation relating to the scheme was implemented by amendments to the Social Security Act (Cap 266).〔Social Security (Amendment) Act, 2014. (【引用サイトリンク】title=Volume XLVIII (2014) )〕 At present the scheme is scheduled to come into effect on 1 January 2016,〔 although on many occasions previous deadlines for commencement have been missed or pushed back. ==History== the British Virgin Islands Health Services Authority provides approximately US$6.6 million worth of services annually, but only receives about $1.8 million from patients. The shortfall is paid principally by the Ministry of Health and the balance is either written off or allowed to roll over as uncollected debts by the BVIHSA. Public health care is also effectively subsidised by pricing services at a level which is deliberately set below the actual cost of providing the care.〔 User fees are estimated to recover just 8% of the operating costs of primary and secondary health care services.〔(【引用サイトリンク】title=Health Systems and Services Profile for the British Virgin Islands )〕 As a result the net expenditure on health accounts for approximately 17% of total government expenditure.〔 Attempts to reduce the strain on Government by increasing the cost of services have proved to be politically controversial. To address the chronic shortfall, the Government proposed devising an National Health Insurance scheme to essentially pass most of this cost on to employed persons and the businesses that employed them. The Ministry of Health developed the supporting operational framework and legislation, in consultation with the University of the West Indies Health Economics Unit.〔 The proposed scheme was first suggested in approximately 2006.〔 Whether by coincidence or design, this was approximately the same time as the Government embarked an ambitious rebuilding project in relation to the main Government hospital, Peebles Hospital. The new hospital has been a financial disaster for the Government. It was originally budgeted at approximately US$10 million, and expected to take just under 2 years to construct. In the event, the hospital cost well over US$100 million to construct, and took over a decade. It also costs a further US$16 million to furnish to become operational.〔(【引用サイトリンク】title=New hospital finally completed; Health Minister appeals for donations )〕 by 2012 public debt had quadrupled from pre-2007 levels to approximately US$113 million (approximately 10.3% of GDP).〔(【引用サイトリンク】title=National debt grows by $73M over last decade; public sector too big – Financial Secretary )〕 Nearly 84% of that public debt was attributable to the new public hospital project,〔(【引用サイトリンク】title=New hospital responsible for nearly 84% of national debt )〕 exacerbating budget stresses. The proposed NHI scheme is seen as a way of alleviating the cash-drain caused by underwriting public health expenditure. Initial budgets provided for the scheme to raise approximately US$22 million,〔 leaving the Government still funding a balance of approximately US$8 million. However, the proposal remains controversial amongst the public, not least because - in blunt terms - it amounts to effectively a 7.5% increase in taxes.〔Total tax revenues for the British Virgin Islands for 2014 were US$302 million (); the NHI levy is budgeted to raise US$22 million, or approximately 7.3% of annual Government revenues.〕 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「National Health Insurance (British Virgin Islands)」の詳細全文を読む スポンサード リンク
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