The Samoa National Provident Fund’s Medi-Insure is ambitious, and with the projections that have been made, it could be the answer to the nation’s health woes. But it needs laws governing it, some questions still need to be answered and above all a referendum is needed.

It needs to be put to the people and only implemented when the majority agree for it to move forward. Yes, it could improve access to health for all people who are SNPF contributors and their dependents but the money belongs to people. You cannot dip into someone else’s pocket without their permission and use their wealth.

The SNPF will take $300 each from the contributors who have enough funds in their accounts making a total estimated contribution of $8 million. The government and the Accident Compensation Scheme are expected to provide $20 million. The start-up for Medi-Insure would be $28 million. It would be even more if dependents were covered.

In the last financial year, the Ministry of Health budget was $156 million, of this $6 million was for overseas medical treatments. The $6 million only provides coverage to limited people. Under Medi-Insure, we may get to see more people get overseas treatment with airfares paid. Medi-Insure also requires the government to spend $20 million extra each year.

But wait, aren’t insurance companies in Samoa doing the same already? Over the years, the SNPF has shifted its focus from its primary role as the retirement fund to becoming a bank-like financial institution giving out loans and now in another move, it is becoming an insurance company where the premium will be compulsory whether the contributor wants to subscribe or not.

Projections are that income in 2025 for Medi-Insure would be around a little over $100,000 and then the projections are for an annual income after expenses to be roughly over $2 million annually. Then in the long term, the profits would lead to the construction of a new hospital perhaps in a decade or two down the line.

It seems like the whole process is being rushed as if a paper has already been submitted to the cabinet who on behalf of the people will say go ahead and use the funds. This is not government funds, this is money that belongs to the people and they need to have a say and the only way to do this is through a referendum.

There are a lot of things that need to be in place before Medi-Insure can be implemented. As the SNPF chair has stated Medi-Insure will be run by a separate body with its own sets of rules, a body which is yet to be set up. Laws are not made in a day, in Samoa’s case, these things take time. Are we to expect the implementation of the healthcare scheme without the guidelines? The laws are important because they will ensure transparency, accountability and good governance.

The laws are needed to ensure that the funds are protected and used for the purpose it is intended if the scheme is to go ahead. There has to be a safety net protecting the funds from abuse.

The healthcare scheme’s motives are not bad. It aims to make healthcare affordable to almost everyone but would it be feasible for people who do not spend less than $300 a year on medical costs? Most people are asking if they would be refunded the balance of their money minus the amount they would have used once they retire. People are also not in favour of getting little benefit from the scheme if they do not get sick. The idea of a fully-paid overseas trip at any time needed sounds good but then again would there be a board sitting and scrutinising who can go and who cannot?

The other concern is that most treatment would take place at the deteriorating hospital. While private clinicians would be covered under the scheme, they too refer all lab tests, radiography, admission and surgeries to the hospital. The hospital and its equipment need upgrading

Get a referendum done to find out how many contributors want to be part of this. That would be the right thing to do. Forcing people to be part of Medi-Insure without consent is undemocratic and almost dictatorial. It is also daylight robbery.

Do the right thing by the people, if people agree, then go ahead.