Health Care and Insurance on Dominica

One of two American medical schools in Dominica

Medical care and health insurance in Dominica bears a surprising resemblance to the current system in the United States. There is no universal health care system, and the government is only marginally involved.

Many people are covered by health insurance partially or wholly funded by their employers. This option is usually limited to larger companies - for example, the island-wide cable and wireless company Lime offers a plan to its employees, but smaller businesses do not.

People who work for these smaller companies or are in business for themselves determine how much coverage they want and can afford. Coverage is available from commercial insurance companies. For younger people whose companies do not offer a health care insurance program, coverage can be more than they want to pay - policies can be had for as little as EC$80 (about US$35) per week. While that may not sound like much, pay scales are much lower in this small Caribbean nation.

The workings of Dominican health care insurance policies resemble those in the United States - there is a small co-pay, and a catastrophic cap in the case of long-term or high-cost treatments. One interesting difference is coverage for prescription drugs in most of the insurance plans. One major difference in system is the fact that government employees do not have government-funded health care insurance - these civil service workers must purchase their health care on the commercial market.

In general, the concept of health care insurance is relatively new. Many, maybe most, Dominicans simply do not buy coverage. When they need medical care, they go to a doctor or hospital and pay the bill. Medical care in Dominica is much less expensive than in the United States as a percentage of income. However, when the required care is not available on the island and patients must travel abroad for care, paying for it becomes an issue.

Most Dominicans we talked to did not express any desire to change what they have now.

Rick Francona