LA passes HSA fee hike

The Cayman Islands Legislative Assembly voted in favour of increasing Health Services Authority fees by 10 per cent Friday, despite resistance from opposition party members.

The fee increase – the first for HSA services since 2002 – comes amid skyrocketing healthcare costs, estimated at eight to 12 per cent annually over the past four years.

‘Even with a 10 per cent increase, many of these fees will be well below the actual cost of the service,’ Health Minister Anthony Eden said.

He described the move as an interim measure, saying a new HSA charge-master still has to be introduced that will allow it to bill for about 4,500 services not included in the current listing.

Those services are effectively ‘un-billable’ and are currently provided for free.

The 10 per cent fee increase and revised charge-master were meant to come into effect on 1 July, 2007, but were put off because the HSA could not reconcile billing codes on the new charge-master with insurance industry codes.

If introduced on that date, the new charge-master and 10 per cent fee increase would have netted the HSA $22.78 million over the 2007/08 year, budget documents indicate.

Opposition resist move

The Legislative Assembly vote was approved seven to three, with opposition members McKeeva Bush, Rolston Anglin and Julianna O’Connor-Connolly voting against the fee hike.

Mr. Bush complained that LA members had only received a draft of the changes Tuesday, saying it wasn’t enough time to consider the proposal.

But Mr. Eden said he warned the house in a speech on 22 June, 2007 (See Caymanian Compass 25 June) that with the cost of healthcare outstripping inflation, changes would have to be made to ensure Cayman’s healthcare system remained sustainable.

‘We cannot continue the way we are going. It is simply not sustainable.’

Mr. Bush questioned whether the fee increase would put health services out of people’s reach. ‘Coming at this time, when the whole outlook of the world is not very good … is not a good time to increase fees of health services.’

He said Leader of Government Business Kurt Tibbetts had recently told a Chamber of Commerce event that there would be no new fees charged in this country. ‘Well, what are these?’ Mr. Bush asked.

‘I can’t see how we can be expected to come and say ‘yes’ to this today.’

Responding to Mr. Bush, Mr. Eden said the Cayman Islands Hospital’s CAT scanner is continually breaking down and said a new MRI scanner is needed. ‘We cannot move forward unless we have the proper diagnostic equipment,’ he said.

The fee increase, coupled with a new charge-master, will put the HSA one step closer to financial independence, Mr. Eden said.

‘It is critical that government allows the HSA to charge the appropriate fees for services delivered.

‘However, until fees are brought in line with operational costs and the Authority is able to resolve its deficit, the government will continue to provide subsidies to the HSA to balance the cost of delivering sustainable healthcare to our nation.’

Mr. Eden did not say when the 10 per cent increase will come into effect or when the new charge-master will be introduced.