Healthcare premiums revealed
Cayman Islands taxpayers are footing nearly double the bill for retired civil servants when it comes to paying for health insurance premiums, the Cayman Compass has learned.
According to rates provided to the newspaper as part of a recent Freedom of Information request, retired pensioner rates under the Cayman Islands National Insurance Company plans go from $870 per month for non-married individuals, to $1,306 per month for non-married people with children, to $1,741 per month for married couples, and finally to $2,176 per month for the CINICO family plan.
Similar rates for working civil servants are $416 per month for single adults, $832 per month for married couples, $832 per month also for single adults with children, and $1,242 per month for families.
The reason retiree premium rates are so much higher, according to CINICO chief executive Lonny Tibbetts, is because insurance companies generally place retirees in “higher risk” categories for medical treatment.
Both civil service plans under CINICO have a $5 million maximum “lifetime limit” for healthcare coverage. There are no limits on prescription drug purchases, in-patient or outpatient care. Overseas accommodations and airfare, if the covered government worker or retiree must fly elsewhere to obtain treatment, are covered 100 percent.
Also, neither retired civil servants or active government workers are required to make co-payments, so the monthly premiums are funded entirely by the government.
According to an auditor general’s report released Tuesday, the government spent between $25 million and $29 million per year between 2010 and 2012 in up-front operating costs to support the government-owned Health Services Authority, which operates both Cayman Islands public hospitals, local health clinics and the George Town dental clinic.
In addition, provision of healthcare at overseas providers has cost the Cayman Islands government between $15 million and $17 million per year in each of the last three government budget years.
A government consultant’s report released earlier this year recommended a number of options to bolster the finances of the Cayman Islands’ public health system, including a requirement that civil servants shoulder at least some of the cost of healthcare premiums.
“Under this option, government employees will need to co-pay for their medical insurance,” the Ernst & Young evaluation stated.
The report also noted that CINICO is often the insurer of last resort, covering all residents in the Cayman Islands who are not offered medical insurance by private companies. In the view of CINICO staff, this allows the private sector to “cherry pick” low-risk healthcare clients while the government health system is forced to take everyone else.
The EY report noted that there would be “significant pushback” on any proposal to require civil servants to co-pay for insurance coverage.
Cayman Islands Civil Service Association President James Watler has maintained that civil servants might not object to paying their share of healthcare costs, but that they would likely want greater choice in medical providers.
Now, individuals covered by the CINICO health plan can use only government medical facilities. Most private doctors and medical clinics do not accept CINICO insurance.
Various government leaders and officials have noted in public statements over the years that “free” healthcare for civil servants is unsustainable. Former Health Minister Anthony Eden used that exact word in the Legislative Assembly during a 2009 debate. In 2011, Health Services Authority chief executive Lizzette Yearwood said some discussions were under way aimed at lowering CINICO’s costs.
“We cannot continue the way we are going; we have to do something,” Ms. Yearwood said at the time.