Prescription for a healthier Cayman: More competition

No government should compete with, show favoritism toward, or otherwise pick winners and losers in the private sector.

That principle extends to our government’s relationships with the country’s private physicians and the emerging Health City Cayman Islands medical facility in East End.

Last Friday, the Cayman Compass ran a front-page story on seemingly stalled discussions, involving the Cayman Islands National Insurance Company and elected ministers, over the potential referral of public hospital patients to Health City for treatment.

There are two considerations here, one less controversial than the other.
The first involves possibly sending patients to Health City rather than U.S. hospitals in an effort to reduce the cost of those overseas referrals.

The Compass’s position mirrors a statement made by Health Minister Osbourne Bodden in the Legislative Assembly in June. He stated that decisions to send patients overseas or to Health City should be based on relative costs. Minister Bodden said, “The better option will be used. As Health City is just getting going, it’s hard for me to say that their [price] is over or under, but I can only imagine in the end that local care is cheaper.”

From a public finance and public health perspective, Minister Bodden is absolutely correct that the government should choose whatever provider, wherever, that offers high-quality, lowest-cost services.

The second issue deals with whether CINICO should consider sending patients to Health City that it currently refers to healthcare providers already on-island. This, as you may imagine, is being met with some displeasure from local practitioners currently getting business from government.

This Editorial Board has a number of concerns about issues raised in correspondence between CINICO chief executive Lonny Tibbetts and Finance Minister Marco Archer, specifically this paragraph from Mr. Tibbetts:

“The authorization and/or support of a referral to [Health City] for services already available locally presents all of us with a number of dilemmas. This will likely result in displeasing the existing local provider[s] and possibly causing irreversible damage to longtime relationships.”

With all due respect to Mr. Tibbetts, CINICO’s remit is not to protect local healthcare providers but to secure high-quality services for its clients at the best possible price to taxpayers – just as Minister Bodden articulated in June. Whether that’s at Health City, the Cayman Islands Hospital or a local clinic should make no difference at all.

Rather than signing exclusive agreements with Health City, or any on-island provider at the expense of another, CINICO should offer standard, public, reimbursement fees based on the particular services rendered, with individual patients (or, when appropriate, their supervising physicians) deciding which provider they prefer.

We’ve heard protestations that the government has already “de-leveled” the playing field by granting economic concessions to Health City (lower work permit fees, etc.), with the understanding that Health City would not compete with local providers.

If public officials didn’t want Health City to compete with local providers, they should have codified that legally, à la Cayman Enterprise City. In the absence of legal stipulations, any talk from Health City to the contrary should be viewed as just public relations.

If Health City is able to out-compete other providers for business, by providing better, more efficient services at lower costs, the biggest beneficiaries will be a healthier population – and a healthier public treasury.

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  1. The Shetty Hospital development has touches of the theme of the movie Field of Dreams – build it and they will come Unfortunately, so far they don’t appear to have fulfilled that dream, so – let’s try Plan B. Make it the default health care provider for the government health insurance provider. Accepting that CINICO is something of a Health Insurance Provider of Last Resort the idea does smack a bit of moving the industry goalposts.

  2. Dear Mr. Editor,
    Lets be real about Health City. THe unfortunate situation is that Obamacare threw a wrench into the Health City plans to get more Americans here and to increase medical tourism. When Obamacare got passed and bit a hung chunk out of Health City plans then they are running around now trying to get CINICO to give them business. I say leave CINICO out of it. If CINICO must provide coverage for the civil service their largest clientele to go to Health City, then let’s be really real and I would support CINICO offering Property Insurance, Auto Insurance to their large clientele of civil servants and see exactly how the other insurance agencies is going to deal with that decision. Gene Thompson is an overzealous business man, a Caymanian just like me and he should have had a better plan. Do you know that every DOctor at Health City CI has their licenses approved in protest from the Medical and Dental Association? Well I read the minutes and that is what it is. I would not be going to a hospital whose Doctors licenses are approved in protest from a board that found that their qualifications are below industry standards of the Cayman Islands. Please get off CINICO’s back, they have the best CEO in history of the Cayman Islands. I suppose my post is too supportive of CINICO and cynical of Health City and won’t be posted like all the others.