Bad debts a problem for public health

Consider the multitude of shortcomings in the Cayman Islands that could be resolved nearly overnight, if not for a want of funding: the George Town landfill, a shortage of ambulances, the abandoned youth remand center, mental health facilities, needed transportation infrastructure, the missing jetways at the new Owen Roberts International Airport, etc.

Now, consider this: Over the past decade, the Cayman Islands public healthcare system has failed to collect some $120 million in debts owed for services rendered. (That’s a lot of jetways!)

We have, in past editorials, commented on the continually accumulating bad debts at the Health Services Authority, which are accruing at a pace of about $15 million per year. We’ve pointed out that much of that probably has to do with the government’s conscious decision, in or around 2010, not to take healthcare debtors to court. From that moment on, HSA’s relationship with its debtors has been that of a humble suppliant. (That being said, a review of our Compass archives shows that the public hospital’s failure to collect debts is not a problem confined to recent years or even decades. See this article from October 2005.)

From a broader point of view, the government’s unwillingness or inability to collect the revenue it’s owed exacerbates the greater problem of government’s unwillingness or inability to cut down its excessive expenditures (such as overly generous entitlements for the civil service). The result is that Cayman’s public sector can’t seem to find the money it needs to provide basic services to the citizenry.

Take the example of the George Town landfill, or, more narrowly, the proposal to institute a mandatory recycling program in Cayman. That would require residents to “sort” their garbage into various categories: paper, plastic, aluminum … You know the drill.

Now, in a country where many people have still not gotten used to the notion that it is wrong to throw their trash out the car window, or for that matter, to dump truckloads of waste on the side of the road (or even in the midst of our “National Park” in Barkers) — there is no way that everyone is going to abide by new rules to deposit different kinds of trash in different bins, much less take different kinds of trash to different locations where special recycling bins are located.

Presumably, Cayman’s government — following the lead of other governments that pursue such policies — would “punish” non-recyclers by levying fines and fees for their non-participation, under threat of not collecting their garbage in the future. There is, of course, little chance that the government would make good on those threats … We imagine any such attempt would conclude with a household of voters placing a phone call with the relevant elected representative. Perhaps a strongly worded text message would suffice.

To those who would dispute our assessment, remember the recent revelation that ministry officials are currently pursuing outstanding garbage collection fees, some dating back more than a decade, totaling about $8.2 million.

Rather than messing around with “recycling” and other nice-sounding proposals that merely serve to distract residents’ attention from real problems (such as the continuing existence of the George Town landfill), we suggest that government focus instead on adopting its own strategy of “sorting.”

By that we mean unmuzzling the Treasury Department’s debt collection unit and “sorting” those debtors who “can’t” pay from those who simply “won’t” pay. If necessary, collectors should pursue the verified deadbeats through the court system.

While it is important for the government to collect the money that’s owed to it, it is equally imperative to identify the debtors who truly can’t afford to pay their bills, for accounting purposes, to maintain the integrity of the system and to ensure that the truly impoverished are receiving the assistance they require.


  1. Maybe the government thought people would line up to give their money to health care. People are people wherever you go and if you throw away money, people are only too glad to take it. As usual the problem is never dealt with and symptoms are treated instead. Refuse treatment and people will soon deal with their own issues.

    In the last number of years, the government and choose whichever one you want, has squandered away so much money, its simply unbelievable.The recent better than the world school is now nothing but bramble. Looks really good next to the previously propoesed hospital site.

    Throwing problems in a bag and hoping they will come out solved after you shake them is not really the way to run a government.

  2. the problem is bigger than just not collecting… you are letting people who owe a debt believe that not paying debts is okay because there are no consequences.
    After a decade or more of this you breed it a culture of a society with no accountability… this also is relation to the Cayman Development bank.

  3. You are really taunting me now with "(such as overly generous entitlements for the civil service)". Do you really think repeating this meme over and over again in your editorials, will make it a fact?

    The private sector needs to step up and match those "overly generous entitlements" rather than asking for a reduction to the lowest common denominator and consequently hurting (what is left of) the middle class.

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