Thanks to healthcare visionaries from the Cayman Islands, the United States and India, we can boast that our country is home to one of the Caribbean’s premier medical facilities.
Health City Cayman Islands is saving many lives, and improving many more. It is creating new career paths for Caymanians and bringing much-needed diversity to Cayman’s economy. And it’s just getting started.
It took years of courtship, negotiations and deal-making in order to attract Dr. Devi Shetty’s Narayana Health and U.S.-based Ascension to our shores; but now, it seems there are public officials who are doing their utmost to chase them away … in the name of (get this) “competition.”
Now, when anyone in government employs the word “competition” — as Health Services Authority Medical Director Dr. Delroy Jefferson did repeatedly during a recent hearing before lawmakers — we put up our guard. When they utilize it in the phrase “unfair competition,” we head for higher ground.
As we report in a news story in today’s Compass, Dr. Jefferson expressed concerns that Health City appears to be competing with local doctors for patients (against the hospital’s stated purpose as a medical tourism facility for international patients), and has an advantage due to duty concessions that other medical providers do not enjoy.
Since Dr. Jefferson broached the subject, let’s briefly discuss unfair advantages, specifically the ones that apply to HSA:
- Section 12: The HSA Law contains an “immunity” provision that prevents people from suing HSA or its staff (including physicians and nurses) for wrongdoing except in limited instances where “bad faith” can be demonstrated.
- Group insurance: The authority has corporate insurance that covers its doctors as a group, giving it superior leverage to individual private doctors.
- CINICO: The public insurance company funnels its policy holders, including thousands of civil servants, to HSA.
- Unpaid bills: The authority has failed to collect some $120 million in debts since 2005, in effect drawing a subsidy from the public coffers to the tune of $15 million per year.
- Public sector HR practices: The authority, like all public entities, operates under a different set of regulations than does the private sector, including work permits, pensions and healthcare benefits.
Need we continue?
Generally speaking, Dr. Jefferson may have a point about unevenness in the competitive landscape of Cayman’s healthcare environment. Here’s our proposal: Level the playing field, open it up to real competition, and see who’s left standing.
We mean exactly that. Any incentives and exemptions granted to Health City should be extended throughout the private medical sector. Health City doctors should be allowed to practice anywhere, and treat anyone, that other doctors can. Section 12 should be excised from the HSA Law. CINICO clients should be able to visit any physician of their choice.
Anyone who knows of Dr. Shetty knows that he has become world-renowned for providing the highest-quality healthcare to patients at the lowest possible cost. That is the model that Health City has adopted and HSA should be studying and emulating.
Specifically in regard to HSA, the government’s goal should be to empower the private sector to such a degree that it effectively puts the Cayman Islands Hospital out of business altogether — not to shore up an institution that is widely perceived to be inefficient, if not ineffective.
When it comes to the delivery of healthcare, the consequences of policies aimed at “protecting” local providers aren’t just damaging to the economy, they are potentially harmful to the health of the population.