Already burdensome health insurance costs are spiraling out of control – as many readers know from personal experience. Last week’s Public Accounts Committee review of recent Cayman Islands Monetary Authority reports quantifies just how out of control it is.
In the 2015/16 fiscal year alone, while health insurance premiums paid by private sector employees and employers soared, earnings for private sector health insurers nearly quadrupled – rising from $14 million in 2014 to $51.5 million by December 2015.
As Bodden Town West MLA Chris Saunders noted during last Wednesday’s PAC meeting, CIMA’s annual reports document significant increases in earnings for the health insurance sector going back to at least 2011 – when the sector’s earnings totaled around $4 million – although none of those were nearly as significant as the change during 2014-15. Troublingly, more recent data about premiums and earnings were not presented to the committee.
Why not? In all matters economic, 2015 is ancient history. Statistics that old are more appropriately relegated to the shredder when analysts do their spring cleaning. Certainly they are not reliable to understand current circumstances.
And so we must ask: Do up-to-date figures exist? If they do, where are they? If they do not, why not?
Health Insurance Superintendent Mervyn Conolly told the PAC the Health Insurance Commission finds premium increases “disconcerting.”
“Disconcerting?” What does that mean? – “Unacceptable … troubling … bamboozling … surprising?”
Mr. Conolly needs to be far more forthcoming about what is taking place in our health insurance markets under the regulatory eye of the commission he heads.
After all, the government forces employers and their employees to purchase health insurance coverage. That mandate, of course, creates a huge captive body of consumers for a relatively few – nine – insurance providers.
Therefore, it is incumbent that the regulator, well, regulates. It must ensure that the favored providers are acting reasonably, relative to both premiums and profits. Government must also ensure that enforcement is applied equitably and consistently and without any hint of favoritism. We are still dismayed that cases of “non-contributions” by some businesses to their employees’ healthcare plans have been in the courts for years – one is approaching a decade!
All of this, of course, is in the context of the private sector. Government employees receive so-called “free” healthcare, meaning they make no contributions to offset the cost of their premiums. (This is doubly vexing to those in the private sector since they are paying not only their own ever-increasing premiums but also those of the “free riders” in the civil service.)
The cost of healthcare, including insurance costs, has driven many families, companies and, yes, countries over the edge into penury. The problem becomes infinitely more complex when governments start “mandating” coverage with little consideration of how their “mandates” will impact the budgets of families and the companies that employ them.
Cayman, may we suggest, needs to do a comprehensive holistic examination of its healthcare delivery model.
If we were in charge of such an exercise, our first call would be to perhaps the world’s leading champion (and practitioner) of delivering high-quality healthcare at drastically lower and realistic costs: Dr. Devi Shetty.