When our minds are in top form, they tend to turn to the “big topics.” When it comes to the future viability of countries, there is perhaps no single larger issue than healthcare.
This is certainly true in the Cayman Islands, where our public health insurer CINICO (aka the Cayman Islands National Insurance Company) expends more than $90 million on an annual basis, plus tens of millions of dollars more for medical emergencies locally and overseas, to pay for healthcare for about 15,000 people, including civil servants, pensioners, seafarers, veterans and the poor.
On Monday’s front page, we reported that Cabinet has approved an “equity investment” of an additional $4.53 million for CINICO so that the insurer can maintain an adequate level of capital to conform with regulations issued by the Cayman Islands Monetary Authority.
As East End MLA Arden McLean and Bodden Town MLA Chris Saunders noted during the debate in the Legislative Assembly, CINICO’s depletions of capital and Cabinet’s concomitant transfusions of cash occur on a regular basis. It’s now become more a matter of routine than emergency. Meanwhile, as Mr. Saunders pointed out, CINICO’s losses are occurring as private sector insurers have earned more than $100 million in profits during the past four to five years.
At this point it may seem somewhat obvious to observe that something is seriously wrong with Cayman’s healthcare system generally, and with Cayman’s public health insurer specifically.
The last time CINICO made headlines in the Compass, it was after CINICO’s appointed Board of Directors summarily terminated the employment of ex-CEO Lonny Tibbetts, who had served in that position for eight years. Neither at the time or since has any public official given any reason, explanation or clarification as to why Mr. Tibbetts was fired, beyond “information which recently came to the attention of the Board of Directors and which has been investigated” …
Aside from lingering inquiries about Mr. Tibbetts’s departure, there are many questions about Mr. Tibbetts’s successor, chief among them being, “Who is it?”
Who is in charge, right now? Who is running CINICO?
In the grander scheme, on numerous occasions over the years we have published warnings, in the form of government’s own estimates, of Cayman’s increasingly exorbitant public healthcare liability of $1.7 billion over the next 20 years. Nothing, to our knowledge, is being done to prepare for that – certainly not the economically elementary (but politically risky) step of passing on some healthcare costs (in the form of premiums, deductibles or copayments) to individual civil servants on CINICO’s plan.
In the Legislative Assembly, Finance Minister Roy McTaggart said his ministry and CINICO are preparing an analysis of CINICO and its operations and “whether what they do continues to be fit for purpose.”
The easy response is “No, of course not” – but that would be answering the wrong question.
Far more relevant for our country’s future is this:
- How should healthcare be delivered in the Cayman Islands?
- How do we afford it?
That is what’s vexing large nations across the globe.
Perhaps we are overly optimistic, but we think it is entirely possible for this small and wealthy jurisdiction not only to address the issue of healthcare long term, but in doing so provide an inspirational example for the rest of the world.
If officials share our vision for creating a model healthcare system in Cayman, their first order of business should be to make one very important phone call – to Dr. Devi Shetty, founder and chairman of India’s Narayana Health, including Health City Cayman Islands – and to listen to what he has to say, and to take meticulous notes. The Compass will even pick up the long-distance charges.