The amount government spends on funding healthcare for uninsured patients will continue to increase, a senior public health official warned Thursday.

Government initially budgeted just under $11 million in spending last year to pay for tertiary level healthcare for those classified as “indigent,” mostly unemployed people and seniors without health insurance. By the end of the year, those costs had escalated to $25 million.

Jennifer Ahearn, chief officer in the Ministry of Health, said that trend was likely to continue this year because of an increasing number of people being classified as indigent. She said the numbers in the program had almost doubled, from 1,000 to more than 1,700, in the last few years.

Government again budgeted $11 million for this expense for 2019.

Ms. Ahearn told the Public Accounts Committee Thursday that would not be enough.

“We know that is not going to be sufficient,” she said, “we are expecting we will be coming for a supplementary.”

She said government had sought to control costs by implementing a “Jamaica first” policy, meaning patients on the indigent medical care program that need overseas treatment are typically sent to Jamaica, where healthcare is significantly cheaper than in the U.S. Citing one cardiac case, she said officials were quoted a price of $250,000 from a South Florida hospital compared with $17,000 for the same procedure in Jamaica.

Asked if Cuba was also considered a viable option for patients who needed overseas treatment, Ms. Ahearn said it was down to CINICO, as the national insurance company, to build those kind of relationships. She said she was not aware of any current plans to partner with Cuban medical institutions.

Ms. Ahearn added that health officials sought to ensure that indigent patients still got quality medical care, despite cost considerations.

She said the real factor driving up costs was an increasing number of elderly people classified as indigent.

“One of the things we have to bear in mind is that the number of people in that group is continuing to increase. The vast majority are seniors.”

She said her ministry would look to collaborate with the Ministry of Community Affairs, which has also highlighted elderly people living in poverty as a key concern, on programs specifically tailored to this demographic. A report on a new standard health insurance contract for people over age 65 has been produced and will go to Cabinet in the next few weeks, she said. She acknowledged the expense of funding care for the elderly and unemployed would only increase without intervention. “It is certainly not going to decrease, unless there are some policy changes around who is accessing, what they are accessing and where they are accessing,” she added.

Ms. Ahearn’s appearance before the PAC Thursday morning followed on from an auditor general’s report highlighting healthcare issues in Cayman.

PAC is reviewing a report compiled by the office of the auditor general, examining government’s progress on its various recommendations.

On Wednesday afternoon, Chief Officer in the Ministry of Community Affairs Teresa Echenique, and Deputy Chief Officer Andre Ebanks were questioned over progress on reform of the welfare system.

Mr. Ebanks said legislation had been drafted to replace the “dreadfully outdated” Poor Relief Law with modern financial assistance legislation.

He said the new law and a new strategic plan for social assistance would signal a “sea change in how we approach this topic.”

Rather than simply administering payments, he said the policy would look at how to help people become less reliant on assistance. “We need to look at our people from a transformative standpoint to get them back on their feet.”

Consultation is taking place to craft the strategy right now and a draft version of the law is being circulated with a view to bringing legislation to the house late 2019, Mr. Ebanks said.

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