Should the Cayman Islands expand government health insurance to everyone, as Premier Alden McLaughlin told lawmakers last week? Of that, we are not sure.
But there is no question that something must be done to stop the out-of-control growth in government’s healthcare obligations and expenditures. Our current path is simply not sustainable.
We urge Cayman’s leaders to think creatively and enlist the help of from experts to find a solution before it is too late.
Already this year, government has blown through the $10 million earmarked for emergency healthcare expenses at tertiary institutions for people who cannot otherwise afford it. This week, lawmakers approved another $11.3 million to cover such medical expenses for this group, which includes the elderly and other medically indigent people who are uninsured or underinsured.
We would not be surprised if government was asked to make another significant cash infusion to this pool before the year is over. Last year, government spent more than $30 million on this purpose — three times what they had initially budgeted. So far, this year’s spending seems to be running apace.
Officials say that a growing number of people have been relying on this pool of money, including many older residents who cannot afford private insurance premiums on modest pensions. Health Minister Dwayne Seymour and chief officer Jennifer Ahearn advised that the ministry has been working on a solution – perhaps in the form of a targeted and subsidised insurance program for Cayman’s senior citizens – but have thus far been unable to devise a program that would be suitably priced.
Even if they were to reach a ‘magic number’ that would make comprehensive coverage affordable, it would address only one aspect of an increasingly troubling picture. At every turn, Cayman’s healthcare expenditures are running amok.
Take, for example, government’s ballooning unfunded healthcare liabilities for current and retired civil servants – estimated at $1.7 billion over 20 years (in current dollars) in 2017.
Last spring, Financial Secretary Ken Jefferson told the Public Accounts Committee that, left unchecked, he envisions these obligations reaching “hundreds of millions of dollars” per year in the not so distant future — “overwhelming the government’s budget”. Still, our leaders have been unable to make even the most modest changes to rein in this runaway train.
Then there are the unpaid bills owed to the Health Services Authority, most residents’ primary healthcare provider, which at one point exceeded $100 million.
That’s not to mention the ever-escalating costs of private insurance and the public health system’s unhealthy dependence on charity to provide essential technology and equipment. Just by examining these few ‘symptoms’, it is clear our health system is critically ill.