Figures suggesting Cayman health insurance providers are making annual profits in excess of $50 million may have been overstated, new data from the Cayman Islands Monetary Authority shows.
CIMA’s original figures for 2015 showed a $51 million profit for local health insurance companies – a statistic which helped ignite a debate over major healthcare reform, potentially including a national insurance system.
Now CIMA has revised its reporting method and republished the statistics, showing that the eight local Class A insurance companies actually made profits of just under $11 million from Cayman customers in 2015.
The original figures included profits from overseas business. For multinational companies like Generali and Aetna those figures can be quite large, creating a skewed picture of the Cayman Islands position.
CIMA’s new data shows local profits fluctuating between $5.6 million and $16.4 million between 2012 and 2017.
Annikki Brown, country manager for Generali in Cayman and the chairperson of industry group the Health Insurance Standing Committee of the Cayman Islands Insurance Association, said she hoped the new figures would shift the focus of the debate on the future of healthcare in Cayman. She said the debate so far had been based on the ‘false impression’ that insurance companies were making excessive profits off Cayman Islands consumers.
“The number that has been thrown around by politicians and pundits to date is $51 million in profit for the year 2015.
“These have been inaccurately represented to the public as being made off of the Cayman population of about 60,000 people. Today we have CIMA’s re-stated numbers pointing to the domestic health profit for that year of $10,546,353.”
She said the figure, which is a cumulative profit for eight different companies, did not represent an excessive amount in an industry where costs are high.
Brown said there was no evidence that a government-run health insurance system, without the efficiencies, innovations and economies of scale used by private insurers, would be able to replicate that profit margin. She said switching to a national health insurance system could end up costing the country money.
Brown added that the CIMA figures show national insurers paid out more than $129 million in claims in 2015, with expenses of over $14 million – a burden government would also take on in a national insurance system.
“If the Government’s [intending] to look into a socialised healthcare system, they need to keep in mind that the expenses will also be shifting to the government. I’m not sure that the actual domestic profit will make it worth it.”
Brown said private insurance companies were able to make cost savings through innovations like Employee Assistance Programs and wellness schemes. She said nationalising health insurance was unlikely to be an effective means of controlling healthcare costs.
“That is not the piece that is broken and it really wouldn’t do anything for government costs.”
She said there were better ways to address the gaps in coverage, such as insurance for elderly and unemployed people, that were costing government millions each year.
She said the insurance sector was willing and interested in working with government to help plug those gaps.
The $51 million figure first surfaced in a Public Accounts Committee hearing last year. Opposition legislator Chris Saunders questioned how profits had jumped to such an extent.
“What is happening?” Saunders said, “I am really uncomfortable seeing … profits jumping up in one year on the backs of the consumers of this country.
“Bear in mind, this is 2015 numbers we’re looking at … I dread to see the numbers for 2016, 2017.”
The $51 million figure has been quoted on numerous occasions in subsequent debates about public healthcare reform.
Saunders did not respond to requests for comment for this story.
Premier Alden McLaughlin has been among a number of politicians to suggest support for a national health insurance system.
Government recently opened a request for consultants to review its health insurance company, CINICO, and present an outline business case for the future of the public company. One of the options on the table is to make the Cayman Islands National Insurance Company the sole provider for all Cayman Islands residents.
CIMA commented on the data reporting on its website, stating, “Historically the Authority reported aggregate statistics for all Class A licensees providing health insurance. In an effort to present statistical information in a form that is more meaningful to its users and audiences, the Authority has made a decision to report health insurance figures of Class ‘A’ insurer licensees’ separately under two categories, namely, “domestic health” and “international health”.
“Domestic health reports figures pertaining to health insurance coverage offered to persons who are ordinarily resident in the Cayman Islands, whereas International health reports figures pertaining to international health insurance coverage offered to persons residing outside the Cayman Islands, but through Cayman Islands based companies.”