Cayman’s health insurance system remains in urgent need of reform, despite the revelation that private sector profits are much lower than previously thought.
That is the verdict of Opposition legislator Chris Saunders, who has led calls for healthcare reform in the Legislative Assembly.
Statistics from the Cayman Islands Monetary Authority showing an annual profit of more than $50 million for private sector insurers in 2015 had helped ignite the debate over healthcare reform.
Saunders, as a member of the Public Accounts Committee, was the first to question the spike in profits. More recently, he has been among several politicians, on both sides of the aisle, to call for a national health 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. CIMA’s new data shows domestic profits fluctuating between $5.6 million and $16.4 million between 2012 and 2017.
Saunders said this week that he was happy to have the figures clarified but disappointed that neither CIMA or the Health Insurance Commission had been able to explain the figures until now. He said the commission, in particular, should have been investigating the apparent spike in profits long before it was highlighted by the Public Accounts Committee.
“The best we can do as politicians is go by the public statistics,” Saunders said. “We need good information to make informed decisions and we have to be able to rely on the statistics we are given.”
He said the new information did not change his belief that reform is needed.
He said CINICO was taking all the high-risk patients while private insurers draw their customers from the healthy, working age population. He added that government was still left with a $50 million bill to fund care for the uninsured.
Saunders believes there needs to be a formula where the risk is shared over the lifetime of the employee, rather than people shifting from private to public insurance when they retire and are in greatest need of healthcare.
He said it was difficult for seniors to afford health insurance, with the price of a policy often more than the monthly pension.
He believes there are too many private insurance companies for such a small market and CINICO should be expanded to provide a basic insurance to all in Cayman, with the private sector then offering extras.
“The basic question we have to ask is, is healthcare a benefit or a right? If it is a right, then we have to make sure it is universal,” he said.