Government foots $73M medical bill for uninsured Caymanians

The Cayman Islands government paid almost $72.7 million to cover healthcare costs of uninsured indigents, veterans and seafarers in 2022 – $39.7 million more than had been originally budgeted for the year.

Lawmakers signed off on the additional funding at a meeting of Parliament’s Finance Committee last week, during which legislators called for urgent action to be taken to combat the ever-increasing drain on Cayman’s coffers.

Former finance minister Chris Saunders, noting that the 2021 Census data showed 93% of the population has health insurance, asked how it was possible that the 7% uninsured individuals on island could be costing almost $73 million a year.

He added, “Does anyone honestly believe that after spending $200 million a year or thereabouts on health insurance premiums, now the taxpayers of this country still have to go find $73 million?”

Finance Committee, which is made up of all members of the House, approved two line items relating to medical expenses by uninsured or under-insured Caymanians – one for healthcare costs within the Health Services Authority system, and a second, much larger, one for medical care either overseas or in non-HSA facilities on island.

Just over $21 million was spent within the HSA, while $51,658,911 was spent overseas or in other clinics and hospitals outside the HSA system. The original budgets were $12 million and $20.9 million, respectively.

Querying the more than $30 million unbudgeted extra spent on overseas and non-HSA care in the “infamous” line item known as NGS 55, Red Bay MP and former premier Sir Alden McLaughlin noted that funding for these costs have long been “chronically underbudgeted”, but added, “I don’t know if I’ve ever seen it be such a divergence from the original budgeted sum.”

According to the latest Strategic Policy Statement, the amount spent by government for healthcare in overseas institutions and outside the HSA last year was $12.7 million more than was spent in 2021, when the cost was $38.9 million.

Health Minister Sabrina Turner told legislators at the 7 June Finance Committee meeting that there had been a 16% increase in the number of indigents last year, and another 4% increase so far this year, as well as an increase in the size of claims, due to rising healthcare costs. COVID-related expenses also played a part in the escalating costs, she said.

‘Indigents’ are those who do not have a healthcare plan or who have exhausted the benefits under their policy.

Saunders, in his comments on NGS 55, called for the Cayman Islands Monetary Authority and the Health Insurance Commission to look into private health insurance companies that are not covering the levels of healthcare for which their members are paying premiums.

“We have had many situations where we know that people out there have these health insurance plans that are absolutely no good when an emergency comes up,” he said. “They have to turn to the [Needs Assessment Unit], they have to turn the HSA, simply because their insurance is no good.”

In those situations, he said, the government ends up having to pick up the tab of the medical care.

“We have insurance companies in this country that need to be shut down,” he added. “And until we have that honest conversation, we’re going to be struggling, this generation and future generations…

Both CIMA and the Health Insurance Commission need “to start looking at some of these companies and shut them down. They’re taking money from people [for policies] that have absolutely no use and the taxpayers of this country are saddled with it. And until we deal with that elephant in the room, we’re going to be having this discussion every single Finance Committee.”

Premier Wayne Panton, who chaired the committee meeting, acknowledged the rising healthcare costs that government was paying for indigents, seafarers and veterans, as well as the repeated underestimation in annual budgets for those costs throughout various administrations over the year.

“It is indeed a continuing challenge – one that we must meet, I think, through a variety of initiatives to the benefit of our people and to the fiscal security of the country going forward,” he said.