Health Minister Anthony Eden has foreshadowed big changes to the way healthcare is funded in the Cayman Islands, warning the present system will cripple government if left unchecked.
Speaking prior to the legislature’s summer recess on Friday, Mr. Eden said it was not realistic for health facilities to provide free services any longer.
‘If we continue to be reliant on the current healthcare model it will cripple the Government financially,’ he said.
Noting that the cost of healthcare was rising, both within Cayman and abroad, Mr. Eden warned, ‘we cannot sustain these increased demands and expectations, while at the same time providing a healthcare system that is subsidised at the present levels by the Government. It is simply not sustainable.’
Mr. Eden did not outline any specific new plans to address the looming crisis he described. But speaking with the Caymanian Compass after Finance Committee, Mr. Eden said he expected Chief Secretary of the Civil Service, George McCarthy, would be looking at a co-payment model for government employees.
‘It’s not sustainable; there is nowhere in the world you can go and get 100 per cent coverage as the civil servants here do.’
A diminished reliance on overseas healthcare is also essential, he said, because its cost is increasing between 15 and 20 per cent a year.
Part of this may include finding new alternatives to sending patients to North America. Many uninsured and under-insured Caymanians requiring overseas care are already sent to Jamaica when possible; on 28 May, CINICO CEO Gordon Rowell said CINICO is looking at a referral program to Cuba.
Though it is not realistic to provide free services any longer, Mr. Eden said services must be affordable.
He warned that the burden shouldered by the healthcare system would only worsen as the population continued to age. ‘Healthcare expenditure per person dramatically increases with age … our over 60 population is large and growing. Everyone must be mindful of this fact, because this will significantly impact our national resources in the years to come.’
According to Mr. Eden, other causes for the mounting cost of healthcare include:
- An increased demand for services – health care consumers expect every expensive new treatment to be instantly available to them, he said;
- The cost of drugs and treatments, which have increased far in excess of global inflation rates; and
- The higher expectations of healthcare consumers, owing to their better education about healthcare options.
Mr Eden also spoke of the need for a healthcare model that is prevention focused. He called on citizens to take a more active role in preventing illness and to recognise that if people do get sick, it will cost money.
Mr. Eden defended the job being done by the HSA, arguing that many people had unreasonable expectations.
‘People often complain about the healthcare services, but tell me the last time anyone was denied access to one of our hospitals, as is commonly experienced in the United States?
‘Have any of our people waited a year for an appointment as they sometimes do in Britain and Canada?
‘The answer is most certainly no.’
Mr. Eden expects some people will say that change to the current system is unnecessary. These people, he claimed, are the same people that will argue that the HSA doesn’t need to increase fees, and that those fees are already too high.
Mr. Eden’s comments came after Finance Committee passed an annual operating and finance budget of $484 million for the Government. Almost $84 million of this will go towards the Ministry of Health and Human Services, including $11.28 million for projected HSA operating losses.
On 28 May, HSA Acting CEO Lizette Yearwood told Finance Committee that government bail-outs for the HSA will be a thing of the past by July 2009.
She outlined a three year plan that includes a 10 per cent across-the-board fee increase for HSA services, new charges for services that were previously free and improved efficiencies within the authority.
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