(CNS Elections): How to pay for the cost of healthcare is a major headache for all countries, large or small. In the US, the promised repeal of “Obamacare” is proving much harder for President Donald Trump than he thought, because millions of people who are now covered under the Affordable Care Act could be left stranded with no way to pay for their medical bills. On the other side of the Atlantic, Britain is struggling to maintain the National Health Service, where treatment is free for all.
Here is Cayman, the current system of mandating private insurance through people’s employer has left certain groups in a precarious position, such as retirees, who lose their health insurance just as they need it most, and people with a pre-existing condition, who are charged exorbitant fees.
If people actually claim on their insurance, their healthcare costs can go up dramatically, not just for that person but for all their co-workers on the same plan. This means that not only do people with health problems have to constantly worry about medical bills but they might also find it harder to get a job, since small businesses especially may be reluctant to take them on as it will make insurance for all their staff unaffordable.
When the Cayman Islands National Insurance Company (CINICO) was first launched during the first UDP administration, the promise was that it would start with coverage for civil servants and indigents and then later be extended for all. This never happened. CINICO does not even cover all public servants, as each government company and statutory authority is free to chose its own insurance company.
So now the situation is that the private insurance companies largely cover the working healthy population of the Cayman Islands, while in addition to civil servants, the government covers the old and the sick.
But CINICO can also terminate the insurance for people on its basic plan, the Standard Health Insurance Contract (SHIC), if they miss one payment. “If a Participant fails to pay premiums within 30 days of the due date or the policy lapses for any reason not authorized, the Participant’s policy will automatically be terminated.” So theoretically, someone who loses their job due to ill-health and is struggling to pay their bills can also lose their health insurance.
On the other hand, a government-funded healthcare system that is free for all is open to abuse, over-use and could implode due to the weight of funds needed.
During the last election there was very little discussion about health insurance. However, Opposition Leader McKeeva Bush has opened the door for serious discussion during the upcoming General Election (see Health insurance costs come under political fire). It remains to be seen if candidates and parties can outline detailed solutions to the issue — and how to pay for them — as well as point out the problems.
Healthcare insurance costs are often not thought about until people get sick, and then if they are unable to pay, the results can be devastating. Unlike Trump, however, most people understand that this is a complicated topic and the electorate should be looking to the candidates for viable solutions.