Insurance firms drive-up health costs
(CNS): MLAs reluctantly voted for massive amounts of public money to cover the healthcare costs of those that are not properly covered by the private sector of government’s own insurance firm Monday. Alongside the millions of dollars that government pays for overseas healthcare for the poor and elderly, local healthcare costs and bad debt at the Cayman Islands Hospital are also in the millions because of issues such as inadequate cover, deductibles and the refusal of insurance companies to cover some patients.
Ezzard Miller in the LA (Photo by Dennie Warren Jr)
Government expects to spend almost $11 million on care for the indigent and a further $2 million on medical care for Caymanians who need treatment beyond their insurance or for those not properly insured. This is on top of the more than $11 million that will be spent on overseas healthcare cost and tertiary care.
During Monday’s Finance Committee hearing, Marco Archer, the minister of finance and chair of the committee which will approve the government’s spending plan for the 2015/16 financial year, umpired as questions flew across the Chamber to Premier Alden McLaughlin, who is now health minister, about the massive amounts coming out of the public purse to plug the gaps left by insurance firms.
Ezzard Miller, the independent member for North Side, described the cash government has to come up with because of the system and the way insurance firms can cherry pick their customers, as well as the still inadequate provision of the standard health insurance cover, as “astronomical”. He said government was essentially subsidizing insurance firms and it had to address the system that is allowing insurance companies to choose who they do and don’t cover and for what.
The MLA pointed to the inadequacies of the basic cover people get and the problems of enforcement when it comes to employers who don’t provide proper cover or pay the premiums.
McLaughlin said it may be time to look at the standard health insurance cover or SHIC plans again but he reminded members that it was only changed three years ago and that any increase in cover would lead to an increase in premiums.
“There is no free lunch available anywhere and some entity is going to have to pay for whatever is provided,” the premier said, adding that health insurance issues are a challenge the world over.
In his capacity as health minister, McLaughlin said the SHIC was designed to be the basic plan to cover most of the needs of most of the people most of the time but it not comprehensive coverage.
“If we need to provide additional cover, it is going to cost everyone more and government has to find a balance,” he added.
As well as dealing with the numerous shortcomings from the SHIC plans, the elderly and the indigent, the hospital is still dealing with bad debt as many bills for visitors, work permit holders who have left or others have not been paid.
The premier said, “We must do a better job at reducing the level of bad debt and pursue non-payment more aggressively than has been the case in the past.”
The chief officer in the ministry, Jennifer Ahearn, told the committee that with the introduction of the improved SHIC there is a decrease in the number of patients that receive treatment but the insurance simply does not cover what the patients need. She said that with the introduction of administrative fines, compared to the past practice of having go to court, the relevant authorities would be able to react more quickly to enforce the law and deal with rogue employers not paying the premiums for staff.
McLaughlin said that government needed to do a much better job tackling the mental health problems of its people and that was why the ministry was pressing ahead and exploring the cost of a mental health care facility. He also noted that this was another area that presented problems with insurance firms, which do not want to offer mental health coverage.
Although some cover is now in the SHIC plan, it is a lifetime maximum of just $25,000, which he described as inadequate and another element in the discussions government is having is to plan the future of mental healthcare in the Cayman Islands. He said that the inadequate cover meant the Health Services Authority is picking up the tab for those patients currently in long-term residential facilities in the United States and Jamaica.
Category: Health, Medical Health, Mental Health
This country is a circus run by clowns. As a Caymanian, I wish I could get the hell as far away from this festival of fools as I can. In this damn place you have pay double and triple for every last thing, all the while the thieving politicians and their cronies double and triple dip their salaries and pensions, on top of their free health insurance. Sick of this old place now.
It is all a domino effect. People who do not have to contribute anything towards their healthcare coverage (in public or private sector) tend to abuse the system, running to the doctors and getting tests done without thinking twice. Plenty doctors (not all) abuse the fact that they can charge ridiculous amounts for a 5-10 minute visit (usually more so done by “specialty” doctors). Insurance companies keep hiking up their coverage because they can. Much funding is needed to pay for civil servants treatment overseas – can’t blame them because if something is seriously wrong with you, GT hospital is likely to send you home telling you that you just have gas. But why does the government have to also pay for plane tickets and hotels for the patient AND the person accompanying the patient? If I opt to go overseas (which I can on my very good and very expensive coverage), nobody pays for my flights, car and hotel.
while the CS do not pay for their health insurance, calling it gold plated is a complete fabrication as its awful.
On the private sector side, you pay extra to have your family covered and for a wife and 2 kids that can be 1,500 a month out of your wages
Exactly what is awful about the CS coverage. It can’t be the lifetime max which is many times the average in the private sector, nor the complete absence of co-pay and annual deductible, or the lack of restriction of any claim to the limits set out in the legislated fees schedule , nor the unlimited mental health coverage, or unlimited air fares to the U.S. for treatment including unlimited hotel expenses.If I have omitted any gold plated benefit please let me know.
look at the average number of sick days taken for the average civil servant compared to a private sector employee. The only reason can be the terrible healthcare they get is the reason they are so often out sick
No mention is made that every employee in the private sector is required to contribute to Government for medical coverage for the indigent yet as far as I’m aware this does not apply to civil servants who pay absolutely nothing for their gold plated coverage. $25,000 life time maximum for mental health care is a joke, our very own George Town hospital charges over $500 a day for residential treatment, so the lifetime allowance will last for less than 50 days!!.
I wonder who the dissenters work for?.
What drives up costs too is doctors asking which medical insurance you have and then when they know you are covered requesting unnecessary testing.
The system is broken. Why should we be paying US insurance prices in Cayman?
Medical insurance in Panama is $us 200 per month and covers its citizens anywhere in the world? Why don’t we buy their insurance instead?
That seems a sensible suggestion to me
Why is it that top quality treatment for major medical issues in Cuba and at most 1/5 the cost of the same here, plane ticket included? Private healthcare here is in league with the self regulated health insurance industry and the generally healthy pay through the nose for those who live on junk and lead unhealthy lifestyles, while seldom needing more than a checkup or teeth cleaning every year.
Both sides exploit the situation for maximum profit, push the prescription drugs like jelly beans, sometimes prescribe unnecessary surgery over non-invasive therapy, and play “that’s not covered, you owe us more” with the patient. All this while the regulatory void continues and both sides rub their hands together as the money is printed, it’s legal extortion at it’s best and no change in sight.
more civil service incompetence….. read miller shaw or e&y reports!!
What in the world has that copy/paste, right wing infomercial got to do with providing adequate health care coverage, especially for services to the mentally ill?
If we’re going to effectively be a socialist welfare state, can we at least jettison some other big ticket expenses like the national airline and Mac’s turtle playground?? Sheesh……how to bankrupt a nation.
WTF do we continue to grant and renew work permits to businesses who we KNOW do not provide health insurance for their staff?
And why the f### do we subsidise that small minority of caymanians who aren’t even looking for a job..
Ah yes 8:41, because some of those businesses are providing a valuable service to the immigration big wigs and their friends that grant their permits. And that service is in the form of eye candy that typically comes in fresh from Latin America every 3 months, but that’s another story….