CICSA not accepting co-pay on health
Finance Minister Marco Archer in the LA, 28 April 2016
(CNS): Claims by Finance Minister Marco Archer that a decision has been made to have public servants pay part of their healthcare insurance by 2018 were refuted Tuesday by the Cayman Islands Civil Service Association. CICSA President James Watler said that his members had not been consulted or informed about any decision regarding co-pay and the last talks on the matter were derailed. However, speaking in the Legislative Assembly last week, Archer said the issue “was a given” and it was in the hands of the ‘Project Future’ unit, which was working out the how and when of the policy change.
In a letter to the civil service membership, dated 3 May, Watler said the association was as surprised as any of its members to hear that they will have to start paying a portion of their healthcare premiums. He pointed to previous “unproductive, discussions”, adding that if everyone was not involved in discussions, they would continue to go nowhere.
The issue of public servants co-paying for their health cover was raised by the minister as he answered a question from North Side MLA Ezzard Miller about extending cover by the government-owned insurance company, CINICO, beyond the Health Services Authority. Archer said government had examined that possibility but said that it would ultimately prove more expensive for government and risked undermining the hospital.
Speaking about the broader membership of CINICO, including indigents and the elderly, Archer said, “Offering a choice of medical providers … will increase the government’s health insurance premiums and more than likely reduce the usage … of the Health Services Authority. With a choice of medical providers … government will not be able to sustain or afford to pay the expected increase.”
Despite the reluctance to extend CINICO to cover private health facilities for all members, he acknowledged that choice would be a factor for civil servants, as government had decided it was going down the co-pay road for public servants.
“It has already been pretty much accepted that the civil service will move to co-pay by the year 2018. It is the finer details that are being worked out between the Project Future office and the Portfolio of the Civil Service with other agencies, I think maybe even the Civil Service Association,” Archer told his colleagues.
“It is accepted that they will move to co-pay, with choice,” he said, noting that the finer details as to how, where and when were still being discussed. “But it is a given,” he said, indicating that the deputy governor had already given a speech in which he said the service would be progressing to co-pay.
However, in his letter Watler said that CICSA did not know who had “pretty much accepted” the issue of co-pay, but it wasn’t his members.
He pointed out that one of the major sticking points in previous preliminary discussions about the issue had been the lack of choice, but it was not the only problem that had derailed past talks.
“The various competing interests could not resolve things, including the issues pointed out by Minister Archer – that this will ‘more than likely reduce the usage and service of the Health Services Authority’ and the rising cost of health insurance, which attempts to void contractually agreed obligations,” he wrote.
The president also raised concerns that the minister was conflating health insurance costs for civil servants, pensioners and indigents. “This leads to attempts to tax civil servants to pay, not just for coverage that they were promised and contracted to receive, but social coverage as well,” he warned.
Watler said that the association was still willing to reach a fair compromise on the matter and had written to the deputy governor offering to host a round table to re-initiate real discussions.
“It is unfortunate that that fairness was not extended to civil servants through the body recognised by law to represent them before claims were made publicly about what has or had not been ‘pretty much accepted’ on their individual behalves by unknown parties,” he added.
See Miller’s question and Archer’s response in the LA below, starting at 3:20:
Category: Government Finance, Health, Politics
I am sorry, but how is the health care issue for Civil Servants any different from those working in the private sector? I don’t get a choice either which health care provide my employer uses and whether I have to contribute towards my health care or not. The majority of the private sector employees have also not seen any pay raises in the last 10 years! There are also people in the private sector who are struggling to make ends meet, single parents on very low wages, no overtime pay etc etc. So I really don’t get it why civil servants always expect a special treatment. If they think that everyone who works in the private sector has “made it” and has no financial issues, well then why don’t they switch to working the private sector?
So you want to drag everyone down to an unacceptable level rather than fighting for everyone to be treated fairly/well? how’s that going to work out for everyone do you think?
If you had a choice between GT Hosp and CTH which would you choose?
I believe (think, someone can please confirm) that civil service/CINICO only got the one choice – GT. I wouldn’t like that. Just as we all pay our contribution in the private sector and can choose which hospital to go to, so should it be for everyone. Seems fair to me.
The Cayman Islands Constitutions starts with “We the People” meaning that we officially defined the fundamental rules of how we want to live together and the role of government in our lives.
As a concept, we the people gave the government special powers and all citizens can expect to be treated equally by the government. So government cannot require that one citizen is commercially obligated to another citizen unless both of those citizens make such an agreement of their own free will.
I am making this point to say that when the government obligated all citizens to buy health insurance or pensions, they obligated a private citizen to purchase a commercial product from another private citizen. That removal of my free will by the government violated my constitutional rights and gave a private citizen power over me that only my government is allowed to have.
Personally, I believe that the idea of health cost and pension planning is a good one, but since it is mandatory for all citizens, then government is the only entity that is constitutionally allowed to collect these health and pension fees. It is time to stop this private health insurance and private pensions nonsense and create the government entity that will collect these fees from all citizens using a break even formula.
Sorry CICSA, this health insurance and pension problem is bigger than you. I want these short sighted laws changed and all citizens means “all citizens”.
You are joking right? Can you provide any examples where the Government is a “well run and efficient machine”? Do you see the state the HSA is in? Have you read any articles about how “well” the Government has done with enforcing labor and pension laws? And now we are supposed to look at them for arranging and collecting on health care provision? Hell no!
If government in effect breaches the contract of employment it has with Civil Servants, would this not send the wrong signals internationally in regards to our heretofore highly reputed jurisprudence?
With no tangible increases in Civil Servants’ pay for at least a decade i.e. virtually no cost of living increases (except one that was given for six months then taken away for years, then only recently restored), and no annual performance based increments in place, existing Civil Servants and pensioners will be pushed closer to the poverty line.
I just don’t see co-pay being reasonable without choice being part of the package — that would definitely be a deal breaker for the next election. And if choice comes into play, the HSA will fall apart. I just don’t see co-pay coming into force at all.
9:05, you obviously are not aware that in every country in Europe, U.S. Canada, Australia etc, civil servants contribute to their health insurance costs. Why should the people who work with CIG be the exception to the rule? Are we really that wealthy here that we can be the exception to established norms around the developed world?
What you also fail to point out is that those civil servants also have choice of a real service providers. Have you considered whether civil servants will get something of quality for the cost? Probably not because the health care in Cayman is at best poor with substandard customer service from the so called professional providers. Is this what you would like civil servants to pay for? Would you pay more for something so poor? Wait. Don’t answer that question, you have already convinced me of your limitations.
The choice to use any doctor of your choice is of no use to us in Cayman Brac. Its the HSA or Dr. Reid. So you are not offering us civil servants in the Brac anything special unless of course you are going to pay our airline ticket to Grand Cayman
Typical lesser Caymans complaint.
Grand Cayman has it so we need it better.
Typical attitude from Grand Cayman. The Brac isn’t asking for “better.” What we want are some choices that don’t always mean added expense.
I have a question. Why would most civil servants choose other hospitals instead of the HSA if they were given a choice with co-pay?
Three answers to that question 1) So we can actually get to see a Doctor and get back to work to fill the vacant posts and try to keep the public happy 2) So when we go to the Doctor we don’t have to leave feeling depressed and have our co-pay gone not to the hospital but to any one of the number of sick, poor and on the waiting list for government help. 3) The Doctors think they can treat you any way because you don’t have a choice and they too are having to work in an environment where people are not even subsisting.
I’m not sure exactly how all the Civil Servants going to Camana Bay is going to help situations 2, 3 and the social will likely get worse and the poverty more stark as the civil servants withdraw. Civil Servants are the ones actually most likely to help the poor out of their own pockets actually interacting with all the people. For many, Government employees are the primary professional they encounter. Looks like we may be heading for a more divided society with places that are no go zones for the poor.
Unfortunately, very little choices for the government if it wishes to continue down this road of road building and development welfare. Already, the problems are showing at the RCIPS and the Welfare office/NAU. And its no wonder, all the entry level positions for our Caymanian youths are being contracted out to temporary employment agencies. For the Caymanian worker and consumer, we have taken the approach that we need to adopt the most detrimental of American system when it benefits the few and the most detrimental of the UK system when it creates Government control (er 1950’s UK that is).
For example, the Health Insurance system is based on the American model whereas before 2000 it was universal. While the pension system model is British. In the American system, the 401 K was develop that allows workers to take their pension subject to a 10% tax penalty for any purpose when the need arises and tax free to purchase a house. This offsets (maybe) against the health care situation and embraces a system that puts one in the drivers seat of ones on destiny. Our system, (as it is now with Cinico) leaves government with that duty. With the proposed system, Civil Servants along with the general population are in the driver seat whilst not in the driver seat in other areas concerning their finances.
My co-pay as a civil servant is about $10 every time I go to the hospital usually to buy a meal for someone.
The last point, of this long reply (sorry) is that for the people out there thinking I am paying taxes and CS need to pay too; just like me. This is an easy excuse, and one the politicians and their bosses (eg the money men) rely on. To that I say, perhaps the real problem is the way we are all being treated.
OK to laugh out loud but think about it…have you been to the HSA lately?
I have no issue with a co-pay but it will have to come with the option of allowing us to go to any physician of our choice – including the private doctors.
What then will be the unintended consequences for the HSA who are already struggling?
Like hell will I contribute to my health care without an option, especially with the protection of lawsuit against the HSA physicians for malpractice. They will not be allowed to take the lives of my family or myself without financial consequences that will provide for the livelihood of the family left behind. This is just another example of the high level of dictatorship by the Deputy Governor and Portfolio of the Civil Service. Stand up to them Mr. James Watler even though we all know that they will be conspiring against you with a view of finding a reason not to renew your contract. Those dictators must be replaced with caring Civil Servants.
It is just another example how Governments over the past 20 years have slowly created a welfare state and it now comes back to bite everyone in the butt!
You are so right! And imagine now a single mother for example with one child on her insurance. She would have to come up with roughly $700.00 to co pay her insurance. How on earth would she be able to pay mortgage buy food and pay for gas and groceries?
This is crazy… this will be a bad move for Civil Servants. They have not gotten a pay raise for donkey years and now this?! From the time this Min of Finance started talk about this, every CS hired should have been hired under the the co pay system. Also any persons whose contracts were renewed should have been under this so call new proposed way forward.
CS on PPE should be left as is. You will be breaking the law if you force them to Co Pay because they have not gotten a pay raise nor cost of living raise for years. They would have every right to fight this and Human Rights law surely would support them.
I am so disappointed with this thoughtless plan on how to address this. CS need to speak up and not let this happen. Other CIG Ministers or and the opposition need to step up and see that this does not come about.
Many many will be crippled if this actually comes about. And the consequence of this poor… POOR…decision is sure to be the final downfall for many of our people already struggling… and barely scraping by.
Shame on the Minister who brought this motion about and all others… who support this thoughtless means to safe CIG funds. There has to be a better way…so find it and stop making decisions that will only make the CS making less money and doing all the real work, suffer even more.
So 25,000 Caymanians are the sickest people in the world requiring billions of dollars in health care?
This country’ people should be the healthiest in the world- sun, nature, sea, yet they are not. Anyone tried to figure out why?
Low fat, high sugar diets guarantee you at least diabetes. Absence of safe bike/walking trails guarantee you more health issues. Yet, focus (and money) is on insurance, not prevention.
By the way war against salt, whole fat and cholesterol is unnecessary and misguided.
The solution appears to not solely be reduction in the present high cost of healthcare it is a simple question of how is healthcare is being managed by the persons most responsible and accountable for the costs and delivery of medically necessary healthcare services. 11.22am you are absolutely right our people should be the healthiest in the world and actually can be if conservative approaches to health care delivery are adhered to and restricted to medically necessary surgeries performed with majority of care being provided locally on island which is absolutely possible utilizing present day leading edge technology. The local government hospital is the hospital of choice of civil servants and majority of persons. Opening up healthcare services provision to the private sector will definitely increase utilization of benefits to the point where co-insurance contributions will prove to be merely a “penny wise and pound foolish” obsolete tool. Better and greatly improved health care budget management should be at the very root of this discussion and is seemingly being overlooked noting that co-pay with open access to private sector will no doubt adversely affect the government hospital following which there shall be no need for a government health insurer as both government hospital and insurer are required to function in mutual harmony and stakeholder partnership one with the other to realize best government healthcare service provision and delivery in addition to outcomes of overall best cost effectiveness along with equitable access to medically necessary treatment. CIHSA remains as the best local healthcare choice of the people in the larger population majority and as such requires the support it so deserves. It is hoped that meetings of inclusion of Mr. Watler and his team are planned for all stakeholders to provide vitally important input.
Cutting down on sugar might be the best health Insurance available and it is FREE.
Marco – implement a sugar tax! I cannot even buy a diet soda in many gas stations.
and starch
One Billion dollars and counting so far. How are they going to pay for “free” health care for their tribe? By raising the fees higher and trying to make driftwood taxes pay for it. Good luck with that business decision. The only question on everyone’s mind is how soon will everyone be leaving the sinking ship?
I have said it before and will say it again. Gilbert and friends failed the country, when they adopted what is basically the failed US model. Assuming that the free-market is the way to go, as compared to every other rational Western industrialized country.
Single, not-for-profit, universal healthcare, was and still is the only way to go. Greater choice and lower costs.
I have said it before and I will say it again. The plan was that Cinico would was to morph into the national insurance plan for the Cayman Islands and that every person working in these islands were to be enrolled. . if that had happened back then Cinico would be well funded . of .course all the private insurance companies were fighting agaiGovernment as is customary, it was not done.
Absolitely right!
Thought you were talking bout CUC for a minute there! 🙂
It is clear that this Administration does not respect its Civil Service. Unilateral changes which affect another party without that party’s inclusion, is disrespectful, at the very least. In 2013 unilateral changes were made to the Public Service Management Law (2013 Revision) and the associated Regulations, which has detrimentally affected civil servants benefits. Apparently only the DG his CO and Legislators knew about that change and the entire CS remained in the dark.
Seems like they’re doing it again!!
CNS – please review PSML (2013 Revision) and the process undertaken for that revision.
Intitled much?
“Unilateral changes which affect another party without that party’s inclusion, is disrespectful, at the very least.”
Er…dude…it’s called being in government. You elect ’em, they get to make laws. It’s called democracy. By the way, if you don’t like ’em, you can vote against ’em. Then the other lot get to make laws instead.
Or you vote for neither of them and claim that no-one’s allowed to pass any laws that affect you unless you approve of them. It’s called futility.
Mr Watler feels it would be unfair to make his members pay a contribution for indigent medical insurance. Yet he doesn’t realise or care that everyone else’s monthly premium includes exactly that.
As a Civil Servant I’ll happily pay the $10 indigent tax. What I will not pay is the hundreds CINICO tacks on to the Civil Service ‘cost’ to balance their books across all of their portfolios.
As usual, you are missing the point he is making..copay to equal choice…
I have choice because I pay 100%. You want equal choice but only to pay 10% of the consequent insurance premium. Taxpayers get to pay the other 90% of your “free” choice. Strike you as just a tad unreasonable?
The civil service has never said what you are claiming. This is the sort of outright fallacies that have made this such a Gordian knot.
Civil servants need to face up to the real world. Not only do they get a gold plated medical scheme for free but they don’t contribute a cent to the indigent coverage which every single private sector employee is mandated to do.
$10???? Find something else to complain about
Your right. If expats are too stupid to want to pay your “help the caymanians” taxes then they should just leave Cayman for someplace that doesn’t make them pay a stupid tax.
CICSA to Mr. Archer….no Fing way! The civil service gravy train is not going to stop until it bankrupts the country.
Why don’t we change the law to say you can get insurance if you want to ,then watch insurance premiums go down and more companies pay for preexisting sickness?
We could pay less money to insurance company and enjoy a vacation to Cuba while doing medical ,dental, and eye care. This idea of paying over US$ 1000 per month per individual WILL NEVER HAPPEN. Why is Gov’t, insurance co.,or hospital believe that they still won’t have a bill. Minimum wage has just reached CI$ 6 per hour? Are you people nuts?? No-one will be able to retire and have medical insurance pay. Because only rich people making over CI$ 6000 per month each can afford it.
Why don’t Gov’t act as their own medical insurance company and charge 10% of people salary and pay all claims. Start sending people to Cuba rather then USA where its cheaper or cut a deal with DR. Shetty’s hospital. I no longer go to GT hospital.
the civil service….. they have no shame…and a permanent anchor around cayman’s neck….
Are you saying that civil servants should not be treated like other employees where they pay for health insurance and can go to any doctor in the Cayman Islands and use their health insurance card? The objection is not copay at this stage, even after full medical benefits formed part of employment contract which the employer is now seeking to unilaterally change, the argument is that if civil servants are to now co-pay for their health care they should quite frankly be fully brought under the remit of the health insurance law and have the freedom of choice to seek medical care outside the health services authority as they choose…like everyone else… Or is irrational hatred of civil servants justified or are we just a lesser class of person than everyone else in the society?
I am a civil servant of over 15 years service to the government and quite frankly to the society in which I live and love. I do not need to work in government, but I choose it because I love Cayman, that is my country, I love my work and it is how i choose to serve the good people of the Cayman Islands and because I believe that our people deserve to have some of the best and brightest too. Like every other organisation there is the good, bad and ugly. In the civil service there are many, many hard working stalwarts…and remember, some of the greatest leaders of our country served our country at some point in time in the civil service.
Civil servants do not be afraid. Stand up and fight for what is fair! There are times to be silent and there are times to have your voice heard. Mr. Watler and CISCA thank you for clarifying the record on the position of our civil service association who acts as our advocate. It is now time to make the clarion call and bring the government to the table… To ensure now that these negotiations are now with the entire membership and put all the wider government issues on the table so that a full suite of reforms come before the Legislative Assembly.Since they wish to make a decision that affects the entire membership, then they now become answerable to the entire membership and the civil service. We have been here before when the edict was handed down that a 10% salary decrease would be required for an indefinite period.
If this is the government’s plan then I hope they also make corresponding plans to further fund the Needs Assessment Unit, because they will now attract a new group of Cayman’s poor… Yes, the many civil servants at the bottom of the salary scale who are paid disgracefully.
It simply does not add up that a small group of 3000 people should prop up a huge government institution because of poor government policies. On the table for debate should be the other group which the government fully subsidizes such as veterans who irrespective of their wealth get free health care ( and use it the most due to their age… It should be needs assessed. And I do not know for certain, but the status of their dependents’ benefits should also be examined as some have second and third families. The government should also reassess those on permanent indigence and put in place a plan for them with prescribed health benefits and not just an open scheme for unlimited use. And also, yes, let civil servants do their jobs without interference and allow them to reclaim the millions of dollars that private individuals get for free government health care and public monies but feel it is right and ok to not hand over their assets of an equivalent value, but instead hand it over to children on their death. This revenue collection should be brought under a non political office to ensure that public monies are in fact collected without political interference.
It is time for government to approach this national healthcare issue holistically, and not just in a manner that is expedient and against an unprotected group because of civil service status. Ruffle a few feathers, but do not ruffle the feathers that will actually fix the problem ? Can the country afford to settle for for anything less?
It is unsustainable for the government to think that 3000 people can indefinitely prop up a multi million dollar entity such as the health services authority and a sick and limping. National health care scheme that is supported by impotent health care policies. It is time for the government to take a strategic look at the long term national health cafe status of this country. What will the landscape be like in 10 years, 20 years, 30 years, when generation x who are now in their 30s and 40s will retire. What is the National Plan? Is it like every other national plan… Non existent and shortsighted. The solution posed to bind the civil service is unrealistic, unfair and more importantly does not even begin to put a bandaid on the national issue that is On my way! up for discussion.
The government t has no choice but to look at the wider picture. Perhaps the government should consider other means in which to do so. For example, since the foundation of all health insurance contracts are standard health insurance contracts which are statutory, then the care to be offered under those contracts should be to the Health Services Authority… This may or may not help address the problems but at least be open with the public so that there is national discussion on the issue.
The fact of the matter is there is a national need for a public hospital. Therefore mechanisms should be put n place to ensure its long term viability for the entire public, recognizing that the money must come from somewhere to pay for it and not just from one source. If national healthcare is not an option, then other global alternatives must be explored. And as much as everyone lauds the Shetty hospital, just remember, the agreement that government signed, the unrealized project and the fact that the. MOU has never been renegotiated to adjust downwards the tax exemptions that it now enjoys by not properly contributing to the general revenues of this country. Where are the 200 hospital beds that were to bring greater business to the islands as a whole and government revenues to this country? In effect we have 2 health services authorities and that has now compounded the government’s problems. This is not to say that the hospital does not play an important role to the islands, but at what cost?
The moral of this story is that the government needs to look at the HSA issue at a national level and against it policies NOT to collect government fees that should be owed to it and its policies not to touch certain groups because of potential backlash. Picking on a small group is not fair, appropriate nor the solution, particularly when you choose to make them pay like the rest of society but deny them the benefits of freedom of choice like the rest of society.
Cicsa… Please call an emergency civil service wide meeting and please bring the government in to account for their policy decision that affects us without consultation. It is time for all these issues to be ventilated and for the government to justify on all fronts the decisions it is making at the expense of our freedom of choice for health care if we are required to pay.
Your sincerely
proud to be a Civil Servant
Most workers in the private sectors only have a very minimum covered by the medical insurance provided by their employer. If in the private sector you want decent insurance and option to go anywhere you can expect to pay about $500 a month per person. If civil servants are willing to pay that then we can just close Cinico and move them all to the the other providers used by the private sector.
If it will be fair and civil servants can go to any provider than they should pay similar rates and co-pay to those in the private sector which most will not want to do.
Stop worrying read the DG memo of today.
I bet that email was written in Govt. time!
You lose the bet. It was written at 5:35am according to the time stamp. This exemplifies what is wrong. You assumed that anyone in the civil service was lazy and entitled. But you were wrong. However your email, time stamped 3:57 pm would lead someone to assume that you are …. not at work so either self employed or on shift. See how easy it was to be fair-minded.
Touché
As a Civil Servant I have no intention of accepting that I have to pay/contribute to my health insurance coverage. It is part of my remuneration package and my retirement package and as I am 59 years old I have no intention of accepting changes to my employment contract and benefits just when I will be needing this benefit. My pension is only going to be $750 per month so how in the world am I going to pay for health insurance coverage and live. At that point I will be indigent and then they will still have to pay for my health. Fifteen years ago I told the powers that be that they should have implemented a co pay for all NEW civil servants entering the service. If they had done that back then they would not be facing this problem now.
750 a month? So….. you have no savings?
No. The reality is many have no savings. The Civil Service had (and has) a lot of staff who were paid relatively little but were on contracts (of various types) and now have little to no savings or pension. While the Service has moved away from these ‘recurring’ contracts there are a lot of low paid permanent staff. Whose new defined-contribution pensions, like in the private sector, will not add up to much when they begin to collect them. Its easy to say, as the pension providers do, that you need to save in addition to your pension but hard to do. (Cost of living and all that.) So at some point these people will become medically indigent. In the private sector its when they retire and they are no longer on a better-than-SHIC plan. (Age 60+ seems to be a ‘pre-existing condition’ to some insurers.) In the public sector it will be when Marco starts trying to charge Civil Servants money they don’t have for a benefit that was previously part of their remuneration package. Hence the scramble to find some ‘cost neutral’ way to do this. (See Compass today.) Because they know this is a national problem, tied up in a staffing problem. And if Government don’t continue to pay the civil servants, their employees, their contracted remuneration Government will have to pay for it somehow else.
No savings. How much you think someone is earning if their pension is going to be only $750.00 per month. With that income you can barely afford to live much less save.
Yup, I had agreed to that too but as usual we don’t have leaders (MLAs, DG) willing to support this because many of new civil servants were also the new status holders aka new voting base. Fellow Caymanians, hate to say it, but ‘da wha’ yah get’
because you all continue to be scared & confused of the Jamaicans taking over the civil service, Jamaicans and West Indians who just came here and reaping same benefit package as Caymanians who built the islands never had pension plans but now after 30-45 years as civil servants have to live their retirement years in poverty.
Keep defending the hiring of Jamaicans and making them and their children ‘equal in entitlements’ and it will only get worse because the politicians will continue to bring them here so that they can have them dependent on them as MLAs & political parties don’t care about their own and at end of day can’t blame any expat that can come here and get government and MLAs to put them first, bet next year the same unpatriotic leaders will be elected, especially those with or claiming to have connections to Jamaicans.
Shame on you Marco. Seems Alden has you all in the dark, repeating foolishness and deceiving people
Not much work gonna be done in gov the next few days, they all gonna be commenting on CNS
The Civil Service association is the tail that wags the dog. Now watch the PPM back track its policy decision in order to try win votes from the largest union in the Cayman Islands
James Watler does not speak for me! Never has and never will.
Me either! But then, I’m not a CS
I think at the end of the day, most civil servants would not mind paying a portion of their salary for monthly health care, provided they “had a choice” to decide amongst healthcare providers in the Cayman Islands. This would be the same as if you’re working in the private sector.
If working in the private sector, I can make a medical appointment (general practice, optical, dental etc…) and get to see a doctor within 24 – 84 hours. (1 – 7 days)
With the H.S.A, I have to wait as long as one month and up to six months for the same service. At the H.S.A. Emergency Room, I have to wait most times up to 4 hours (depending) to see a doctor and then I’ll be given a prescription that cannot be filled at the HSA pharmacy because it’s not in stock. This is a waste of peoples precious time and it’s also counter productive in their occupations.
If I go to C.T.M.H (Tomlinson Hospital) or Health City Cayman Islands, I can see a doctor in the E.R in less than an hour and have the best medication available at their pharmacy on site. If I need a follow up visit, this can also be done within days or less.
In the world of any successful business today, if I’m going to pay for something, the product and service must be good or exceptional, or else it’s not worth paying for.
Service and Care should meet or exceed one’s expectations. Plain and simple !!
“This would be the same as if you’re working in the private sector”. yes it would be – if you were paying 100% of the premium. And BTW, there is absolutely nothing to stop you from going out and getting your own private health insurance cover at your cost which will allow you the choices you are looking for. You would have to pay for it yourself, of course, rather than rely on the tax payer as usual, who of course also pays your salary.
Pretty ironic to read “In the world of any successful business today, if I’m going to pay for something, the product and service must be good or exceptional, or else it’s not worth paying for.” when the Caymanian taxpayer gets to pay for a civil service which does not produce good or exceptional service, yet those same civil servants expect the taxpayer to fund their access to exceptional private sector service.
We can’t choose who we want and the prices are outrageous. CS shouldn’t be supporting all the indigents and prisoners on CINICO. I’m sorry but I refuse to support (pay medical) for those lazy a– people I see walking on the road who are quite capable of working. I pay to see a private doctor most of the time anyway.
I will gladly pay for my own healthcare!!! And I will gladly engage the services of another entity, as opposed to that of the HSA. The problem is, if CINICO does not have the Civil Servants to charge these outrageous rates, they will have no one to cover the costs associated with all the seamen and poor people, whom they cover.
And CINICO will not be able to pay for breast augmentation for certain friends of XXXXXX.
We all know that breast augmentation is not covered by CINICO and that a certain person got hers done and paid for by CINICO. So that just goes to show that corruption is still alive and well in CINICO and the civil service for those that are part of the “clique”. They are the same ones who do not need to show for work, leave work early, are out and about all day doing personal errands for the “boss”. and the list goes on and on and on.
I know a few people that had lasik covered by CINICO but mine wasn’t. Let’s hope this gravy train has pulled into the last station.
When I was hired by corporate my insurance was included with no deductible. Over the years that has changed and I now have a $500 deductible. According to these CS’s I should be angry?
Roll with the punches. Everything is NOT a free lunch.
I’m busting out to be abreast of who got a boob job done by CINICO! C’mon, tell us please!
No not a troll. What was stated is a FACT.
Its a troll if (1) it spreads salacious rumor without anything to verify it; (2) it detracts the conversation from the core topic
you know the civil servants have been given a black eye for this over the years. You want us to pay then we will but it comes at a price and that is you cant tell us where to go. HSA you are in serious trouble most of your customers now are civil servants but they have been forced to go there. Now they will not have to go.
And don’t forget we civil servants are paying for the prisoners too.
And retired MLAs, Ministers & Speakers!
Franz – another reason why the best are reluctant to be civil servants. The health insurance and healthcare that come with it is viewed as greatly inferior to the private sector alternatives.
8:08. After they leave the private sector, who pays for their insurance? Civil servants who retire are covered, so if they are required to co-pay now or in the future, they should consider it.