Health remains costly challenge for CIG

| 08/09/2017 | 29 Comments

(CNS): The most recent financial report from the Health Services Authority has demonstrated that from health insurance cover issues to the management of the hospital’s accounts, as well as continued inefficiencies and access problems, managing healthcare in Cayman remains a major and costly challenge for government. When the Legislative Assembly met recently, the new health minister revealed that $15 million of debt was written off last year and there will be around another $7 million more to be written off in the next financial year.

Answering a parliamentary question from Opposition Leader Ezzard Miller about the hospital’s bad debt, Dwayne Seymour claimed it was implementing initiatives to reduce debt. But he said that the hospital board had made a decision to write off part of the accumulative $90 million owed to the facility in unpaid patient fees as it was uncollectable. He also revealed that the HSA was employing the services of a debt collector to press people who owe money to the facility to cough up the cash, something which is likely to cause further controversy for the health authority.

Seymour claimed some improvements in the HSA’s financial situation overall when he presented its latest financial report, but the auditor general found a number of major problems that led to another qualified opinion for the struggling authority.

Auditor General Sue Winspear found that the reported figure for the money collected on patient service fees of $89.5 million could not be relied upon because of a lack of internal controls, and the accounts receivable of $27.9m was not necessarily fairly stated either, as that was directly related to the problem regarding revenue. The bad debt figured was impaired too, she said.

Alongside those problems, Winspear pointed to the hospital’s major liability of post-employment costs, which were not recorded at all in the report. On top of all that, she raised concerns about the hospital falling foul of its own law, as it has a shortfall of around $21.5 million in its reserves to cover the day-to-day cost of running the hospital and clinics.

During the Finance Committee meeting on 25 August, MLAs voted for another $12 million appropriation in addition to the tens of millions already budgeted to cover the costs of overseas medical expenses for local patients, as well as fees for uninsured Caymanians, illustrating the continuous drain on the public purse and the failure of the current insurance system as well as the excessively high cost of medical care in the US.

As he delivered the Strategic Policy Statement on Friday, Finance Minister Roy McTaggart outlined government’s plans for the health sector over the coming administration and glossed over many of the fundamental problems the hospital faces. But he said government was hoping to extend the partnership arrangements between health providers to give Caymanians better access to the best possible healthcare. Health City will be the main target, as government hopes to cut overseas medical expenses by encouraging the use of the East End hospital instead of sending patients overseas.

McTaggart said the HSA would use new procurement practices to reduce the cost of drugs and equipment and another way of improving efficiency. He also pointed to a planned review of the health insurance regulations.

In his speech on the motion for the SPS, Premier Alden McLaughlin said that “improving the efficiency and effectiveness of our healthcare system will require a long-term strategic change”.

He added that a first step would be to talk to industry players, including those at the HSA, to determine what reforms are needed, and to devise new working arrangements and see what services should be focused on in future years.

See financial report here

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Category: Health, Health Insurance, Politics

Comments (29)

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  1. Anonymous says:

    I would like to say as a service user, I have waited behind numerous people at the pharmacy claiming they have forgotten their card, don’t have the money, the Meds are for someone else and they are picking them up. They then, usually get the Meds and walk out. I have even heard a girl gloating on her phone outside that it was easy to get the Meds!! The cashier needs to be trained properly to say to these people ” please go and get relevant card. Or cash and then return. In the meantime, move on to next customer. If they stand firm, it will then be known that you must have what’s needed to pick up Meds. So much time is wasted there unecessarily.
    On a different note, why make us come every month to pick up Meds when I, for one am on blood pressure Meds for life. They should give long term users six months at a time to cut the paperwork and time down. I have asked about this and was told some people will sell their Meds in this case. So don’t then give them more until their script is run out ( i.e. Six months). This should be an easy fix.

    • Anonymous says:

      We have become a charity for all the imported economic dependants that politicians need as woters.

    • Anon says:

      I agree 8:47 am. Some renewals must add unnecessarily to the pharmacy load and certainly to the patients’ burdens.

      I can see that the first time you are prescribed before you have stabilized it might be wise to give a month at a time, but those established on meds should be able to get a bunch at a time.

      Those who return after they have been issued would then not have a prescription to be filled and should then be referred to their doctor.

      Those patients whose dogs ate the meds should then be coded for month to month only dispensing. Then the rest of us patients on established prescriptions can avoid the monthly trips unnecessarily cluttering the pharmacy and our busy lives.

    • Anon says:

      8:47 am: the cashiers probably need a trained supervisor who is doing his or her job.

      Too many civil servants have supervisors who are not doing the job they are paid to do.

  2. Anonymous says:

    politicians canmot run a hospital….period!?

    • Anonymous says:

      Ezzard Miller could!

      • Anonymous says:

        11:09am he is a qualified Hospital Administrator. At least, back in the the days, when John Whalen was HA, he saw the need to train 2 Caymanians for that position. Not so these days, they train foreigners for most of the positions.

      • The Ghost of Dr. Hortor says:

        Yes, further in to the ground.

  3. Anonymous says:

    We need to get rid of the private health insurance companies and move towards a national health insurance system.

    • Anonymous says:

      In this country? Really? Can you say kick backs? That is the worst idea ever, no accountability and endless funds. We will be bankrupt by Christmas.

  4. Anonymous says:

    The problem is the insurance companies and the medical institutes.
    An MRI in Shetty hospital cost 4000 CI compared to 800 CI in Jamaica.
    Same machine, same quality of care, just they drive a corolla instead of 4 bmw’s.

    In cuba it is even less, with better care than anywhere in the world.

    Greed of medical professionals and insurance companies shareholders, corrupt and not-interested in the people politicians and churches who WANT you to die and be scared, ARE the cause of the problem.

    Social, governmental healthcare is THE only way.
    Same goes for schools.

    But unfortunately this is what the world has become, and it deserves it…….

    • Anonymous says:

      Small countries like Cayman eventually end up with a dual health system. Very poor get very poor free Gov. provided care. Those that can get good Insurance and get quality care outside the Gov. provided free care. If health care is viewed as free the system be abused as it is now, it will run out of money, Taxes will have to be raised, prices will go up, cost of living increases. There is no free lunch.

      • Anonymous says:

        If you have a pre existing condition, they will only cover you for the minimum. If you need testing for the condition say cost 3000, they will only pay the minimum. They will only pay minimum. so what is a person to do “DIE”? Some people don’t mind or can afford to pay a bit more for pre existing condition, but what about the people who can’t?

  5. Elvis says:

    Why don’t all civil servants pay a standing charge of 100 ci per month towards health care?

    That way there will be some sort of contribution being payed in regularly, I am a civil servant and I don’t care how loud the so called leader of civil servants complains I for one would be willing to pay it, it’s not enough but if we all pay it will be something,

    Don’t slaughter me it’s a suggestion

    • Anonymous says:

      Those who have property, should a lien on it until the bill is paid off. Years ago that is what was done. Our greatest problem is, we have too many new commers who are living below the poverty line an have become governments liability.
      Those are the ones who are demanding meds and care for free.

    • annonymous says:

      Why should a civil servant who was hired back when insurance was a perk have to pay for insurance? I ask this question especially when CIG is paying for so many who are not CS and they are the ones who are constantly ill and running up the bill, not CIG employees.

      Those ppl are the reason why CIG is strapped with having to pay all that money. You or I as CS hired by the CIG from years back, should not now have to take money from our salaries to pay for worthless lazy ppl who refuse to work and only want hand outs from.

      My budget and many other CIG employees cannot afford to pay for health insurance because many of us will not be able to find it, from the meager amounts we have to live off each month after paying essential bills.

      $100.00 may not be much to some ppl’s salaries but it is not the case for some who make little or nothing (under 2,000.00) per month and others who make nearly nearly 4G per month but have children and a mortgage.

      Then you also have house insurance and the usual monthly bills CUC, WA, Cable and groceries on top of clothing 2/3 children etc. Some just cannot afford it and shouldn’t have to unless they get a pay raise that is taken right back out to pay toward the insurance.

      If CIG start charging CS in those pay range for health insurance, they will increase poverty in our county and will be faced with even more social issues. Crime will escalate mark my words and some of us can think it won’t affect us but it will because sooner or later we all will get robbed at some point and the rich will get richer with gap widening between. Recipe for disaster.

      They need to deal with it without a doubt but it need to be dealt with in a manner, so it will not affect the community negatively on a whole; and it need to be sustainable and a long term change across the board that benefits ALL.

      From years ago when talks first began, all newly hired CIG employees should have had to co pay health insurance and any employee whose contracts was renewed so they would have a choice to stay or go.

      Workers employed many years before with the benefit, should be left alone unless they have more than an agreed amount of dependents. They should have to pay a specified fee for monthly for any children over the amount of say two.

      Just my thoughts on the situation. Thank you.

  6. Poverty stricken! says:

    The billing and collection services at the HSA is in utter disarray. I booked a procedure at the hospital more than 2 years ago and they made me pay in full in advance of the treatment. When the insurance claim was then paid in full (to the hospital despite me already paying the bill personally), I applied to have the money I had paid refunded. Six trips to the finance department and 2 years later, I have still not got my money back. But they do keep sending me a statement asking for money on another follow up visit despite me being well in credit over all.
    They simply cannot appear to put two and two together correctly, and work out that they ow me money, not the other way around. They seem unable to produce a statement of all my transactions with them despite repeated requests. Now I go to Health City if at all possible where I can be sure the billing will be promptly and correctly dealt with.

    • Anonymous says:

      The HSA’s problem is and always has been that it caters to the riff raff of our society. The other hospitals would “run them” but this is a government hospital and ” I am a Caymanian whose forefathers built this country etc etc etc” is the prevailing attitude. Just sit in the Pharmacy and listen to the deadbeats of our society going off on the staff and everyone else there about how badly Caymanians are treated, at the same time checking their smart phones with expensive monthly fees. We have become a ” Government can pay” society, encouraged by populist politicians like Ezzard, Arden, Chris Saunders, Bernie, Mac and nowadays Anthony Eden, provided you are god fearing and anti gay.

  7. Anonymous says:

    It seems to me that when a politician receives cash for political favor it is corruption.
    When a politician directs that cash owed to the people of the Cayman Islands not be collected for political favor it would seem to be more akin to theft AND corruption. Every day, in every way, I wonder more and more just how true Legge’s editorial was.

  8. Anonymous says:

    A family member went to the Hospital a year ago paid her co-pay, 4 months later got a bill from HSA to pay the balance that Insurance did not pay. Paid the outstanding balance 3 week after receiving the bill, got a receipt. In the last 2 weeks received a bill for the same outstanding balance from 2 different departments in HSA. Someone is asleep in the HSA, politicians interfering with patients not to pay their bill have to stop. What happened to the ACCOUNTABILITY and EFFICIENCY the DG keep talking about? We are turning into a welfare state fast all because of the people we elect. Just imagine, some now want to build homes for people to stay in till they get on their feet. When do you thing they will get on their feet after getting free accommodation? Very few will make an effort to get on their feet and provide for their family! We have to start teaching accountability and responsibility in the schools, because the people that are now believing they are entitled to everything for free, very few will make an effort to change their ways and get back to working full time. Yes there are people that are truly in need, they must be helped. Those that are just lazy and basically beggars must be told get a job, any job. $350.00 a week is better than sitting at home doing nothing and could lead to getting a better paying job depending on your performance while you work. Have some pride and be accountable for your obligations, your obligations are not other people responsibility. Life is about taking responsibility for your on decisions and choices. Yes we all make mistakes, guess what, we have to get up and take responsibility for ourselves and family. Now, re-connect with your pride, take that job and move on to better things. Yes you can do it.

    • Anonymous says:

      The DG is not responsible for the HSA. The Board is. It’s a statutory authority thanks to that genius Gilbert McLean.

      • Anonymous says:

        Yes, Gilbert the genius who was supposed to be one of our outstanding teachers and still talks to the likes of Lucille on the radio as if they were both brilliant contributors to Caymanian education. Both got out of the classroom as fast as they could and Gilbert used to boast he was going to be Cayman’s first prime minister. Didnt work. MLA for the Brac, managing a condo then sitting at the blow holes selling coconut water to tourists. But his best pal Roy appoints him to do a report on why Caymanians don’t go in for teaching!! Totally useless report blaming expats of course.

      • Anonymous says:

        The Board IS the problem. I’ve seen vendors propose sound and globally acceptable hospital cost saving solutions, but unless someone (Brac) gets the biz the deals are tossed

      • Anonymous says:

        8:45pm and he had the guts to run, expecting to represent BT. Some people fail to remember.

      • Anonymous says:

        I presume you meant to put the word genius in quotation marks to denote sarcasm, 6:45?

    • Anonymous says:

      We can not teach accountability in school when we are told to always praise children’s efforts and actions, even if they glean no results. An age of mediocrity and “wuzification”.

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