When health insurance doesn’t cover health costs

| 15/11/2017 | 44 Comments

Cayman News ServiceHave a heart Cayman writes: The numbers just don’t add up when it comes to insurance and the average person. I’ve been unable to work due to ill health and my husband earns $30k a year to support us both. My medical insurance premium is almost $4,500 a year for what is considered a good plan, and yet in the past 18 months we have had to pay more than $30,000 in medical costs for my treatment that my insurance will not cover. And I have been going without tests and care I need because we can’t afford it now.

Our savings are gone. I’ve just cancelled my appointment with my cardiologist because I can’t afford to pay for it. Something has to change or people like me (and maybe I myself) will die because we cannot afford medical care.

This comment was posted in response to CINICO boss backs failing insurance system

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Category: Health, Health Insurance, Viewpoint

Comments (44)

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  1. Anonymous says:

    Radical deregulation of the health care industry is the only way to control costs for the long term.

  2. Cheech says:

    Health insurance is a scam, when will you all realize that we are being taken advantage of?!

  3. Anonymous says:

    Free health care never works. You will always run out of someones else’s money.
    The community maybe should do more for each other and leave the government out health care.

    • Anonymous says:

      I want you to think for a minute and imagine this lady is your sister, your mother, or your wife.
      Would you still have the same opinion ?

      That is the problem with our western society. We don’t care, because we don’t know the people. But when it hits home, you will understand that something is really wrong with healthcare.

  4. Anonymous says:

    Bring in international insurance…It will be cheaper and better coverage. CIG are small mind and idiots people for banned international health insurance.

    • Anonymous says:

      Generali, Aetna, Britcay are not Caymanian companies, are you aware of that? The first two are very very large international groups with more employees than Cayman has citizens (including expats). Believe it or not, there is a world outside of Cayman. Take a look one day, you might find out.

  5. Anonymous says:

    the majority of the doctors and private clinics are just as bad as the insurance companies. Bunch of crooks!

  6. Lisa says:

    Income tax is inevitable.the farce of a tax free jurisdiction is killing the middle and poor people whilst the rich people milks the cow

    • Unison says:

      So would, you say, it be permissible to tax from hard working people in order to run a health care program?

      Is it alright for us to take other people’s cash or property without them willing for a “good” cause? ?

      • Anonymous says:

        Would work out far cheaper than an insurance based system and provide better care by every meaningful metric. Compare European health care system to the standards of care in the US.

      • Anonymous says:

        It is a mistake is to think that income is related to how hard one works.

        The healthcare premium should be related to the income a person has. No matter what you make, you get the same care.

        This lady has the same rights as a hedge fund manager, who wouldn’t blink about 30k in healthcare cost.

        Don’t you think they have the same rights ?

  7. WhatTheHeckIsHappeningToOurIsland? says:

    I agree that health insurance is a scam. Most insurance companies are in business to make money, period. When you look at the level of benefits provided compared to your yearly premium, you have got to wonder. Look at the fancy offices, cars, high salaries of executives plus all of their benefits, you get the idea.

    I suggest CIG assemble a committee of consumers, employers and government officials to research single payer systems around the world to see if that would be something for us.

    • Anonymous says:

      It amazing just how facile brained people are. Single payer system means “Everyone starves within a decade!!!!!!” No one including Caymannians will want to work here!!!

      Are you really *THAT* ignorant? Single payer system ESPECIALLY in a place this small, means, GET THIS THROUGH YOUR HEADS!!! With a very limited revenue of 50K people OR LESS in the workforce, means shit Venezuela style healthcare! ALL private jobs WILL BE lost in healthcare except government jobs, and ALL insurance companies will exodus off this island which means YOU HAVE NO CHOICE OR MONEY TO PAY FOR HEALTHCARE OVERSEAS!

      No more Health City!
      No more TrinCay!
      No more CTMH!

      Do you understand that???

      Single payer systems have failed and are failing AROUND THE GLOBE!! Even Canada shifted and are now allowing private insurance (of course for the select few that can afford it)

      Get a Goddamn CLUE!


      Morons!!!! Especially the idiot politicians pushing this! Idiots!!!!

      • Anonymous says:

        Why is it that those that shout always understand less than they pretend to?

      • JMM says:

        I have a 100% solution to this problem.

        Step 1- Eat healthy
        Step 2- Exercise
        Step 3- Avoid unnatural medications, doctors and pharmacies like the plague
        Step 4- Accept death when it comes. There is no shame in this…

        Medications are damaging to humans as a species. Individuals with illnesses, deformities and other ailments are able to live past their time and reproduce, passing their genes down to future generations. These same sickly people rely on insurance to pay for their medications and life support, simply to stay alive. THIS is why the premiums are sky high.

        Which other species does this? None. Guess what? They are all perfectly suited to their environments. They eat the food that nature intended for them to consume, they live the lives that they are supposed to and they die when it is their time. Survival of the fittest leads to strong genes.

        The word Pharmacy comes from the ancient Greek word “Pharmakeia” meaning witchcraft or sorcery. The sorcerers of ancient Babylon did not cast spells or enchantments, they made potions and medicines. THIS is what was condemned throughout the Bible.

        There is nothing new under the sun, son.

      • Anonymous says:

        Your comment is so dumb, that i can’t even reply, but what is your solution ?

      • Anonymous says:

        45000 people die in the US every year, because of your system.
        One of them will be somebody close to you.

        It seems to me, you are young and inexperienced in life. One it will be your turn, or somebody you love (i doubt you are old enough to understand).

        • Unison says:

          Trust in God, unity and inner potential. The state is not God! But like previous commenter compared to a Babylonian system, its takes from one group and give to the other: theft

  8. Proud Caymanian says:

    I agree with you. Something has to be done. The insurances here are just out to reap (rape) us here. Also most of the doctors forget where or how they got to the point of practicing medicine. When they are in med school they go and beg and beg for everything until they receive their certification as a doctor then they soak you really good. And who are you then. If you have a pre existing condition the insurance companies will NOT cover anything that they would say has anything to do with that preexisting condition but they in turn charge you exhorbatant high price and say that that is because you are a high risk person. Government need to do something not just say they are going to look into it. The Minister of Health need to get up and make a stand and do something. Many many Caymanians are like this individual who cannot afford the high cost of worthless insurance coverage and health care. Hats off to the few Caymanian doctors who try their best to help and do help. I know a few of them who really care. God bless all. I truly hope Minister Seymour prove his worth in salt.

  9. Anonymous says:

    Time for income tax?

  10. Anonymous says:

    When you follow the US system (which apart from CINICO) we do, then you are going to have issues everywhere, and this lady is just one of many examples that has fallen foul of that system. A single pay system for locals and expats alike at a fair price, and services/drugs bought at a fair price (as happens elsewhere) can make this work. If people want the option of queue hopping and can afford private care to do that, let them do it, it will take the strain off the public purse, but they still have to pay the local social insurance. There are US based companies who specialize in reducing health costs, even after the fact by writing to hospitals and essentially saying “you charge X, the cost is X-30%) and successfully reduce those costs. I have yet to understand why these are not being employed, and I also do not understand why CIMA or an Ombudsman are not looking at the rip offs that go on here. I am lucky, I am an employed expat with an employer who pays most of my insurance cost, but I look at what they pay and what I have to pay as deductible or copay and I know its crap.

    • Anonymous says:

      If the queue you’re in is long enough you can skip the insurance and just die where you stand. Government healthcare ALWAYS means rationing of care.

    • Cos says:

      To be correct, CINICO for non-Govt employees is really a US model. And it is a waste of money for both the employees and employers. Due to the restrictive nature of our Health Insurance scheme, we cannot shop better policies abroad, which is myopic and self serving for government.

      I had close friend die of cervical cancer, because she was denied the testing under her policy, which was the worthless SHIC plan. It is cheaper for you to die, and they have no pity. I have a pre-existing medical condition, I have good coverage that I have maintained in the States, but I am forced by these foolish laws to pay for wholly useless coverage to not violate a law conceived by persons with no background in insurance, whom have great coverage at no cost for them and their families! They count on your compliance, ignorance and fear.

  11. Anonymous says:

    All of them are ripoffs!

    • Anon says:

      I think its very onesided to look only at insurance companies. When the other side of the coin is the charges from healthcare providers and over-use by the insured. The issue is a system that doesnt incentivize frugality of use. I recieve no benefit for the 10 years i have had never using my insurance… when i know several people who go to the dr at the first sniffle. The dr has no incentive to tell you to get on your bike and stop being ridiculous (insured hypocondriacs are great business). Insurance companies are allowed to raise rates to offset costs created by over use and so also have no incentive to manage costs… Regulation can fix this – government should not be in the business of running business but of creating legislation and regulation that create the proper environment for public benefit.

      • Cos says:

        True true. And I have brought this very issue to several MLA’s, with specific details. Guess what? They do not give a f***. They have no interest in true health care reform, or anything other than their own backsides.

  12. Anonymous says:

    Let us buy health insurance on the US or International market. Then watch the quality of cover increase, and the cost of premiums go down.

    • Anonymous says:

      why do you think large international insurance companies would be itching to sell to such a small group?

      • Anonymous says:

        Because I walked into one of their offices when I was outside Cayman for a year and purchased cover – very easily. It was so relatively inexpensive and good that I kept it even after I came back and still have it. I bought a crap cheap Cayman plan in addition to keep local regulators happy. The Shic plan I bought is so bad I could not even use it if I wanted to.

    • Anonymous says:

      1.42, I have seen it first hand and sadly you are mistaken.

  13. Anonymous says:

    Quick question. Where do you want the money to come from to pay for your massive health care costs?

    • Have a heart Cayman says:

      Are you asking me, as the original writer of this featured comment? I don’t expect anyone to pay for my medical costs. I have done everything right but still cannot afford the costs. I took out a good insurance and paid it every year on time. I paid all of my medical bills promptly from my own savings, and don’t owe anyone anything. I’m not responsible for any of the unpaid bills at the HSA. I declined necessary treatment because I cannot pay for it. I’m not expecting anyone to pay for me. If I need treatment and can’t pay for it – I die. That seems pretty straightforward and is a realisation many people will come to as they age or if a serious health condition occurs and savings are exhausted.

      If something happened to you, you were injured/became ill, lost your job as a result, lost your employer paid medical insurance and then had to take out a very expensive private medical insurance that didn’t cover any of those pre-existing conditions you now have – how long would your savings last? How many medical procedures could you pay for until all of your money was gone?
      Where would the money come from to cover your medical costs in your time of need?

    • Anon says:

      I think the assumption is that for 25+ years she paid premiums well in excess of what she used and expected that when she did need it that she would be covered??

    • Anonymous says:

      From proper medical policy . Instead of paying bill of CAL and building 100-150 million dollar schools. We are a british dependent territory, we are indirectly paying exorbitant taxes. Why doesn’t it cover the same benefits as the UK? Don’t get me wrong, you can still build schools but no more expensive then Catholic, Triple C or Baptist . Stop the corruption of medical ins.

    • Cos says:

      Okay, number one: stop blatant over coding for procedures. If my kid goes to the pediatrician for an ear ache, look at their damn ear, and prescribe some Cipro drops. In and out, level one. What do they do here? Bundle in a lot of useless procedures and code it level four. And guess what? The docs here bill it for $200. Wow, so f-ing shocked that health care cost are out of control.

  14. Anonymous says:

    …and Lonny says the system is ‘ideal.’ Instead of focusing on single-payer and bashing its limitations what government should really be exploring (and at pace) is universal coverage.

    There is no reason why every single legal resident of our country should not be entitled to affordable basic health-care. Start by banning insurance companies from cherry-picking the healthiest and adopt a more progressive risk management strategy (eg. link it to age.)

    If we wanted to be really ambitious we could explore a single payer system where all legal residents were required to register with CINCO which would guarantee basic coverage for all. Fund it through existing taxation (eg. duties, etc.) Yes- the knock on impact would see the cost of living increase but this would be off-set by a reduction in insurance premiums as this would no longer be a necessity. Take it one step further and fund it through legalising and regulating gambling, marijuana with any slack picked up through general taxation. Private insurers can continue to exist (in a reduced capacity) as the ‘premium product in the market’…

    • Anonymous says:

      You basically described what Lonnie described, a hybrid public/private system where there are proper funds (taxes) in place to pay for the public coverage for, in this case ‘medically indigent’ persons, while the private insurance remains in business as well. All he tried to say was ‘neither a totally private, nor a totally public, insurance system will work well; a hybrid model is ideal’.

  15. Anonymous says:

    health insurance is a scam by all involved……

    • Anonymous says:

      And we should stop IMMEDIATELY allowing XXXXXX and his insurance buddies he brings along with him, free radio time on Radio Cayman (taxpayer funded) to praise the health insurance system and bash single payer systems. It is ridiculous he is allowed this free advertising so often for his and other insurance companies.

  16. Anonymous says:

    Yet the Civil Service claim they are underpaid. This poor lady is one of many in the private sector who are having to pay out tens of thousands of dollars for medical treatment, whilst our pampered public sector can have treatment in the States with airfares and hotels paid for at no cost to them. What is worse is that this lady’s husband as a taxpayer is subsiding all this free treatment.

    • Anonymous says:

      So your solution to the problem is to blame the public sector because the private sector treat their employees like disposable cogs? How is that going to make anything better for anyone? Or will you only be happy if everyone in Cayman is hurting?

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