Health minister gets $8M to cover budget gap

| 03/07/2018 | 25 Comments
Cayman News Service, Cayman Islands health ministry

Cayman Islands Hospital entrance

(CNS): Finance Committee has approved millions of additional dollars for the health minister after he revealed that the budget for overseas tertiary healthcare for Cayman Islands people who are indigent as well as elderly seamen and veterans had already overrun its budget allocation at the financial year half-way mark. Committee members voted for the extra $8 million Dwayne Seymour asked for, but not before he was grilled by opposition members on what he was doing about spiralling healthcare costs, possible policy solutions and plans for a national system. 

Seymour said that the extra cash was for the budget allocation that deals purely with the healthcare costs for this group of people who don’t have insurance but who are in need of overseas medical care, and the $8 million requested was to cover the second half of this year only.

In a statement to the committee justifying why he needed the supplementary appropriation, he said the number of indigents being taken care of by government had increased over the last six years from 1,100 to more than 1,600 who were now in need of temporary or indefinite support for medical needs. More than half of those were over 61, and of those 1,600 people, 907 were now permanently being covered. From that group of those with an indefinite need for support, more than two-thirds were over the age of 61, making it clear these costs were going to continue climbing.

He said the healthcare needs of people over 60 in Cayman justified his feasibility study regarding healthcare for older people and the need to provide better and more sustainable cover for this growing population. Concerns have been raised, however, that shaving off the older members of the community from insurance pools will make the current situation worse, not better, and that there is a pressing need for a national system using CINICO as the primary insurer.

Seymour also revealed that the segregated insurance fund, which was set up to collect contributions from the health insurance sector to help cover the cost of indigent healthcare needs, was collecting around $5 million annually, which was significantly below the amount government is spending on this group. The public purse is currently footing a bill of around $1.8 million per month on overseas healthcare alone for the indigent and elderly who are not insured.

Government is also covering around $1-2 million worth of local healthcare costs for the same group each month, separate and apart from this specific allocation for overseas medical referrals.

Although the committee supported the health minister’s request, he was questioned about the current policies and plans and whether it was time for government to introduce some form of national system. Seymour told the committee he was very uncomfortable with how things were and the spiralling costs. He admitted that he did not yet have a solution but said he was determined to find one.

The minister also revealed that there was no data, research, analysis or dependable information that could be used to justify a national system yet. He said discussions were underway at caucus level in government about the possible options for the future of health cover, but he said he was not ready to talk about that publicly yet. However, he did say that the discussions have included the idea of expanding the government’s insurance company, CINICO.

Despite having collected no information at all, the minister claimed that since being elected over one year ago, he had been looking at trying to curb costs and had been meeting with people to find a solution. He said it was an area he was working on and he had three years left, and even if he didn’t find a solution, he said he would have some ideas to put on the table for members of the Legislative Assembly to digest. 

The government is spending in excess of $40 million per year on health costs for the elderly and indigent. However, members were also concerned about how far off budget allocations are, and Chris Saunders, the opposition member for Bodden Town West, pointed out that the prediction for this allocation was more than 70% wrong.

Seymour said he was “uncomfortable” with the costs, but the same thing happened last year and the year before that, as he insisted he was having conversations about what could be done. He described the issue of health costs for those not covered as being all over the place and that there was a “need to bring it to one place…so we can manage it better. There is no joy in talking about this out-of-control spending,” he added. 

Seymour said that he was looking at everything, from older people to children, as he raised concerns that the insurance companies, which made a collective profit last year in excess of $55 million, were making profits on the backs of people’s health bills. He said it was “something we are looking at”.

The minister was grilled about why so many patients still had to go overseas to be treated and whether it was a question of incompetence or fear at the George Town hospital. Despite being the health minister and responsible for policy, Seymour said it was “not easy to get answers and drill down to the questions we need to ask”.

He said more studies were needed on how costs could be kept down and to get answers on why there were major differences in costs. He said he was looking at why certain overseas hospitals were being used when, despite giving the Cayman Islands Government discounts on service, they were often the most expensive facilities to choose. All of these issues, he said, were “not easy puzzles to resolve it but I am on it”.

The minister was unable to answer several questions from the committee about a number of areas under his responsibility, including the under-utilisation of the costly, medical robot that the HSA now has, and the fluctuating and inexplicable high charges on some medications at the hospital.

Asked how he did not know, given that he was the one bringing the budget allocations, Seymour said he had a “lot of fires to put out”. But he said he was “plugging away and I intend, as minister, to make a difference before the term ends”.

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Category: Government Finance, Health, Health Insurance, Politics

Comments (25)

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  1. Anonymous says:

    Why so many sick people? Is human race on its way to extinction? Until 70 years ago, castor oil and some other home remedies was all that needed.

    Today, cutting out your gallbladder, uterus, tonsils, seems to be a new norm that accomplished nothing. No one was ever cured by a doctor or a pill or a surgery. Human body is a self-repairing mechanism.

    “I’ve tried all the medical faculty: they can diagnose beautifully, they have the whole of your disease at their finger-tips, but they’ve no idea how to cure you. There was an enthusiastic little student here, ‘You may die,’ said he, ‘but you’ll know perfectly what disease you are dying of!’ And then what a way they have sending people to specialists! ‘We only diagnose,’ they say, ‘but go to such-and-such a specialist, he’ll cure you.’ The old doctor who used to cure all sorts of disease has completely disappeared, I assure you, now there are only specialists and they all advertise in the newspapers. If anything is wrong with your nose, they send you to Paris: there, they say, is a European specialist who cures noses. If you go to Paris, he’ll look at your nose; I can only cure your right nostril, he’ll tell you, for I don’t cure the left nostril, that’s not my speciality, but go to Vienna, there there’s a specialist who will cure your left nostril. What are you to do? I fell back on popular remedies a German doctor advised me to rub myself with honey and salt in the bath-house. Solely to get an extra bath I went, smeared myself all over and it did me no good at all. In despair I wrote to Count Mattei in Milan. He sent me a book and some drops, bless him, and, only fancy, Hoff’s malt extract cured me! ” (The Brothers Karamazov
    by Fyodor Dostoyevsky, Chapter IX. The Devil. Ivan’s Nightmare)

    • West Bay Premier says:

      Anonymous 6:33pm , I believe that you are on to something about Doctors and money today, and they are just like some mechanics, where you take your car in for an oil change, and they find a problem with your brakes .

      Speaking about old time cures for different things . Do we see the white spots that some people get over their upper back and arms , that is caused from the sun , that’s a fungus that is caused from the sun, but it is not contagious . That is what I had a Dermatologist tell me about it . And I got the prescription at the sand bar in the north sound before there were stingrays . The prescription was , apply the blue selsum blue shampoo 3 times daily . I did and within about 2 weeks all the white spots were gone , I continued to work in the sun on my boat trips for many years after , and the spots never came back .

      See Doctors sometimes don’t even need to be in the office or the hospital to fix some of our problems, and my prescription was a tip for giving the Doctor a good boat trip . Then one of the other passengers heard him telling me about the spots , and asked him tell her because her son had the same white spots , but the Doctor reply to her , you have to bring her son into his office when he get back home and he gave her his business card . I don’t believe that she was given such inexpensive prescription .

  2. Anonymous says:

    Good news. I was in intensive care last year and my tv and the blinds in my room was sooooo dusty perhaps they could use a few dollars in cleaning them dusty blinds and them 1970 tv’s

    • Anonymous says:

      You got a TV? Also, that sounds more like health violations that should be reported.

  3. Anonymous says:

    The CIG is taking $20mln: $10mln is being requisitioned from “Reserves” which were already earmarked for paying down our $312mln 5.95% bond due 24 Nov 2019; the other $10mln is being unlawfully requisitioned from the fast-depleting Environmental Protection Fund. It’s remarkable that no media have reported on what the other $12mln are bailing out, and there are no press releases from the site or the Finance Committee. Hello?!?

  4. Anonymous says:

    Wouldn’t it be cheaper for Government to pay for health insurance for these people???
    I mean, as the taxpayer has to foot the bill anyway, it seems to make more sense to pay for health insurance rather than for medical bills……

  5. Anonymous says:

    I pay for healthcare and can’t afford to go off island for treatment so why should someone who doesn’t pay for healthcare be allowed treatment off island on our dollar?

  6. Anonymous says:

    So, Dwayne Seymour under-budgeted his Health Ministry by $8mln, even though he knew “the same thing happened last year, and the year before that”. Should Roy McTaggert be fired for making this $8mln error, or should Dwayne Seymour for deliberately under-budgeting? Oh, btw, is anyone going to ask what the other $12mln is for? This is worse than the NBF cookie jar!

    • Dr. Know says:

      The Chief Officer Jennifer Ahearn is responsible for preparing the budget at ministry level. HSA CEO Lizzette Yearwood is responsible for preparing the budget that is submitted to the Ministry of Health.

  7. Anonymous says:

    Surely a Health Minister should be able to at the very least distinguish between his ass and his elbow? Still, a big step forward from the days of Ezzard.

    • Anonymous says:

      The ability to discern as ass from an elbow is not necessary for a Government position which is handy given the current crop of Ministers. They are looking for people who might, on a good day, be able to organise a XXXX up in brewery, but while that is seen as desirable level of minimum competence it remains just an aspirational threshold as evidenced by Dwayne’s appointment.

  8. Anonymous says:

    Jon Jon needs to replace the CEO and board of HSA

  9. Anonymous says:

    Hey, how many of the people we are providing free healthcare for are not Caymanian? Get your head around that and the Immigration implications, or we are truly lost!

    • Anonymous says:

      @ 7:17… I don’t know of anyone other than Caymanians getting free healthcare. How about some examples?

  10. Anonymous says:

    This only highlights the need to have one health insurance plan for our small island. As much as the have people do not like it, eventually they also will get old and sick. Please Honorable Premier stop playing footsie with the elite and do the right thing for the people of the Cayman Islands.

    • Anonymous says:

      One health insurance plan for the whole island?! You mean like we have one electricity provider? How’s that working out for us? We need proper competition to keep rates reasonable, and stamp out collusion between providers.

      • Boggy Sound man says:

        You must be a insurance industry employee.

        • Anonymous says:

          Boggy Sound, did you think before putting pen to paper? Proper competition keeps prices down, whereas a monopoly can do what it likes. An insurance person would want a monopoly. Having said that, if the supermarkets can collude on prices, then anything is possible here.

          • Boggy Sound man says:

            We all know the excuse is that the pool of members is too small hear to achieve good rates and as far as collusion, that is rampant for anything (what about fuel?) as far as pricing on this little island. Now if all had to go thru the Cinico or another insurer that the government could make a deal with and then have a group of experts (sounds like you are one) help to regulate and ensure fairness then we as a whole could get better pricing; example healthy young people, older with conditions and then of course our seniors. If the current companies here are so interested then have them put proposals together to do this but the current system does not work because when a person get old or has a health issue, they get dropped or rates go thru the roof. It seems though you are more worried to keep the status quo which on a whole is not helping the regular person and it can not keep going on like this. Now you can come back with some more comments.

            • Anonymous says:

              I make a point of never letting “think they know it all’s” tell me what to do.

              • Anonymous says:

                Well too bad you can not come up with any suggestions that are better as this and pensions for our older population is a crisis that is very near to affecting everyone. But perhaps you are one of the 25 year residents who will disappear to somewhere else once this happens.

  11. R We C Ree Us???? says:

    Dwayne Seymour as Health Minister is comparable to Shellbun being Captain on Cayman Airways To Miami tommorow…….it is totally un fathomable. The man is lost and out of sync….if you can’t get trash collection regularized, how in the hell will you or CAN you do anything to fix health care. And to,think that we have 36 more months to deal with this circus government. GOD HELP US!!!!!!

    • SSM345 says:

      The man cant even handle garbage collection let alone the health system. His plan is too commission more consultant reports.

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