Health insurance challenge dominates PAC

| 17/01/2019 | 33 Comments
Cayman News Service

MLA Chris Saunders

(CNS): Public Accounts Committee member Chris Saunders (Bodden Town West) articulated the frustrations of PAC and the community when he expressed concern that the health ministry had failed to respond to shocking figures revealed more than three years ago that the local insurance companies made a collective profit of more than $51 million in 2015 from health insurance policies alone. And they do so while the public purse is picking up a tab that is now exceeding that amount in healthcare costs for elderly members of the community because of the market’s failure to provide affordable cover for local retirees. 

“The profits should have raised a red flag,” Saunders said. “But what has been done?” he asked rhetorically, as he railed against the failure of anyone in government to say or do anything about this glaring “red flag” while the public continues to foot the ever-growing bill for subsidizing the healthcare insurance market. 

As well as the near $30 million spent on overseas health costs for the indigent, seafarers and veterans, the government picked up the tab of $16 million for the same groups’ medical bills locally. In addition, CIG paid several million dollars in indigent premiums to CINICO for people who cannot otherwise get insurance, plus a growing number of subsidies to cover the costs of prescription medicines and other health programmes for those who cannot access or afford cover, most of whom are retirees and pensioners.

Echoing Saunders’ concerns, PAC Chair Ezzard Miller said there were probably around eight or nine budget line items that, when added together, were in the region of $60 million coming from the public purse to pay for the medical and health needs of the poor and elderly.

Miller said the insurance companies were making a profit because they were not covering anyone over the age of 65, as he criticised the proposal for a SHIC65+ plan for seniors, saying that this would not solve the basic problem of the prohibitively high costs of premiums for the elderly, who were on fixed incomes and the least able to pay but the most in need.

Saunders, who is increasingly advocating for some form of universal health cover for all Caymanians, agreed with Ezzard, saying the country had to establish whether we believe healthcare is a benefit or a right.

He pointed out that many retirees who cannot afford insurance have worked all their lives and paid many thousands of dollars in annual premiums over the years while they were healthy and hardly claiming.

But the day they retire on relatively modest fixed incomes, the insurance companies are dropping them or providing only prohibitively expensive policies that they simply cannot afford, leaving government to shoulder the growing burden.

“The problem is the private sector is dumping clients on government while the businesses are making millions of dollars in profit and the taxpayers are taking care of the elderly who made the insurance firms their profit in the first place,” he said. 

Describing this as “a national problem” Saunders said the opposition had agreed to work with the government on this, but warned that there was a vacuum of information from the ministry, which was needed to begin finding solutions to this pressing issue.

“I know the insurance lobby is strong,” Saunders added, implying that this might be why the ministry was not moving quickly enough. “But we can’t have CI$40 million being spent on indigent healthcare becoming the norm.” 

Saunders accepted that the problem was “bigger than the ministry, bigger than government and something the whole country needs to understand has to change”, but he urged the chief officer of the health ministry, Jennifer Ahearn, who was before the committee, to supply the necessary accurate statistics and information to enable the Legislative Assembly collectively to begin seeking a solution.

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Category: Government Finance, Government oversight, Health, Health Insurance, Politics

Comments (33)

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  1. Anonymous says:

    Just pay for all Caymanian necessary medical care ncluding the unemployable, the old and the drug addicts. You are almost doing it now. Eliminate the middleman. Let any local or foreign insurer compete for everyone else.

  2. Anonymous says:

    The core problem is not what the companies charge but how few companies there are. Restricting competition pushes up oligopolistic pricing. Free up the market to new entrants and pricing will go down, or service will improve, or both.

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  3. Anonymous says:

    I have to say I was pleased with how Mr Miller conducted this PAC session. Good hard questions without the aggressiveness and combativeness. Saunders asked good questions and once he stops believing what people whisper in his ear before the hearing he will be fine. He has a lot to learn and needs to know when he is being used and set up.

    Bernie well…, he asked the Chief Officer for Community Affairs a question about the fire department??zzzzzz do I need to say more. Bernie is so angry because he is not the Minister of Education he self destructing rapidly.

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  4. Anonymous says:

    In a nutshell, here is what masterminds like Chris Bernie-Sanders is proposing.

    No more private health insurance companies, No more more private health service providers (Like Health City, CTMH or Trincay). You all deal with government for your healthcare like we are all on Cinico, but much worse.

    If you want to see what that’s like, go visit a Cuban hospital, or go to the Bahamas.

    And by the way, if you need to get to the States for healthcare, sorry, no can do. Government won’t have to money.

    Not to mention, all of the jobs lost in the insurance industry and healthcare.

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    • Anonymous says:

      This all explains why Canada is renown the world over for shitty healthcare services right?

      Newsflash:
      -Private health insurance companies will still exist for persons who want supplemental coverage, for procedures not on the universal plan you are LYING

      Health City and CTMH will continue to function as normal,universal healthcare does not restrict healthcare providers or mean that only the public hospital will remain open you are LYING There is a distinction between Universal Single Payer coverage and Socialized medicine. Different countries use different systems
      In Canada for instance the coverage is provided by the government but many of the institutions are private
      Whereas in the UK the government is both the provider of coverage and the provider of services.

      Dealing with a single provider for universal healthcare means lower costs, no profit incentives. It also happens to be the system of choice the world over in most developed nations excluding the US which also happens to be where you got your talking points from

      **** Examples of countries with Universal Healthcare:
      Austria, Belarus, Canada, Croatia, Czech Republic, Denmark, Finland, France, Germany, Greece, Iceland, Ireland, Italy, Luxembourg, Malta, Moldova, the Netherlands, Norway, Portugal, Romania, Russia, Serbia, Spain, Sweden, Switzerland, Turkey, Ukraine, and the United Kingdom. ****

      https://en.m.wikipedia.org/wiki/List_of_countries_with_universal_health_care

      The problem with CINICO is based on the fact that the only people included in the insurance pool are older persons and poor people
      There is no healthy group being used to spread the costs effectively (which is the entire point of insurance in the first place)

      “If you want to see what that’s like, go visit a Cuban hospital, or go to the Bahamas.” – Their systems might not be perfect for a multitude of reasons but assuming we would mimic them rather than Denmark or Canada, Intellectually dishonest comment at best

      “And by the way, if you need to get to the States for healthcare, sorry, no can do. Government won’t have to money.” – The entire point of

      “Not to mention, all of the jobs lost in the insurance industry and healthcare.”
      The jobs will still exist both, sure they might be shuffled from the private sector to the public sector but the same number of persons will need to be employed

      The real question is, what makes you brazen enough to actually lie and think no one is going to challenge you on all your bullshit?

      Healthcare and a healthy life are human rights
      Not privileges to be bought if you can afford it

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      • Anonymous says:

        Have you lived in Canada or any of those other countries that offer ‘free’ healthcare? Do you know how long and inconvenient it is to wait on treatment? Goodness you think the wait at GT hospital is long for emergency? Try going to a hospital in Canada. You can even register online for your 8 hour wait.

        I left Cayman to go to Canada thinking it would be better well what I surprise that I had. Cayman is much more advanced. At the very least in Cayman if I need a specialist, I can use my insurance and walk in and see one and get treated immediately. I don’t have to wait for a referral by a GP that’s just pushing paper and then see ‘if’ that specialist has time/space for me. That process can take months! This is even with private insurance available in Canada.

        No system is perfect. None. But Cayman has it quite good. As for the elderly that’s the problem, the insurance companies shouldn’t make the cost so high. If someone was paying for years, the cost shouldn’t just dramatically increase. That’s the problem. But please don’t make it like the other countries where it’s universal healthcare. More people will get sick and die. Rather than now people can get treated early and quickly.

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        • Annon says:

          Fear monger Much??
          As it is now Cayman has shit insurance policies based on the US . The Americans will literally through people out on the street if you don’t have insurance. there are many vids on youtube about this just search it.

          Insurance companies profit so much off the existing systems now, so of course U.H.C is not in their scope of business. I hate how much Cayman is like a minature version of the US.
          Class segregation
          Corrupt politicians
          Huge Disparity between rich and poor
          Lack of opportunity
          Shit insurance
          I am even hearing rich people who can afford Premium can’t get reasonable coverage even though they are paying horrid amounts for health care. I personally can only go to the doctors once or twice with my standard coverage.
          and the true tragedy is some of us are only one sickness away from bankruptcy.

          We need universal healthcare where everybody pays into and everyone is covered.

          Richard Ojeda said it best,
          The dirt poor are going to one day eat the rich!

    • Anonymous says:

      Yea and all these old Caymanian geezers expecting to get affordable health care, the nerve of them! You tell it old nutshell; just hope one day you have problems so they turn the tables on your stink behind. Maybe you and your insurance buddies can come up with some way to get rid of us old farts who are taking space up from all your kind and generous type who have moved in after the old timers got Cayman started for everyone.

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  5. Say it like it is says:

    The insurance companies raise premiums every year yet restrict claims to the limits set by Government based on medical costs in place more than 10 years ago.
    As for the hardship endured by the private sector’s soaring premiums this has never received much attention from Government for the simple reason it does not affect them.

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  6. Anonymous says:

    Nothing wrong with any company charging anything it wants in any industry, however its not cool if the general public/locals/expats/whomever are being forced by Law to purchase something that’s subjected to minimal oversight and open to scoundrel practices as is happening with Health…a nationalized system is easily enabled in Cayman and should be open to all residents regardless of citizenship…on related themes, the banks must be stopped from pillaging (fees for online inter-bank pmts; fees for check books; the utterly unjstified CI$-US$ conversion rates 84/2/0 that enable the banks to steal legally from us; and so forth)….also CIREBA must be stopped operating this near cartel at such commissions….supermarkets must be brought under price control and limited to minimal mark-ups on the vast majority of their goods….enough guys, we all love capitalism, but wake up, the tiny, tiny few are creating a nirvana for themselves here and 99% of us cannot afford it….

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  7. Anonymous says:

    Being required to pay health insurance is a violation of my human rights as a Christian Scientist.

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  8. Anonymous says:

    Mr Saunders sounding more like Senator Sanders every day

    But of course can’t let the voting base hear that as we pretend to detest social democracies while taking their key policies and programs, mocking them while we idealize the same systems

    It was less than a month ago he was standing in the LA railing against the UK and the EU for their “vast welfare states”

    I love the idea of a national healthcare plan

    But pick a side

    Cause the flip flopping might be convenient politically but it certainly is unattractive to those of us who bother to listen

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  9. Anonymous says:

    You go chris – do the things that matter to us in Cayman- well done!

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  10. Anonymous says:

    I got a letter from BritCay stating that because I have Diabetis they can only insure me for $50k usd per year!!!

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    • Anonymous says:

      Then have people like Saunders allow more international foreign insurance companies to bid in Cayman, instead of protecting them. (Including pension investment funds), then talking out of both sides of his mouth.

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  11. nickcayman says:

    The insurance industry is a cartel, a cartel holding Caymanians for ransom.

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    • Anonymous says:

      CIREBA’s long lost cousin

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      • Anonymous says:

        No, you have an option not to use CIREBA. The government forces us to use the insurance cartel. Why doesn’t government allow us to just get reputable international insurance. We would get as good or even better cover, at much less cost.

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    • Say it like it is says:

      Only Caymanians?, do they pay higher premiums than expats?.

  12. Anonymous says:

    I don’t get sick. I don’t go to doctors. Why should I be forced to pay for something I’ll never use?

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    • Anonymous says:

      How do you know you will never use it? If you can foresee the future with that kind of accuracy, please let me know next week’s Powerball numbers.

      The fact is that most healthy young people they will never get sick. People who have been healthy their entire lives suddenly have heart attacks or strokes. I’m certainly not wishing that on you, but you really need to be a little less sure about what the future holds for you.

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    • Anonymous says:

      What a ludicrous, selfish, naive argument.

      I’ve never caught fire. I’m not an arsonist. Why should I be forced to pay for the Fire Brigade?

      I don’t get robbed, I don’t commit crimes. Why should I be forced to pay for the Police Service?

      I don’t leave the country. I don’t buy anything from abroad. Why should I be forced to pay for the immigration and customs department?

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      • Anonymous says:

        Wrong. I’d happily pay for any services I chose to use, I will not continue to pay for services I don’t use however. Insurance is second only to religion in the greatest scams of all time.

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        • Anonymous says:

          Check back in on this comment in 5 years to see the about face, repeat as necessary until you see the results you are looking for

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    • Anonymous says:

      757 my dear you are a hypocrite and in denial. Everyone gets sick and when you do you will want help and fast.
      Good luck having a perfect life!
      Insurance payments are a pot of money for anyone in the group to use. It should protect you if you become ill. You are a cheap skate and expect the Government to foot your bills.
      You are a typical socialist like Bernie Sanders of USA.
      Health care is not a right.
      Why not get cars and food and phones and electricity for free.
      It is another service first started in Texas. Google that.
      Health insurance is not for everyone. If you do get a catastrophic illness good luck if you do not have a good coverage.

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  13. Anonymous says:

    Isn’t it strange that insurance companies set what they deem as reasonable costs for Cayman healthcare and it is always lower that what is charged, yet we can’t set their profit limits.

    Modern day crooks that are in the risk business without any risk!

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  14. Anonymous says:

    Insurance companies in Cayman rake in more than banks, with greater profits; yet they’re very stingy when it comes to paying out valid claims! Rip off!! And our successive Governments continue to be held hostage by these pirates!

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  15. BeaumontZodecloun says:

    The last time I suggested that CINICO should be nationalised, my intent was misunderstood.

    If CINICO were offered to everyone here — work permit and Caymanians alike — the insurance base would be much broader, and would be MUCH easier to absorb the costs of indigent and elderly health care.

    Added benefit would be relief to the NAU, which is stressed partially due to rising number of elderly whose retirement is completely consumed by their day-to-day needs, leaving CIG to pick up their health care costs. That could also create a framework for covering heath care costs for people getting assistance after they get a job; cover them until their employer takes over.

    Currently, those over 60 can purchase the Silver Plan for about $300/month, and it pays for $400 worth of yearly benefit, and, of course, catastrophic injury/illness.

    We can do so much better if we extend this system to everyone. You don’t want it and have something much better? GREAT! You’re not part of the problem, good for you.

    As it is now, with the mandatory health care ‘scheme’, the insurance companies are making millions, and CIG — which is financed by you and me — picks up the tab. We can do so much better.

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    • Anonymous says:

      Amen!! Will gladly pay my CI167 a month to Cinico vs private. Right now my health insurance has ignored me for over a month and im in their system as a non existent customer even though im fully paid up till Jan 31 2019!! Havent been able to access my benegits for 2 months now! Please somebody tell me how its legal for them to get away with this crap?!?

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      • Anonymous says:

        Same way you can buy an airline ticket and if you need to change it you pretty much have to buy a brand new ticket instead of them just removing you from the flight you already paid for and adding you to the flight you need.

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