MPs vote CI$8M more for healthcare bills

| 21/06/2022 | 40 Comments
Cayman News Service
Health Minister Sabrina Turner in Finance Committee on Friday, 10 June 2022

(CNS): Finance Committee has voted another CI$8 million to cover healthcare costs for Caymanians who are uninsured or under-insured and have been treated outside the Health Services Authority facilities. When the committee met at the end of the last session of Parliament to deal with supplementary spending, health ministry civil servants told MPs that healthcare for local and overseas treatment for those without insurance is costing about CI$3.3 million per month.

The $21 million already appropriated in the 2022 budget is expected to run out before the end of the summer. But Health Minister Sabrina Turner said she would be asking for more before the year was out because the money she was asking for was also likely to run out.

The budget line item for ‘tertiary medical care’ was increased by over 38% because, the health minister noted, it was under-budgeted, even after government had increased it by around CI$5 million over last year.

Turner told the committee that she expected the entire cost for the year could be more than CI$40 million. She pointed to several reasons why more people need help and don’t have health insurance but noted that inflation was also playing a part.

“The cost of healthcare has gone up, and in all honesty, unless there is a huge change in the cost of healthcare… we can see ourselves coming back before the year-end,” she said. “This has always been one of those appropriations that has been underfunded for years and we are hoping to change this.”

Finance Minister Chris Saunders, who chairs the committee, outlined some of the efforts being made to address this long-running public spending headache. He said one was for the HSA to offer more services that would prevent patients being sent overseas for treatment.

Opposition MP Alden McLaughlin urged the government to take a more realistic approach to this area of public spending. “This is an appropriation which is chronically under-budgeted, and having been in charge of two governments, I understand all that is involved in it,” he said.

“But I think it is time that we become more realistic in the budgeting for this. I don’t think there will be any fights from this opposition… because we are fully aware of how challenging this is… We have to find some way to make handling these matters more affordable,” McLaughlin said, as he referred to the government’s plans to expand CINICO.

At the same meeting, members voted an additional $5 million for CINICO to help it move forward with previously announced plans to expand its services and offer health cover to people outside of the civil service.

Saunders said the government agreed with McLaughlin, pointing out that much of the funding being considered was spent on emergencies, since uninsured people don’t seek intervention for developing health problems until it’s too late.

He said that if people were “in the network, seeing doctors and getting regular check-ups before they become emergencies”, in the long run this would reduce costs, especially for these very expensive emergency situations. Saunders said the objective was to be more proactive and manage this chronic problem.

See the full Finance Committee hearing below on CIGTV:


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Category: Government Finance, Health, Health Insurance, Politics

Comments (40)

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  1. Anonymous says:

    Does the uninsured or under insured need a CINICO Card Issued to receive these services?

    Looking for written guidance notes/(application procedure) hard copy form or CINICO Website.

  2. It's Your Health says:

    If it’s not an emergency, ask for a copy of the pre-approval request from the provider and response from your insurer.

    You’ll then be able to see first hand what has been approved, what co-insurance or deductible is applicable and that your plan has sufficient benefits remaining to cover the cost of the procedure.

  3. Anonymous says:

    The system of private, for profit, health insurance providers, as practiced here in imitation of the USA, is the worst health care funding system in the world…..worst that is, except for the insurance companies.

  4. Anonymous says:

    It would be interesting to know what portion of these medical expenses are caused by the annual cap (typically $150K per annum) of benefits prevalent in the SHIC plans. In short, although your health plan may state you have $2M (sometimes more) in lifetime coverage, you are limited to $150K, or some similar amount, of coverage per year. Many Caymanians are insured, but if they have a severe illness, they often find that their SHIC plan benefits are quickly exhausted for the year (even though there may be millions left in their lifetime benefits) and are left with no option but to empty their savings account to help pay for mounting health bills and ultimately have no choice but to seek assistance from the NAU to be covered by their indigent plan. This is no fault of their own, as getting additional insurance when you are very sick is impossible. For those that find themselves in this position, the NAU application process is very humbling as they are likely used to supporting themselves and being left to the mercy of the Gov seems wrong.

    The points covered in this article are important, but we should continue to revise the SHIC requirements and look at ways to improve the overall health insurance framework in our islands. The local health insurance industry designed the SHIC, so not surprisingly, they cap their annual liability to smooth their expenses/payouts over time. A great business model, but unfortunately, life events and health care requirements are often at odds. Not having health coverage in a time of crisis can quickly deplete the healthiest of savings accounts and subsequently leave hard-working Caymanians alarmingly short on funds to support their retirement and ability to live out their golden years with dignity. By the way, this is when they will likely need their health insurance the most and normally when private insurers do their best to force ageing clients off their books.

    I also note this is not a CINICO issue as many private insurance plans are modelled using the shortsighted SHIC requirements.

    During one of the many press briefings during the days of our lockdown, Alden referred to the SHIC plans as a bill of goods sold to the CIG that are not fit for purpose. This short sentence was a mouth full, and I hope he and our Minister of Health continue to press for change on this matter. If you look at the alarming increase in spending that our Gov has been forced to absorb over the last 5, 10 and 20 years you don’t have to be an economist to realise there is a systemic problem and the situation is and always has been unsustainable.

    There is no easy answer here, but time is ticking and for many Caymanians it might be too late to recover from crippling health bills.

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  5. Anonymous says:

    When I had no medical insurance in the US, I paid out of pocket and MRI was $699. Ultrasound $250.
    You only need insurance for catastrophic accidents or emergency surgeries anyway.

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  6. Anonymous says:

    Why can’t the NHS have branches in the overseas territories? I guess that would require us to pay some sort of tax to pay for it. Anyone want to give honest opinions below? Would you be willing to pay a small tax for an NHS-type system here? I’m just curious so please be nice!!

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    • Anonymous says:

      Unlikely to be a small tax tho. 2021 NHS revenues from taxes £330 billion for a population of 67 million – so about $6K on average. But healthcare has pretty high fixed costs that are easier to spread across a large population. And then you have the problem of the cost of setting up a revenue department to collect and enforce the tax.

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    • Stan says:

      And NHS is perpetually in crisis mode. Not like some magic solution which just works.

  7. Anonymous says:

    spend and borrow…the pact-plan.

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  8. Anonymous says:

    Private health insurers in cayman generate a net profit of 50illion a year .
    Compared to the 40 million the government needs to help the victims of this system, the solution seems obvious to me

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    • Anonymous says:

      I guess Generali pulled out of Cayman because they were exhausted from counting all their profits.

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    • Anonymous says:

      Chris Saunders was a member of CINICO Board when it was created many many moons ago. When CINICO was set up it was the understanding that eventually it would be expanded to include everyone. All previous governments has failed to do that. He and the Health Minister should now ensure that it happens under their watch. Anyone who desires private insurance can get it but they should be insured under CINICO.

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      • Anonymous says:

        All you are doing is creating a larger money losing enterprise, but under Cayman accounting rules, every statutory authority makes money if you exclude the CIG subsidy.

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        • Anonymous says:

          One day your insurance will not pay for the the care you need.
          Hopefully you will remember your comment by then.

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      • Anonymous says:

        No. CINICO was set up to ‘manage the book’ of Civil Servant health insurance so that the Government could have enough data to outsource it to the private sector successfully after the first company that won the contract went broke / broke their contract because they were losing money on the deal having mis-estimated costs vs payments.

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  9. Anonymous says:

    Welcome to the Nanny State. Don’t bother striving for minimal success in life. Just sit on your ass, eat garbage, watch tv and wait for the other hard working residents to foot the bill for your inevitable health issues. For Shame!

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  10. Anonymous says:

    It need rip up all private health insurance and become 1 national coverage due private insurance are rip off to make much profit as possible! Or allow overseas company to work in cayman like BUPA.

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  11. Unhappy Caymananian says:

    HSA is. a failed organisation with no external accreditation or inspection, a pretence of achieving “international standards`”, no accountability with at best, questionable clinical outcomes.

    It should do more?

    It can’t do what it is supposed to now.

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  12. Anonymous says:

    Maybe the time is here to create a law which allows persons to die on their terms with dignity. Not being kept alive with technology and procedures, to bankrupt family and drag out the inevitable. This will not be for everyone but some would appreciate the option instead of extended suffering.

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    • Anonymous says:

      Big pharma and the US based healthcare machine needs victims. It’s your obligation to pay insurance to Charon (boatman of Hades) and die in most severe cases with debt.

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  13. Anonymous says:

    Ok, in over her head.

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  14. Anonymous says:

    So, someone is not enforcing the health insurance law? Would that be our #worldclass civil service Franzie?

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    • Anonymous says:

      These private hospitals/clinics get away with too much!

      One example I can give:

      Some time ago between 2014 to 2016, I received a medical bill in the mail for $3000.00+ from the XXXX. This statement was for a CT scan done in 2011 while I was employed at this hospital and was insured with Cayman First. The radiology staff advised me that they would send the CT scan request to Cayman First for pre-approval and about a week later they called to tell me it was approved and scheduled my appointment, etc. I tendered my resignation in late 2013 and not once between 2011 to 2013 had I received this bill. Fast forward to a few years later and they sent it by mail. I thought “Ok, this is an error because it was pre-approved.” I called the hospital’s accounts department and can you believe that they threatened to send my ‘delinquent’ bill to a debt collector which could result in me being taken to court! I called Cayman First only to find out that they had no record of XXXX everrrrrrrr sending in a request for pre-approval. So the radiology dept. lied to me when they told me they got it pre-approved and trying to use scare tactics to get me to pay.

      So I was nice enough to provide them with a copy of Section 20(2) of the Health Insurance Law which states – “Notwithstanding any provision of the Limitation Law (1996 Revision), no sum due to a health care facility or to a registered medical practitioner in respect of medical care provided to a compulsorily insured person, shall be recovered as a debt under subsection (1), either from that person or from the approved insurer, after the expiration of one hundred and eighty days from the date on which the medical care was provided.”………..and politely told them to kiss my backside! I also reported them to the Health Insurance Commission.

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      • Anonymous says:

        Yep, I know someone who did that as well. If they fail to notify you before the 180 days that is on them.

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      • Anonymous says:

        I just had this exact same thing for an MRI scan. I knew it had to be pre-approved and told the hospital. 2 weeks later they call to tell me it is pre-approved and I can now make my appointment, only $88 to pay. So I had the MRI, left it to the hospital to make the claim. Five months later they tell me the claim was denied because there was no pre-approval sought so I am liable for the whole bill. I have no means of paying almost $3000 so now I am not able to afford any further medical care and have a huge debt. Something has to be done for a single agency to take over the management of our healthcare provision, without profit or corruption. But I have no hope that it can be done, especially the without corruption part.

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      • Anonymous says:

        HSA sends me bills all the time. Just ignore them or send them back.

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  15. Anonymous says:

    So he was “in charge of two governments” and precisely what did he do about it?
    Ego Ego Ego!

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  16. Anonymous says:

    Just as well Chris is borrowing all that money, eh.

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  17. Anonymous says:

    Maybe the licensed insurance companies, profiting from being allowed to do healthcare business in the Cayman Islands, can be ordered to raise their customer coverage to be in-line with real world inflation-adjusted medical actuarial tables, so that patient benefits equal a true 80:20 split of delivered treatment cost.

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    • Anonymous says:

      Its the government that sets the level. They need to raise it at their level.

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      • Anonymous says:

        Agreed. The SHIC requirements are the issue. Private insurers are hiding behind this inadequate set of coverage they convinced the government to implement.

  18. Anonymous says:

    Raise the cost limit so us to obey laws and get insurance are actually covered.

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  19. Retail sales sick of the injustice says:

    We need to get away from the failed US model for health insurance. Basic coverage, at least for Caymanians, should be the standard. I am no scholar, so not sure how funding should occur, but let’s here from some people who are well versed. If the person is on a work permit, then require mandatory employer coverage, if Caymanian then under government blanket. Would make Caymanians more attractive as employees, win, win. Idk, maybe I am wrong, but at least worth a look.

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  20. Anonymous says:

    Gross mismanagement at all levels.

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