Tertiary healthcare spending already over $24M

| 15/08/2022 | 62 Comments

(CNS): Government’s spending on healthcare for people who are uninsured or under-insured is already more than CI$13.9 million over budget and there are still four more months of the year to go. The line item in the annual budget known as NGS55, the allocation of spending on tertiary healthcare at both local and overseas hospitals, is largely for retirees from the private sector who can’t afford the premiums and workers who cannot get coverage because of pre-existing conditions or whose health plans don’t cover the care they need. So far in 2022, the public purse has picked up a tab of over $24.3 million.

According to the unaudited public finances for the first half of this year, this output to Non-Governmental Suppliers (NGS) is one of the biggest single items fuelling the increase in public spending so far this year, wiping out the savings made on personnel costs and consumables. This line item is running at almost $14 million more than its year-to-date budget and exceed prior year-to-date spending by $8.5 million.

The financial report published last week confirms that Parliament approved, via section 12 of the Public Management and Finance Act, an additional $8 million for the 2021 financial year but will need to do the same, and probably even more, for this year.

The line item continues to surpass the budget each year, even though the estimated allocation for this appropriation also grows. The PACT Government has said it is taking a look at the health insurance regime and has plans to expand CINICO to help provide insurance for the elderly.

Government’s healthcare costs have increased from almost $91 million in 2009 to an expected $200 million by next year, which is a rise of around 120%. Finance Minister Chris Saunders noted in April when he announced the plans to expand CINICO that healthcare costs were on average 19% of core government’s total operating expences.

Government has also spent some $5 million more than it had budgeted for the first six months of this year on the Ex-gratia Stipend. However, the last payments will be made this month, as displaced tourism workers are transitioned to the Needs Assessment Unit and businesses are re-opening, so further supplementary funding is not expected.

Additional spending on healthcare and other support programmes, such as the school meals programme, and propping up some statutory authorities and government companies totalled around CI$37 million, but this was covered by savings in other areas and significant increases in revenue.

See the full report in the CNS Library.


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Category: Government Finance, Politics

Comments (62)

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  1. Anonymous says:

    There needs to be serious health cost reform on this island. Cost and insurance premiums are astronomical. Too many providers milk insurance with unnecessary tests and procedures simply for more income leading to ridiculous costs for everyone.

  2. Anonymous says:

    Does this include all Civil Servants who abuse sick leave and sick leave extended time; believing that they must use it all within the first 6 months of any year?????

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  3. Anonymous says:

    Why is it when an employee retires from the private sector and is unable to obtain insurance due to a preexisting condition it becomes a government problem? Then taxes are increased to pay for these expenses and everybody pays except the previous insurance company where the individual was previously insured. Our government should fix this loop hole and ensure children and retirees medical is free.

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    • Anonymous says:

      All private companies should have to cover their retired employees who were employed more than 15 years. High time this was legislated instead of allowing them to throw their retirees on CINICO.

  4. Anonymous says:

    As healthcare is a basic human right Frankly, I do not care how much the government spends as long as it is spent on children, the elderly, the indigent populace and the others who qualifies for ‘free’ Healthcare e.g. Civil Servant Pensioners.

    Until our politicians take care to not spend huge amounts of the public purse on their own agendas, start and stop projects, and personal gain
    (Whatever that may be), I say thank you CI Government for providing Healthcare for those mentioned above.

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  5. Anonymous says:

    Cinico should create a group plan for over 65 retired Caymanian people, hire a third party insurance administrator to run it, and pay what it takes every year. It would at least be organized, unlike now, so you could see what was happening overall and could plan for the future.

  6. Neverwannabeacivilservant says:

    So what’s the tab on all the Civil Service and their dependents?, does Govt have any idea?.

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  7. Anonymous says:

    Caymanian doctors admitted to practice as fully registered medical practitioners in the UK or USA (after graduation)can only get provisional registration in Cayman for 2 years. The excuse given is that they have no experience. This in practice means that young Caymanian doctors have no reason to come back to Cayman as they would prefer to gain their experience overseas in USA and UK where they are paid and treated as fully qualified doctors. Once they have started working in USA and UK they are on a career path and will no longer come back home.

    Brain drain!

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    • Anonymous says:

      Hmm. What happens after their provisional 2 years expires? Their registration is confirmed? So what’s the issue with them serving a probationary period? They are going to be paid as newly qualified doctors irrespective of where they are – the US and UK are not going to pay them the same rate as someone with years of experience. Your explanation doesn’t quite stack up.

      • Anonymous says:

        If they are on probation in Cayman they cannot count the 2 years as being 2 years working as full doctors and they cannot accordingly get a good standing showing they worked as full doctors. This will in turn wind the clock back on their careers.

  8. Anonymous says:

    Maybe it is time to educate people about fast/junk food.

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  9. Anonymous says:

    I don’t believe in term limits
    I don’t believe in minimum qualifications for elected politicians

    But the current crop of representatives in Cabinet makes me rethink my position daily!

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  10. Anonymous says:

    Simple, police health care providers who are milking the system and stop providing health care to non-Caymanians.

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    • Anonymous says:

      What do you mean? Health care is mandated for all employees, including WP holders. Perhaps what you mean is “stop providing free health care to non-Caymanians”. People talk about that frequently, but I’ve never read any firm evidence of that taking place. Please enlighten us, if you have such evidence.

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      • Anonymous says:

        Hundreds of non Caymanians are receiving free healthcare. They include foreign spouses and children of Permanent Residents and Civil Servants. The NAU’s own statistics confirm details, but there is much more when the uninsured and under insured expatriate workforce is taken into account.

        If the Caymanian people are paying for your health insurance, or you simply don’t pay your bills, that counts as free.

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  11. Anonymous says:

    Net profits of private health insurers in the cayman islands average is 50 million a year.

    Make cinico available for all and problem is solved and get rid of the private ones.
    Cinico is then the only provider and can set the cost of medicine and medical procedures.

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    • Anonymous says:

      100% publicly run things are great, I love going to the DMV. Monopolies are also great, my CUC bill hasn’t gone up in a long time now!

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  12. Anonymous says:

    Another direct result of McKeeva’s “population growth” plan….Status giveaways!

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  13. Anonymous says:

    There is a need for a national healthcare system. The private insurance companies don’t want to insure individuals with medical conditions or the elderly so the burden of this falls to the government. The offset these costs the government needs to take over the profitable segment of the market that the private health insurance providers and abusing today.

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  14. Anonymous says:

    These guys are mortgaging our future so they can get elected again. I cannot wait until the next election so we can be rid of them and anyone who has joined them at the table. It’s time for a real cleanup! PACT was a mistake, they deceived us and got elected and bullied their way to form the Government using CMR to frighten certain new politicians into joining them. It’s time for PACT and CMR to go!

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  15. Anonymous says:

    Who cares as long as pact keep writing cheques?…they are creating a welfare state for locals who will never be able to stand on their own 2 feet.
    Welcome to a a soon to bankrupt wonderland…

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  16. Anonymous says:

    There needs to be further analysis on breakdown for
    Types of diseases
    Types of treatment eg surgery

    Then the government need to put plans to reduce future costs such as
    Preventative plans
    Hiring specialist within HSA to deal with treatment at government facilities to reduce costs

    Then they need to look at medical facilities and the costs. Overall medical costs are ridiculous on this island. And a lot of the tests etc performed are unnecessary and only done for more income which leads to higher premiums for everyone

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    • Anonymous says:

      They need to stop civil servants going overseas for treatment that can be done at HSA.

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      • Anonymous says:

        A) Said treatment is approved by HSA. Which they only do for things not really available here.
        2) Not the point. Of the article or the problem (un/under-insured costs.) Focus on the major problem and don’t get distracted by minor crab-in-bucket side issues.

  17. Anonymous says:

    Medical insurance for the retired population isn’t working. It’s at its most expensive at the time they need it most but can least afford it and let it lapse.
    Medical care for the over 60’s should be free and unrestricted, paid for by the government from our taxes and their other income. These people have given everything their working lives and built Cayman on their efforts. Leaving them to poor healthcare in retirement, or to begging for someone to help them pay is an insult.

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  18. Anonymous says:

    Illness amid our populace has significantly increased since around January 2021 – everywhere I turn in these islands there is some talk about this one sick, this one in hospital, this one had a heart attack, this one died last week… geesh… what is going on?

    I am wondering if I am now simply in that age bracket where everyone around me is sick, or has something drastically changed in the past 20 months within these islands that is contributing to significant deterioration of the human body?

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    • Anonymous says:

      What’s happening is that a huge percentage of Caymanians are overweight or obese and do no physical activity. There are quite significant health issues related to eating Burger King or KFC a few times per week…

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  19. Anonymous says:

    Someone is not enforcing the Health Insurance Law, and we are all being required to bear the consequences!

    We are being dragged to hell, carried in a handcart of our own corruption. #worldclassmyass.

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    • Anonymous says:

      Not just health insurance. The Maintenance Act and Labor Act too. This is a problem Substantially of our own making. An ineffectual civil service with zero accountability.

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  20. Anonymous says:

    “Government’s spending on healthcare for people who are uninsured or under-insured is already more than CI$13.9 million over budget”

    What the heck!

    Any chance the medical profession would reduce their fees to make healthcare more affordable or make health insurance utilisation more reasonable? Where and how is the Segregated Insurance Fund spent?

    After all it’s the individual who will end up paying in someway, either financially or with their health.

    This isn’t Cayman Kind or sustainable.

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  21. Anonymous says:

    Let’s have a discussion of the current healthcare situation in the Cayman Islands so it can truly be world class. I believe Cayman’s healthcare system can be significantly improved and we can have a much healthier society for a fraction of the cost if the current medical system were to be revamped.

    1) Stop allowing big pharma to dictate medical insurance.

    2) Doctors need to stop prescribing so much antibiotics and medication.

    3) Substantially reduce or eliminate childhood vaccines altogether due to negative side effects and the massively huge correlation with skyrocketing autism rates.

    4) Eliminate any and all COVID “vaccine” requirements immediately as they do not prevent one from contracting COVID nor from passing it along and it too has HUGE negative side effects as evidenced by the actuarial proven increased death rates among the populace.

    5) Increase coverage and availability of alternative care such as acupuncture, chiropractic and naturopathy which I believe is better for many health issues.

    6) Hospital visits for cold, flu, etc. should be a last resort. Western medicine is best for broken bones, etc. Stop fixing the symptoms and concentrate on eliminating the cause because the quick fixes often have other deleterious side effects that can be worse than the original health issue.

    I’d love to see healthy and fit people living happily into their 80’s and above.

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    • Anonymous says:

      Agree with first two and last sentences as well as line item 5).

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    • Anonymous says:

      You are mistaken. Your plan sounds like a disaster.

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    • Anonymous says:

      Yeah, eliminate childhood vaccination so we can have the return of diseases like polio.

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      • Anonymous says:

        And yet, somehow, mankind survived for thousands of years without vaccines. You and I are living proof.

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        • Anonymous says:

          you absolute idiot…for thousands of years the life expectancy for most people was 30-35 years old.

          People got polio, paralyzed and lived like that forever, or DIED because they couldn’t cut it. Living to 80 or beyond is possible thanks to medical breakthroughs including vaccines. STFU and keep your foolishness to yourself.

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          • Anonymous says:

            Thanks for your invaluable contribution 10:39am. May I suggest you voluntarily learn some manners and respect or you just might find yourself in need of the western medicine you so love because of your own doing.

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            • Anonymous says:

              Nice – threat of physical violence because they point out some inconvenient facts.

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              • Anonymous says:

                No threat. It is a fact. Just because you can’t see the other posters, you need to be respectful. If the person acted that way in real life, they would get there arse kicked.

        • Incredulous says:

          Mankind survived, yes, but one in every two children did not reach adulthood. I guess your plan helps with overpopulation though if you’re good with plenty of kids dying.

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    • Anonymous says:

      LOL

  22. Anonymous says:

    Seems like there are only 4.5 months to go on 2022.

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  23. Anonymous says:

    What are the eligibility criteria? Are these prerequisites known and applied? Is there a controlling person accepting full responsibilities for these decisions?

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  24. Anonymous says:

    Q: Why so many sick people live in so called Paradise?

    Q. what is being done to figure out why there are so many sick people?

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    • Anonymous says:

      It’s because they are elderly and poor. Being elderly of course leads to more medical issues and expenses, but compound that with being poor and the elderly aren’t getting good nutrition, and aren’t taking care of themselves with preventative healthcare and screening because they can’t afford it. And because they can’t afford health insurance all of their medical expenses fall to the government. Once someone has to wait for NAU to assess their medical needs each time and authorise a test or dr visit, medical care is delayed leading to a worsening of the condition and therefore even more medical expenses.

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    • Anonymous says:

      Obviously, questions asked by non-Caymanian.

      First, if Caymanians receiving health care treatment is concerning to you, then leave Cayman and you need not concern yourself with such questions.

      Second, Caymanians have more older population numbers that rely on government-funded healthcare, since most that come to work (or retire) are not Caymanian and (aside from wealthy retirees) are intercepting job opportunities and businesses opportunities as well as professional services opportunities.

      Do the math and use uncommon sense (as common sense isn’t so common anymore). If you don’t like it, then leave Cayman.

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      • Dr. Strangelove says:

        Mr. Anonymous 5:49 P.M.
        You are sick in the head. I don’t believe there is anyone that can help you, since there’s nothing that can be done for imbeciles.

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      • Anonymous says:

        No this is not accurate at all. We’ve been asking for YEARS to know the actual incidence of cancer in Cayman because it seems to be higher than most places. But we don’t track it so it’s just a gut feeling.

        The prevalence of diabetes in Cayman and the Caribbean as a whole is much higher than elsewhere in the world. Men’s health issues are higher here because everyone is too homophobic to get checked out by a doctor.

        There is virtually no transparency about what the mosquito plane is dropping into our water, or what leeches from the dump (or in a dump fire).

        Asking why everyone is sick is a perfectly good question and for you to be giving them crap saying “leave” when you don’t even know if they’re foreign is exactly the type of stupidity that will doom this place.

        One reason people are sick…it is expensive as hell to eat healthier anywhere in the world. Things in general are extra expensive here so eating healthy is prohibitively expensive.

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    • Anonymous says:

      Your population is old.

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      • Anonymous says:

        Obviously age plays a part.

      • Anonymous says:

        Our population is largely uninsured, and mostly Jamaican.

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        • Anonymous says:

          So .. when they landed in the 60s/70 they were Jamaican … when they toiled to build this country they were Caymanian… but now that they are old and ill they revert to being Jamaican … can’t make this $h!t up !!!

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          • Anonymous says:

            Ummm, they were Jamaicans with status – and too often not because they toiled, but because they promised to vote for the right politician. The “way of doing business” so many brought with them.

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          • Anonymous says:

            The ones that helped build are mostly dead and they were paid to do so. The ones in the last 30 years are here destroying not building.

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