Public cash pays for failed health insurance system

| 17/07/2023 | 47 Comments
George Town Hospital Grand Cayman, Cayman News Service
George Town Hospital

(CNS): With many local people still either uninsured or under-insured, the government’s healthcare bill is climbing while the local health insurance sector continues to make a profit as companies cherrypick their customers. Earlier this month, Cabinet approved another CI$13.5 million of public cash to cover healthcare costs this year for indigents and for those with inadequate insurance.

This additional multi-million dollar spending comes just a month after Finance Committee approved almost CI$40 million more than initially budgeted to cover the healthcare needs of local people for the financial year 2022/23. It is now not inconceivable that by the time the 2023/24 financial year closes, the public purse could have subsidised the health insurance sector to the tune of more than $100 million.

Using the national census, which was taken in the wake of the COVID-19 pandemic and is already woefully out of date, the Economics and Statistics Office estimated that around 93% of the population has health insurance. However, since the basic SHIC plan falls far short of what is needed, the health insurance industry is totting up its profits while taxpayers continue to subsidise the sector.

According to the brief summary of the Cabinet meeting on 5 July, the government has now added CI$9 million to the budget for tertiary care provided locally and overseas and another CI$4.4 million to pick up the tab for those who are not insured at all or who have already used up all their benefits.

Answering questions in Finance Committee last month, Health Minister Sabrina Turner said the number of people in need had increased in 2022 by over 16% and had grown another 4% so far this year. The value of claims was also rising significantly because healthcare costs were increasing, she noted.

Chris Saunders (BTW), the former finance minister, said it was absurd that while more than CI$200 million a year is collected in health insurance, “the taxpayers of this country still have to go find $73 million”.

He called for both the Cayman Islands Monetary Authority and the Health Insurance Commission to look into private health insurance companies that are not adequately covering the healthcare needs of customers, who are paying monthly premiums but not getting the cover they need. “We know that people out there have… plans that are absolutely no good when an emergency comes up,” he said.

Saunders suggested that some insurance companies should be shut down and said the country needed an honest conversation about how health insurance is provided, as he blamed the private sector for “taking money from people” and then selling them policies that are “absolutely no use”.

During his time as finance minister, Saunders looked into expanding the government insurance company, CINICO, so that it could provide health cover to more people and eventually allow it to offer property, motor and life insurance as well, thereby generating more income. But he has also hinted at the idea of making CINICO form the basis of a nationwide health insurance system to increase the pool.

Premier Wayne Panton, who chairs Finance Committee, said the rising health costs that the government was paying and the constant underestimation in annual budgets were challenging and had to be addressed. He said a “variety of initiatives” would be needed to tackle the unsustainable position government was in over the current healthcare problem.

Former premier Sir Alden McLaughlin said that while these line items had been “chronically underbudgeted” for a long time, he had not seen such a large divergence from the initially budgeted sum before.


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Category: Government Finance, Health, Health Insurance, Politics

Comments (47)

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  1. Tom McCallum says:

    Let’s look at the source need. One measure of a rich country is one with a healthcare system that all can rely upon.

    Next, in order to value the system it is useful for people to receive a statement for each service received showing what that cost, even where the cost is covered by someone else.

    The cost of providing health cover in Cayman now runs to several hundred million dollars.

    Cayman society is growing in inequality and eventually direct taxes must come in order to redistribute to some extent to ensure a fairer and more inclusive society.

    Put all of that together and let us then consider the success of 75 years of the NHS in the U.K.

    How about introducing that with a few changes for Cayman that learn from and improve upon the NHS.

    First, introduce a small direct tax (starting above a certain income threshold only) as a Health Insurance charge.

    Second, bring all healthcare under public ownership (over time) under the Cayman NHS.

    Third, every service receives a bill so we see the value of what we receive. The bill is then zeroed out as the country pays for it from that national Health Insurance levy.

    Everyone is covered. All costs are transparent. Everyone pays a percentage of their income to pay for this.

  2. Anonymous says:

    Maybe Sabrina should fly out to Taiwan to learn how that government runs their national health care system.

  3. Anonymous says:

    How is CIG doing collecting the $100M in unpaid health care receivables?

  4. Nicholas Robson says:

    If health insurance companies wish to operate in the Cayman Islands the cost of their so doing should be giving coverage all Caymanians and Residents.

    However, until the CIG up-skills the civil service with Caymanians holding post-graduate degrees in various areas of governance we shall continue to flounder.

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  5. Anonymous says:

    Put all residents in one big health insurance pool under a government mandated policy with decent coverage. Then let reputable insurers bid on all or a percentage of the pool. Award the lowest bids until the pool is filled. Bill the pool members whatever is fair or politically expedient, and pay for the indigents. All done.

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  6. Anonymous says:

    time for class action lawsuit against the incompetence of the civil service and cig.

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  7. Anonymous says:

    This abuse is never going to be solved. The Government is suppose to stop unfair business practices like the medical insurance. A blind man could see the corruption of the system.
    Only one consultation per year, really? Medical insurance is suppose to spread the risk. That means we have a population of people pay from the time they are young. Because the risk they will have a major illness is smaller then older people. But unfortunately they play games. Why would anyone pay high premiums when you are spreading risk? if you are a couple you don’t qualify but if you are a company with 3 people you do? What nonsense is this? The last insurance I paid US$220 each, 6 people. Company closed because of death, I must pay 1000-2000 CI$. Ah lord give us strength to see the abuse and stop the madness.
    Solution: Government needs to open the medical insurance market to the USA OR become the medical insurance company. They need to grab the bull by his horns and make everyone in Cayman who doesn’t have insurance to buy it from Government. Why ? Because at the end of year GOVERNMENT STILL PAYS FOR IT ANYWAY.
    Another solution: https://www.youtube.com/live/yPW9jurozPM?feature=share Panama is a lot cheaper, anyone who has been there can tell you. Thank God they finally opened up the flight. Albrook Mall has many dental, Eye clinic plus 700 stores from too cheap to middle class varieties stores plus 400 restaurants. There is a hotel Panama Marriott attached to the Mall. So even if it rains you girls can shop till you drop. Check out the video an insurance agent explains how Medicare recipients can use outside of USA.
    Have a wonderful day

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  8. Anonymous says:

    If the health insurance act were actually enforced, we would not need to be subsidizing as much healthcare. Many untouchable employers are responsible, and should be held to account.

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  9. Anonymous says:

    The beatings will continue until morale improves.

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  10. Anonymous says:

    Welcome to the Cayman Welfare State, proudly subsidising:

    – Cayman Turtle Farm
    – Cayman Airways
    – OfReg
    – Needs Assessment Unit
    – And most recently a pivate mega profit making health insurance provider, CINICO

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    • Anonymous says:

      to 4.15 You left out a dew other subsidised organisations…
      Prison Service
      Police Service
      UCCI
      Primary Schools
      High Schools
      HSA

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      • Anonymous says:

        The Civil Service charitable organisation as a whole
        The indulgent and,frankly obscene lifestyles, of the “Honourable”members.

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  11. Anonymous says:

    The health insurance companies are only required by Law to sell the SHIC plan to individuals that we all know is insufficient. They won’t sell individual insurance with better benefits.
    Even the corporate rates are inflated as some are affiliated with big worldwide brokers that economies of scale should result in more affordable premiums.
    There is no reason why premiums should be as high as they are here but like everything else they get away with it.
    Same thing is going on with homeowners insurance and many local companies are no longer taking out new policies claiming that the insurance companies are maxed out with the risk they will take for the region due to costly payouts in other islands and Florida.
    All we can do is take it up the you know what unless Government gets their act together.
    Don’t get me started on the miserable performance of the pension providers and how they continue to make off like bandits with our money.
    Government are like the scarecrow from Wizard of Oz “If I only had a brain”.
    The people of this country need to have a brain the next election and stop voting based on favors and handouts. It is disgusting!

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    • Anonymous says:

      My homeowners in Cayman is about the same as my homeowners in the US except for the hurricane deductible which is twice as big, but its hard to be worked up about it considering Ivan.

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  12. Anonymous says:

    Education, health care shouldn’t be in the form of business, and it should be a service by the government. Unfortunately, it’s not.

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  13. Anonymous says:

    no handouts without means testing. end of story.

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  14. Anonymous says:

    more cheque writing by no-plan-pact who have achieved nothing and are totally incapable of addressing the issues causing the problems.
    welcome to wonderland.

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    • Anonymous says:

      @12:56pm I guess it is okay to blame PACT when PPM was in power for 12 years and did absolutely nothing regarding this issue.

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      • Anonymous says:

        no-plan-pact and do-nothing-ppm…its all the same.
        direct rule for 2 years while a new raft of political candidates are selected/vetted based on qualifications, experience and integrity. then we have new elections.

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  15. Anonymous says:

    The math on this is very simple. If insurance companies collect in excess of $200M in premiums, then in round figures $3000 per years is spent for every man, woman, and child in Cayman.

    Scrap the mandatory health insurance requirement and leave those who wish to have it free to negotiate with the insurance companies.

    $6000 on average extra for every family to spend will result in them finding less time to go to the hospital, so there will be a precipitous drop in government spending on healthcare and everyone will be much happier.

    The only ones left feeling sick will then be insurance providers.

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  16. Anonymous says:

    The healthcare system needs to be torn down completely and rebuilt.

    Big Pharma controls the system and never seems to cure anyone. They just give drugs and cover up the symptoms which then cause other deadly side effects.

    The money spent in our current system should be reallocated with 50% or more going to wellness and preventative cure.

    NEVER again force experimental jabs that have killed and wounded millions.

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    • Anonymous says:

      You sound like the ideal candidate for the new mental health facility.

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      • Anonymous says:

        Are you part of the Trump Patriots? Only one of them could say the foolishness you are spewing?

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    • Anonymous says:

      sounds simple but no-one has achieved the perfect system yet.
      things that would help:
      sugar tax
      make fruit and veg duty free
      increase duty on meat produce
      get serious about childhood obesity…make parents responsible
      obese people should pay extra for health insurance

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  17. Anonymous says:

    Lol Tax Payers?

    How about we start taxing the thousands of companies that launder in Cayman and save millions every year?

    Surely a corporate tax can pay peanuts for healthcare.

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    • Anonymous says:

      Why so many people down voted this?
      Your all happy with increasing costs on utilities/food/goods and everything.
      But you don’t want to tax the corporations that do nothing to help you.

      So stupid, Cayman has been exploited by corporations and Caymanians don’t have a clue.

      Shows you the level of IQ of the CNS readers. Worst than marl road.

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      • Anonymous says:

        Companies set up in low tax jurisdictions like Cayman because of the low taxes. If you raise the taxes on them there is a point that they move to the next low tax jurisdiction. Helth Care (or education, or whatever) is not a question of how much money Cayman has available (because the answer is enough) but a question of how well is it being spent. So raising someone else’s taxes to pay for someone else’s health care (or whatever) which will nto address the core problems and risking the loss of half of the economy to do so … results in thumbs down.

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  18. Anonymous says:

    Cayman hosts many foreign-dominated predatory industries that don’t serve resident consumers. It’s not just insurance and healthcare. Personal and corporate banking treat their customers like something stuck on their shoe. Missing are universal published client acceptance policies, investment products, services, ring-fenced account segregation, fraud errors and deposit insurance, and fee transparency. Anyone moving to Cayman had better keep their regulated financial accounts from elsewhere or be prepared to join the ranks of others that have suffered asset freezes in court appointed liquidations. Even the merchant point of sale systems are from 1995.

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  19. Anonymous says:

    Health insurance has been a scam since its inception. Everyone knows it and politicians just talk about it. They are covered head to toe and can afford it, but the average Joe does not get value for money. I have had two dental visits this year, one for cleaning and one for a crown. Now I am told I am maxed out on coverage already for this year and I pay almost $800 a month. It is robbery pure and simple!!

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    • Anonymous says:

      Cayman First is the worst. they take our money and we get nothing from them.

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    • Anonymous says:

      You are very lucky to have ANY dental cover under your insurance. Most have none at all.

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    • Anonymous says:

      I’ve never understood why eyes and teeth are covered separately. Health insurance for one body should cover the whole body!

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      • Anonymous says:

        Don’t forget ears. If you are unfortunate & need hearing aids it’s a one off life time benefit. That means you get your first set of hearing suds covered (or grandad got about 75% of the cost) then when they need replacing (in about 5-7 years like most electronic equipment) he has to pay 100%. Cost about $6,000 and he’s 70. Assuming he lives to 90 that could be 18,000. A lot out of your pension payment of $1400 when insurance is costing $800!!!!

  20. Anonymous says:

    Characteristically dumb comments from government, un-characteristically dumb comments from CNS (totting up profits??).

    Yes private business makes profit. If there was no profit there would be no insurance at all. Only 9% of each dollar received is profit. CNS are you suggesting it should only be 5% or 2%?.

    So you want national healthcare? Already here. Government pays which means we all pay. By the way CINICO has been losing money for years, where the government makes up the difference, and there is no mention of the unfunded liability for future health costs of civil servants.

    Do the math. No free lunch. But if you think we are all better off with CIG running the health insurance operation, I suggest you reconsider (eg. the dump, schools, etc.).

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    • Anonymous says:

      Completely agree. I am usually a huge fan of CNS reporting but this article is a sloppy in my eyes. Govt is not subsidizing the insurance industry. Insurance companies issue policies that legally cover certain items in exchange for a fee. I agree with CNS that this leaves some people under insured but that is not the fault of the insurance company. If the Cayman Govt is paying for things not covered, they are subsidizing HEALTH CARE for some residents…not insurance.

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    • Anonymous says:

      It is obvious that private health insurance is a massive money earner with huge profits. If it were not so, we would not have half the private hospitals, clinics and physicians that we now have. They are all here to get in on the action. What is sickening is that, as CNS says, the insurance companies cherry pick the healthiest people ( where the money is) and leave the rest to government to cover, the unhealthy uninsurables, the prisoners, indigents and, of course, as soon as you retire and get older and more vulnerable they either stop your coverage or offer it to you at horrendous rates affordable only by the elite in the gated communities.

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  21. Anonymous says:

    I turn to Youtube now for my medical needs and try to self treat, because I can’t afford a ‘better’ insurance policy than the SHIC and the policy barely covers anything. I’m sure my health will pay for it in the long run, maybe I will pay with my life.
    For such a rich country, its a national shame that so many people are suffering and unable to afford the basic medical care they need.

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    • Anonymous says:

      I get all mine of Tick Tok
      I’m just finished watching “Perform your own Vasectomy.
      I’m just need to borrow a pit bull and I’m ready.

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    • Anonymous says:

      I do not think you are alone at all. While there is lots of rubbish posted you can often find things that just makes sense. We are so often prescribed drugs just to mask the symptoms. Lots of everyday natural foods can often cure many ailments along with the simplest of exercises like brisk walking each day! Remember healthcare is a business these days, it is no longer about caring. Big pharma needs doctors to push their drugs.

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    • Anonymous says:

      Me too! I’ve been doing daily physio exercises following videos on YouTube after my insurance maxed out for the entire year after only $250 of coverage.

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