Cabinet re-jigs $8 million to pay for locals’ healthcare
(CNS): Less than four months into the current budget cycle, Cabinet has approved changes to the health ministry’s appropriations for this year to cover some $8 million in medical bills for overseas patients, the elderly, people who are inadequately insured and those in need of chronic care and other treatments. This ever-increasing healthcare requirement for those who cannot afford their medical needs is being met, in the first instance, through the reallocation of money and not additional public cash.
According to the very limited summary of the meeting held on Tuesday, 23 April, Cabinet approved the reallocation of CI$3,500,000 from the Mosquito Control Services budget. CNS has learned that this was supposedly money from the previous year that was unspent. Meanwhile, almost $4 million appropriated for policy advice and ministerial services has also been moved to pay for healthcare, along with $500,000 that had been allocated for unspecified health and wellness assistance.
The infamous line item NGS 55, the allocation for Tertiary Care at Various Local and Overseas Institutions, has a budget allocation of $18,645,673 in 2024 but just $14,426,032 in 2025, even though the Cayman Islands Government spent $52,419,000 on these medical bills for local people in 2023.
The re-jig has seen over CI$3 million go to this one line item alone, with another $2.5 million going to the provision of geriatric services. Over one million dollars has been moved to cover medical care for those who are uninsured or to pick up the tab for care that is not covered by insurance. Meanwhile, another $1.4 million has been reallocated to pay for chronic ailments care and public health programmes and treatments.
The CIG is currently drafting a new National Health Strategy for the next ten years, and Chief Medical Officer Nick Gent has said he wants to hear from people about health insurance cover and access to care as he is concerned that too many people are not getting the medical care and treatment they need because they are under-insured, not insured at all or cannot afford the co-pay or medicines they need.
Successive governments have been complaining about the inadequacies of the current private insurance system in Cayman, in which around ten private healthcare companies generate profits that go well beyond the money the CIG is paying out to help Caymanians and it is still unable to meet the demand for assistance.
The idea of a single-payer system has been floated many times over the nearly twenty-five years since the law calling for mandatory health coverage for all was passed. However, due to pressure from the private insurance sector, politicians have consistently backed away from a national system of some kind.
While all employers must cover 50% of health insurance costs, the Standard Health Insurance Contract (SHIC), which is provided by most employer schemes, is far from adequate, but increasing the level of cover is prohibitively expensive for the majority of workers. In addition, meeting the legal requirement for health insurance coverage for those in retirement, self-employed in small or micro businesses or out of work is almost impossible.
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Category: Health, Health Insurance, Medical Health
Cinico needs to stop 100% coverage of Jamaicans with Status. They’re the main reason elderly Caymanians can’t get NAU assistance. HSA keeps referring them to private doctors like eg: Dr. Foley’s clinic and they don’t pay a cent. Yet the rest if us pay at least 20% of the bill if we’re lucky.
Here’s a fact that few know: The “usual and customary” fee (80% most commonly) paid to doctors for consultations and treatments by the insurance companies has not increased for over 20-years! That’s right, doctors have not has a pay rise from insurance for two decades — no increase to cover cost of living expenses, increases in practice running costs, etc., etc. YET, insurance premiums go up year-upon-year, ALL to the benefit of shareholders (well it’s not being paid to the doctors) and into fancy office buildings– think Cayman First building. Government must act to stop the private medical insurance companies making out like bandits.
Serious question…
When we signed up for health insurance over a decade ago, the policy stated that we have a maximum lifetime amount of coverage. This lifetime amount has not changed, so why do the premiums go up each year?
If the police covers an agreed amount, surely the original premium covered that lifetime amount?
I would be grateful if someone can explain why it apparently doesn’t.
Would it not be cheaper for Government to pay health insurance premiums for those people instead of the medical bills?
Most of those people will be on SHIC. Most of this coverage is ‘post-SHIC’.
There are two problems with SHIC.
(a) it doesn’t cover good preventative care, which is really expensive. (In a year I might see a dentist and a GP each a couple of times. How many checkups does SHIC cover?) And such preventative care is even more expensive for indigents who need home attention.
(b) its doesn’t cover major incident care, i.e., coverage is quickly maxed out. (Think of the regular appeals for aid when some member of the community is the victim of a horrific accident and needs ‘more than normal’ care.)
The Government is essentially acting as ‘self-insurer of last resort’ for Caymanians in these situations.
It would probably be cheaper if the Government took out a giant gold-level insurance plan for everyone that gave more than SHIC and then divided up the premiums between us all. A single-payer or socialized system. The problem is that neither individuals, employers or government want to pay ‘more than SHIC’ for burger-flippers, etc. This is also why we fight over minimum wage, and ignore pension. But lets stick with health insurance today.
Also, at some point with single-payer you have to have the hard discussion of ‘we are not paying for that, you now get palliative care to die with comfort and dignity’. Its an important discussion that we avoid by having a self-pay system where those who can pay, those who can’t either ‘go home’ (and hopefully receive state aid there) or get Government to pay. (So those hard discussions are had individually and in private and ad hoc.)
Highway robbery for both medical and property insurances. How do the expect a retiree to survive? Something needs to give!!!
FIRE! Health Minister Right away for doing absolutely nothing but posing for social media pics with DCR the other big fraud in government.
No one is addressing the root of the problem that creates this outrageous expense – poor lifestyle choices.
Until people get more active, eat and drink healthier, and even throw in a little fasting to induce autophagy now and then, this fat medical bill that the CI government continues to pay will only get fatter.
For $3.5 million we could have bought a new mosquito plane that actually works. Give that money back!!!
There is no copay in Cayman. It’s co-insurance.
No. I Co pay the cost of insurance (50%) then copay the cost of treatment which can be 10-100 % of the cost depending what the insurance company think they should cover. They cover less & less, despite premiums rapidly increasing. They still use very old agreed rates for services. Leaving many dentists/doctors/other health Professionals waving the Co-pay for those they know cannot afford it, but don’t qualify for NAU or indigent coverage.
Insurance companies are ripping off the Cayman population.
It’s not sorted by govt as most voters are civil servants & get free coverage in retirement for themselves & spouses.
Anyone know what percentage of a premium goes to cover the insurance company’s overhead, salaries, directors benefits, shareholder profits and so on, and what percent goes towards actually paying for customers’ healthcare costs..?
As one now deceased member of the local insurance industry memorably said in a meeting back in the 90s to discuss why the companies were not giving better coverage and were leaving the vulnerable and uninsurable for government to deal with while the companies cherry picked the healthy people, “we are not benevolent societies you know”.
Yes, that seems entirely fair. People must live or die within their means – too few people are doing the latter. Save money during your working life, live on those savings when you retire, and die when they run out.
Instead, we have socialism: blatant wote-buying. CIG is cooking the books by keeping liabilities off the balance sheet, but after the hassle with the Turks and Caicos Islands 2009-2012* and BVI in 2022** and given that the UK itself has long since fallen to high taxes and socialism, there are no prospects of intervention.
Cayman will be insolvent at some point in the next few decades – it’s just a question of whether the current generation of Caymanian voters are dooming their children or their grandchildren.
* http://news.bbc.co.uk/2/hi/uk_news/politics/8202339.stm – “The UK has imposed direct rule on the Turks and Caicos Islands after an inquiry found evidence of government corruption and incompetence.” Sound familiar to what we get from CIG?!
** https://www.bbc.com/news/uk-61736373
There’s so much wrong with this.
The public continues to pay thrice: once for expensive know-it-all MPs, again for their engineering of deliberately broken systems, which then trigger endless benevolent Cabinet-initiated “you owe me” vote-buying. Until anti-corruption efforts gain traction in the Cayman Islands, redirecting the appropriated $4mln in professional consultation advice -that will never be read or considered by our Cabinet – is probably the most sensible news here, strange and tragic as that sounds to newcomers.
God forbid any of our overpaid politicians and civil servants should be asked to make any, any, contribution to the healthcare pot..
Yep, elections coming up so pay up private sector.
Where does the other 850MIL go?
$500M goes to the civil service.
The rest is frittered away by our uneducated leaders by way of pay raises, travel jollies and Kenneth’s self glorifying projects that never happen.
Illegal billboards
Not one word in the article about doing something about the ever increasing, crazy, high premiums charged by the health insurance companies who make record profits and dividends for their shareholds year after year. CIG must legislate to reduce what can only be considered as gouging by the health insurance companies.
Well to be fair to the private health insurance company directors, the cost of fine wines has gone up.
True story. Maybe, just maybe if CIG lowered the duty on Montrachet they could then lower our premiums.
Trickle down baby. Trickle down.
Get in line after CUC.
Not defending CUC, but health insurance we have to pay whether we use it or not.
well since they haven’t even adjusted rates to fit what people are charging our copays continue to be ridiculous as well.
My family’s monthly health insurance has risen to $2500. I can’t pay it. I bring in $750 more than that per month. I have worked all my life since high school. I have worked hard and lived simply. We are screwed.
We split up the family on the plan(we both work for the same company). My spouse is with the children. I am on my own. It is cheaper by a few hundred dollars. If you are able to do the same, it makes a huge difference.