CMO: Despite huge spending health system failing
(CNS) UPDATED with survey links: The amount of money spent on healthcare in the Cayman Islands is “astonishing” but the system is failing, Chief Medical Officer Nick Gent has said, as the health ministry launches a public consultation on a National Health Strategy. Dr Gent said the cost of healthcare here “worries me hugely” and questioned whether the money is being spent on the “right things and the right people”. He said that many patients are falling out of the system as the money available is not going to meet their needs.
Appearing on Radio Cayman’s For the Record on Monday with Chief Nursing Officer Felicia McLean, Dr Gent raised concerns about vulnerable groups that cannot access or afford the healthcare they need. He said Cayman has a “disparate healthcare system” that is “quite unlike” many others and has several challenges, compounded by a growing community.
“It’s not so much that there isn’t money in the healthcare system,” he said. “If you look at the overall funding of health care… the sheer amount of money spent… is astonishing… The question is: is it being spent on the right things and the right people? There are undoubtedly a lot of people falling out of the system and the system is failing because the funding that is available is not going to their particular needs.”
Dr Gent noted that there are many people suffering from chronic conditions, such as diabetes and hypertension, whose needs are not being met because they are not being tested, diagnosed or properly treated because they can’t get to the hospital, they don’t have insurance or can’t afford their medication or treatment.
“We have got a healthcare system that grew up around what was available, and it’s grown explosively,” Gent said. “But it has tended to leave behind, in my opinion, the poorest people… and the chronic diseases and… the continuity of community-based care that can help make sure people live longer happier lives,” as he pointed out how much diabetes can destroy the quality of life.
The CMO said that vulnerable and poor people, who need to be taken care of most of all, are not getting the care they need, but they are also the least likely to take part in the type of consultation that the ministry has launched. He urged those who are in need to become involved in the consultation because the ministry needs to hear, in detail, about the barriers they face accessing healthcare or taking care of themselves and about the experiences they have had.
As well as addressing affordability and access to healthcare and medications, the new strategy, which will guide Cayman’s healthcare for the next decade, will address areas relating to practitioners.
Gent said there is a “preponderance of health practitioners here”, but they are not all being properly utilised. Asking registered medical professionals to also take part in the consultation, he said that this could help the ministry support their needs so they can do more for the community. Medical professionals are well placed to comment on the challenges they see in the system that can be improved, such as their own professional development and the delivery of community-based care, he said.
The survey will cover all aspects of healthcare, from the future resources necessary to meet the growing population to dealing with addiction. Gent said he had growing concerns about addiction and wanted to hear from people about their experiences, especially with prescription medication. He said the scale of prescribing of addictive medicines “concerns me an awful lot”, and it was an area that needed extra attention.
Everyone is encouraged to take the online survey, which will be posted on the
Ministry of Health and Wellness website.Details of public meetings and other opportunities to engage with officials and submit comments will be posted on the website.
Comments about the future of health care in Cayman can be emailed to MOHFeedback@gov.ky
See the full show on Radio Cayman’s YouTube channel and more about the National Health Strategy below:
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Category: Health, Medical Health
No money being spent on me. I am a retired caymanian public servant with over 20 years service. I always thought I could go on cinico only to find out it is for civil servants only. I have a pension of $1200 a month, I can’t afford health insurance so I don’t have any.
Let’s face it, as a population our diets are awful, we drink too much alcohol and simply don’t exercise enough. There is no amount of healthcare spending that can make up for that.
In spite of a mega budget and staffing, no phones being answered, no means tests for expensive treatments on millionaires, district clinics closed weekends, No preventative education campaigns on these lifestyles by their marketing, and even HSA staff have opted NOT to use CINICI..but private insurers!
7.42 pm HSA is run by Jamaicans. Some are great but majority are here for the $$ and keep getting contracts renewed until able to apply for Status. Guess where H/R Recruitment manager is from.
Sabrina is over her head, which is currently covered by junk in her district. The prospect area is becoming over ran by garbage and unkempt properties. Just look at her prospect constituency office as proof.
hence the nickname of “Projects”
I am impressed that he was even allowed to speak. Normally senior civil/public servants cannot appear on any media platform without prior consent of the Minister.
We need to have these uncomfortable conversations. We all know what the problems are and the solutions won’t please everyone but we can help a large majority.
Early prevention is key to many genetic illnesses. A large part of the problem is that people may know what they need to do if they are predisposed to an illness but it is very expensive to eat right!!!
It has been scientifically proven what causes obesity but will still look at people that are overweight as lazy etc. We all know that one person that can eat whatever they want and not gain weight but I am going off the point.
The diabetic drugs are helping the obese to loose weight but they are costly and need to be taken for life.
I said it before and I will say it again that in order to aide the most vulnerable a subsidy is needed and that can only happen by getting civil servants to pay a part of their premiums and earmark those funds for the vulnerable. I am not in the medical profession just trying to sound pragmatic.
This suggestion will get some thumbs down from many and the politicians won’t enforce it cause it will cost them votes.
People in the private sector are reduced to the SHIC plan upon retirement and struggle while all civil servants get free medical plus their spouse on retirement.
A single provider would solve alot of these imbalances and the more wealthy can source outside insurance if they so wish.
Civil servants would then have freedom of choice to go outside the HSA too.
It would be interesting to know what % of my premium goes to pay salaries overheads benefits and shareholder returns for employees and directors of the private insurance companies.
My premiums just jumped 45% over last year…!
I would love to have a business that can do that and just shrug my shoulders if questioned.
Cayman is among the most obese countries in the world. Any strategy that does not include systematic changes to encourage better diets and more exercise (ie prevention) will be pouring good money after bad.
https://worldpopulationreview.com/country-rankings/obesity-rates-by-country
look at who we elected
Well duh, the cost of living is too high. If you can afford a good gym membership and fresh groceries please open your wallet to the rest of us.
Plans are useful if auctioned.
What happened to the 2012 Plan
Seems like the highest bidder got it..!
The CMO is clamping down on the waste and fraud. All sorts of pigs are squealing now.
How about trying to implement a cross governmental approach to health and wellness?
Start by improving public transport (cutting down the time spent in private vehicles, adding more bike lines and shaded walking paths, lowering import duty on fruits and vegetables which would allow for many more Caymanians and residents to keep a healthy and fresh food lifestyle.
Adding more shaded play areas for adults and children would encourage more fitness activities and save the nation so much in the long run.
Gent has been briefed by the Minsiter to cut costs, probably at any cost. His agenda will not be primarily about improving healthcare, it will be about saving the GIC money. Question is: Why would we want a CMO from the UK, just look at the failing NHS system. Caymanians and Expats alike enjoy a high quality of care in Cayman. This “new agenda” is just about cutting costs and medical care in this country will suffer, especially for the local population.
3.50pm I guess you think the CMO should be from Jamaica where 75% are recruited from.
No surprise here look no further the totally useless and out of touch minister and her inept senior leadership and their photo Op’s very little in the way of knowledge, credibility, ability .
Make all government employees, and yes politicians too, pay something from their generous incomes into the health insurance pot.
The standard CINICO health premium will not damage any of them.
Everyone is fixated on medical interventions when we should be asking ourselves why shouldn’t this be preventable?
Public Health preventative medicine has been asleep for decades.
except for jabs tho!!
I think we can start by emulating some of the plans from the UK. I also saw something about a programme about delivering food to people but I can’t remember where I found it. I think a prevention programme should be the first step. I remember when the public health nurse came to the school to give vaccinations. We should go back to that.
https://www.diabetes.org.uk/guide-to-diabetes/enjoy-food/eating-with-diabetes/meal-plans
CINICO needs to investigate those expat people who are gaming the system. How can you keep adopting nieces and nephews and relatives bring them all here to ride on your health benefits?
Yup, those nasty expats again. Yesterday I got a hangnail – you guessed it, all because of an expat.
The target of the criticism is third world expats, who are parasites. Probably fair.
Wotes my friend..Wotes.
When you keep replacing light bulbs when the wiring is faulty the cost of buying new bulbs would keep growing. The same is with “Healthcare”.
This man is very annoying. He has nothing positive to say about our medical system or our doctors. He instituted draconian prescription rules that get in the way of doctor and patient, where whole classes of medications can no longer be prescribed for more than 30 days, or be given with any refills, and must be collected from a doctor’s office in person and the script carried to the pharmacy in person. He talks about a system that grew up around what was available, but he now forces patients with well-established needs and long-prescribed medications, and their doctors, to ignore technology, and do everything a laborious, manual way. When doctors raised hell about what that would do for the cost of care for their patients, this CMO said the cost of care was not a concern of his. All that mattered was his desire to get the angle of picture he wanted on the prescribing of those medications. He said it was his obligation to get a handle on our problem – what problem? Publish your results then Dr. Gent, show us the problem we have – and too bad if that was expensive.
I have not seen any evidence yet that this person is here to do anything but interfere and impose his view of the role of medicine in society on us. The rules he forced on pharmacies are not even legal, they have to be drafted and gazetted etc. but he just came up with a one-pager of ‘directions’ and pharmacies have followed them anyway.
I don’t trust anything he says. What good has he done? All he did for me was increase my cost of care and inconvenience me. As I told my doctor, we need to Anwar this guy. He doesn’t know what his lane is, that’s fine, he can find another populace to lecture.
There’s nothing positive in a modern medical system.
I guess you favor leeches and bloodletting, surgery with a saw and without anaesthesia?
you’re just an addict who is mad that someone is making your supplier work harder to give you a fix. I know for a fact he’s actively investigating the rampant Cinico abuse by certain medical facilities. He also knows he won’t be around long because of what is doing but because he have morals he can’t turn a blind eye to it and will see it through. those are the kind of people you fight to keep.
Don’t enforce your laws, exempt all civil servants no matter where they are from, and support the mass importation of poverty, and dat wha u get!
Say it again!
Why do we have so many doctors and other medical practitioners here plus so many hospitals, clinics etc and plans for more? Because the health insurance system is one which is based on profit and there’s tons of money to be made from those who can pay. For those who can’t pay or who are uninsurable…tough shit bobo. That’s our health care system.
So many calls to reduce costs and increase availability, but no calls for a single payer system.
Because 90% of people have no idea what a “single payer system” means.
Single payer doesn’t work: look at Canada or the UK. Singapore or perhaps European insurance models are the best.
Also, unproductive people, fat people and smokers shouldn’t get healthcare subsidised by people who make better life choices. Let evolution take its natural course.
You are right, get rid of old people to as they get sick easier and are unproductive. Will you start camps like they had years ago?
Why don’t you evolve and get the hell out of Cayman!
We also have a huge problem with uncollected debts by the HSA and the extra billing by Doctor’s Hospital once the insurance “doesn’t pay the full amount”.
Definitely a problem at Doctor’s Hospital. And when you file a complaint with the Medical Board they just simply write back saying there is nothing they can do
almost like private based healthcare is a scam and since we are already writing off so much healthcare deabt we might aswell just make it single payer like the rest of the civilized world…
3.24pm Doctors Hospital is a rip-off as they overcharge for everything. I know someone who had surgery, spent one night in hospital and after paying Surgeon, Anaethasist etc(as all bill seperately) was charged $8800.00 for overnight stay,use of surgical suite for 1.1/2 hours and a few intravenous bags of painkiller. Then had to pay extra for bandage change (just gause) as no follow-up care is included.
This is surprising, the largest hospital system in the Cayman Islands is the HSA, and the highest paid Board of Directors in the public sector is at the HSA. How then can the system be failing? We are paying top dollars for people to run this system. MaybeDr. Gent is be mistaken, this surely cannot be.
If you are not intelligent enough to figure it out for yourself then your part of the never ending problem in Cayman Islands.
They are being sarcastic genius!
And yet, watch as a 2 billion dollar debt so far just magically turns to 3 billion dollars just like expat magic because you have all figured it out. Or?
Tried to log in for the survey- No Joy (Error message)..
Overblown and incompetent health ministry. Wrong people at leading positions with lack of competent consultants.
Why don’t we emulate Cuba’s world class free healthcare?
Oh wait… people are willing to die at sea to get away from it…
People dying at sea for a bunch of reasons other than the healthcare – lack of political freedom, economy in a death spiral, access to food …but sure, indulge your prejudices. Never heard anyone say that the health care is sub par – quite the opposite.
It is sub par.
in what way? as of 2023 cubas healthcare system ranks 27th world wide, higher than Canada, the united kingdom and the united States.
It is appalling for those who are escaping & dying at sea. For those with money, it’s fantastic. It’s a two-tier system and for the vast majority in Cuba, it is terrible.
they aren’t fleeing the healthcare system. in fact medical tourism is one of cubas main sources of government income, they are fleeing an economic collapse brought on by decades of embargo, a world wide pandemic, a corrupt and authoritarian ruling party and failure of said party to modernize in a changing geopolitical landscape. Don’t trivialize the struggles of the cuban people by using them as a talking point for a silly and inaccurate attempt to demonize single payer healthcare.
So many calls for expanding access to healthcare and reducing costs, but no calls for a single player system.
One solution in the battle against health care costs – become a civil servant.
I’ve had to make the difficult decision to go and live with my son overseas. my medical insurance just hit more than 50% of my pension and with all the co-pays deductibles and exclusions I seem to pay two thirds of my modest income on medical insurance and costs. so much for a happy retirement. health care should be free for caymanians over 65.
There is no room for parasites: people can’t take out more than they contribute. That way lies societal collapse. Sorry – there’s no nice way to say it.
You have no clue how insurance is supposed work. Here is a clue. ‘The many pay for the few’ , but the system is corrupt and health care is no longer care it is a profitable business. Anyone who has worked all their life and contributed should receive real and free healthcare. There have earned it.
And these are good Christian comments?
12.21pm It should be but since most “Caymanians” are now actually Jamaicans herein lies the problem. Govt can’t actually help older natives who built this country that others now take advantage of.
Cayman has the worst possible combination for healthcare. We are taxed to subsidize healthcare and yet HSA charges like it’s private. HSA is paying the senior staff way too much.
Cayman is what the GOP wishes the USA could be, no separation of church and state, No direct taxation, little to no rules for the super rich, an indentured workforce of low cost immigrants, government funded church schools, no standard for public office, a failing public education sector, a private based healthcare system and a population too comfortable with the status quo to do anything about it.
Jeez … when you put it like that …
Sounds like NY and California if you ask me. Dem strongholds now destroyed. 🙂
Pal, California’s economy is greater than many countries but you do you with these Faux news right wing tropes.
Health care is a business.
Money rots.
Greed wins.
Look at the size of your doctor and dentists homes, their fancy cars and expensive toys. Look at your heatlh care premium, its not that the insurance company sets them on their own, they have to cover the charges the dentists and docs determine
the entire thing is a scam. BTW, no you don’t need another floss, 2 a year is fine, 1 a year is fine.
Good luck trying to get qualified healthcare professionals to stay or move to cayman to serve your capricious demands for mediocre pay.
Health care is a disease prevention. Sick care is about treating a person who is not healthy. Medical insurance is about covering the cost of sick care.
Free health care for all Caymanian seniors 65+ (not just civil servants). Stop free health card for civil servants families. Make them pay
There is no “free” healthcare. There only a question of WHO pays for it
It’s not about free vs paid.For all the money spent by the government, we need to decide what would be a worthy spend.
In a Christian country, you’d think being able to take care of the least amongst us would be a priority but it doesn’t feel that the powers that be govern that way. For all of the country’s growth, who is benefiting?
Not being able to afford to retire in your own country is shameful and the largest voting block will make their voice heard if they care enough.
1.00pm The largest voting block is unfirtunely not born here and only cares about “wha me can get”.
100% of Caymanians over 65 are not healthy. Too late for their health care.. They now need medical, rehabilitation treatments. The cost of the treatments is covered by a Medical insurance Policy, if one has it. What you are trying to say is that this cost must be covered by the CIG.
I see nobody, absolutely nobody is talking about health care which is disease Prevention.
I am Caymanian & 100% healthy ( as far as I know). I get regular checks & I am not overweight or diabetic. My health insurance is 75% of my pension payment each month. I then have to pay copay.
I am not a civil servant.
Where did you get your data?
That is probably the same idiot who wants to get rid of older folks.
The idiot with nonsense figures has entered the chat room. I work in an office with many in their 60’s and their sick days are far below the younger workers!
had an opportunity to sit down with Dr. Gent. The man is a fountain of knowledge and experience and could be a great asset to this country. Unfortunately those qualities are not what politicians like so he will be getting the boot.
Yep, he’s a white expat who knows what he’s talking about. This Government will get rid of him for sure.
Unlike some of the prior white expats who didn’t know what they were talking about and got to stay…
9:29 – I totally agree. Soon, one of the many uneducated buffoon politicians will attack him to rev up the voting base. The valuable Dr. will be forced out and the deterioration will accelerate. It’s a repeat process.
What is being done for senior citizens? It seems like nothing. In the US they have medicare so older folks can get affordable health insurance/treatment without fear of being tossed out because of preexisting conditions. Just what is the government doing for older folks? Seems like the comments I read yesterday that people just want to exterminate our elderly who are also struggling financially. Guess Cayman is now only for the rich and famous (as shown on the stupid reality show) or cheap imported labor. Utterly disgusting.
In the US they also pay income tax, some of which goes towards Medicare.
I’ve paid import duty my entire life here. The financial service companies I worked for have paid license fees and company registration fees. Consumer tax vs income tax.
Same result. Income for our government to spend on new schools & services in the Brac! For votes.
Some of our fees & taxes should go towards taking care of our elderly.
That is the main problem with our fiances, the politicians will spend every penny to make sure they have created fancy projects to help get them reelected. They could care less about anyone or anything.
That is not correct, from a workers pay they must contribute to social security and medicare. Income tax is a whole different deduction.
By the way, how it is working in Cayman now with the duties and fees, the average worker would be better off with an income tax but all these rich people who are in Cayman hiding from paying their fair share of tax in their home countries, should have to pay income tax here in Cayman. But as they have the financial resources to influence the elected politicians, that will never happen in Cayman.