De Silva: FutureCare is good value for money

SUNDAY, FEBRUARY 5: The following is a speech by Health Minister Zane De Silva to the House of Assembly on Friday about FutureCare.

Mr. Speaker, late last year the Opposition and the Government spent many hours going back and forth about FutureCare.

We argued over the cost of premiums, the sustainability of the Fund, the benefit package, and the way that FutureCare was implemented.

I presented a long Ministerial Statement which set out the history of FutureCare, the public consultation that had taken place, and the way in which this insurance plan was implemented in phases.

In the run-up to Christmas, Senator Dunkley raised questions in the Senate about when the Government would provide FutureCare policy holders with a detailed explanation about the implementation of co-payments for care provided by surgeons and other specialists.

Mr. Speaker, on 8th December, 2011, the Health Insurance Department issued a detailed press statement on FutureCare co-payments in which the Director of the Department acknowledged and apologized for the fact that the introduction of the co-payments had not been properly communicated.  The Director also pledged to ensure that policy holders were informed in writing – and this has been done.

Now, today, Senator Dunkley seems surprised that the Director has written to policy holders.

Mr. Speaker, let me take a few moments to comment on the statement released today.

Let me start with statements made by the Honourable Member opposite, Ms. Jackson.

Ms. Jackson said, on the record, that HIP coverage is better than FutureCare coverage.

This is clearly incorrect.  The most cursory review of the benefit brochures on the Department’s website will show that.

In addition, Ms. Jackson raised the issue of the 25% co-payments for Overseas Care.  She said this information was only in brochures from 2010, but that the wording was not in the first FutureCare brochures from 2009.

In this instance Ms. Jackson was partially correct, and I acknowledged that in the past.  The 2009 brochure did not specify a 25% co-pay, but it did say that overseas care would be paid at rates approved by the Bermuda Health Council.  It was also pointed out that from 2010 the Department sent its overseas care brochure to policy holders on several occasions.

Mr. Speaker, the OBA is claiming that FutureCare was irresponsibly launched in 2007 – but the product was not made available to the public until April, 2009.

Many of the points made in the statement about the origins of FutureCare have been previously addressed.

Government was transparent in how it developed and rolled out FutureCare.  There was a full “Request for Proposals” process to select vendors for the design of FutureCare.  There was a detailed one-year process of research, focus groups, data collection and actuarial analysis prior to launching FutureCare.  All major local stakeholders were consulted.

Regarding implementation, there was a separate rigorous tender process that had been completed for the Health Insurance Department’s automated system.  The system was implemented in stages just as FutureCare was implemented in stages.  It was planned, systematic and the principle part of the system implementation was complete within 18 months.

Mr. Speaker, let me say a few words about financial viability.

It has been stated clearly that FutureCare is a plan that is subsidized by Government.

This has been no secret, and funds have been appropriated through the normal budget process for FutureCare since its launch.  Amounts of $10 million, $8 million and $6 million were allocated as FutureCare capital injections in each of the three fiscal years since its inception – and these funds were approved by this Honourable House.

The plan is actuarially evaluated annually, and the premiums are set accordingly.

Like any other high risk insurance pool, the viability of the plan is linked to the level of premium, benefits and amounts of subsidy received.

This is being managed by technical officers with expert advice from the Fund’s Actuaries.

FutureCare is well capitalized.

Mr. Speaker, the Opposition speaks of a disconnect between the policy decision and the target population.

However, to date there have been merely a dozen calls from FutureCare policyholders over the letter sent out. None of the callers were upset or angry at the change. All of them understood the rationale for the co-payment and accepted it once they had the opportunity to pose their questions.

This is hardly a public outcry.

Moreover, since the co-payment was implemented in April 2011, the Opposition seems to be the only group criticizing the move.

In fact, the Department has only received one complaint about the implementation of co-payments for local specialist care – and that was for a co-payment of $300.

Finally, Mr. Speaker, there is no scapegoat or forcing of any civil servant to write to FutureCare policyholders.

One only needs to examine the Department’s website to see the numerous letters sent directly to policyholders over the years advising them of various changes.

This is a normal part of the marketing and communications function within the Health Insurance Department, and it doesn’t stop there.  Technical officers at the Department have presented at dozens of Town Hall meetings and other public meetings over the past three years reaching over 1,000 members of the public, and the Department continues to reach out directly to communicate with its policyholders.

Mr. Speaker, let me take this opportunity to congratulate the entire Health Insurance Department, ably led by the hard working Director, Mr. Collin Anderson, for what, at times can seem like a thankless job.  There are days when all they seem to get is criticism and can’t seem to please anyone.  But, they soldier on, and continue to give service where it counts most – to our seniors and our HIP clients.

Before I close, Mr. Speaker, I have to ask the question, “What health insurance options would our Seniors have if FutureCare wasn’t available?”

The answer isn’t pretty.  Seniors would either have to go without health insurance, sign up for HIP (which does have limited benefits) or purchase health insurance from the private sector at two to three times the cost of FutureCare.

But cost isn’t the only factor.  Many private packages limit lifetime coverage and don’t let a senior sign up at all if they have a pre-existing condition or if they are over a certain age.

That’s not the case for FutureCare.

It’s open to anyone over 65, over 85 or over 105.  There are no lifetime coverage limits and no exclusions for pre-existing conditions.

FutureCare isn’t perfect, but it is GOOD VALUE FOR MONEY.

Mr. Speaker, let’s remember that the total cost of Bermuda’s healthcare system is now over $630 million per year – and we have spent untold hours arguing over a piece of that system that accounts for only 1% of the total.

We have to provide adequate insurance coverage for our seniors and the rest of Bermuda’s residents, but we also have to address the unsustainable increase in the TOTAL cost of healthcare on this island.

And that, Mr. Speaker, is why the team in my Ministry is working so hard on the National Health Plan.

We are focused – not just on the pieces of the system but on the big picture, the whole system.