Major shake-up for health care

Unveiling the National Health Plan 2011 today, he said greater education and preventive measures would cut the cost of health care in the long term.

Bermudians have the second-highest health care costs among OECD (Organization for Economic Co-operation and Development) nations, surpassed only by the U.S.

In 2007/8 Bermuda spent $4,959 per person on healthcare, in comparison to the OECD average of $2,984.

But this only covered 90 per cent of the population.

The National Health Plan 2011 aims to ensure access and affordability for all, with contributions based on an individual’s income or ability to pay.

Mr. DeSilva said the reforms would require “re-engineering the way we finance health care so we can be more cost-effective and get better value for money”.

He said the financing of universal access to quality health care was still “a work in progress”, but that the Plan’s promotion of healthy lifestyles would save millions of dollars.

Diabetes

“We have to start our kids off early,” he said.

“If you don’t put the money in the front, we will certainly put it in the back.

“We have a lot of people suffering because we can’t look after ourselves and don’t eat properly.

“We are number one in the world for diabetes (at 13 per cent of residents), and yet Type 2 diabetes is preventable.

“If everyone started exercising tomorrow and cut down on the fried chicken and fatty foods, then guess what? It’s going to be cheaper for everyone all-round.

“One way for getting costs down is education and awareness.”

Mr. DeSilva said an analysis of other countries had shown universal healthcare could be achieved at no greater cost.

 “A quality, equitable health system does not have to be more expensive. It just needs to be smarter,” he said.

The key was organization.

“Equity, in fact, is often more cost effective,” he said.

“All countries have to pay for healthcare, and we can choose to do it equally from the outset of life, or to spend it on treating the consequences of inequality.”

The Minister said five to 10 per cent of the population did not have health insurance.

“This compares poorly to most developed countries which spend less than we do. Clearly, equity is possible without spending any more,” he said.

Asked about financial restructuring, he said: “The way we plan to do that is going to be proportionate.

“Those who can pay more should be able to pay more, and those who are struggling, we want to make it that they don’t pay any more.”

The National Health Plan 2011 outlines 11 goals on the principles of equity and sustainability, to be phased in by 2018.

The public is now invited to give feedback, before April 30.

Over the next few months, Government will also consult health service providers.

“We need a community effort to get the reforms right for Bermuda,” said Mr. DeSilva.

“No stone will be left unturned during this consultation period.

Consultation

“Already we’ve had consultation with the insurance companies and we’ll be sitting down with the physicians, dentists — anyone associated with healthcare, we will talk.”

On financing the system to achieve access for all, he said: “It’s going to be a work in progress after consultation with the stakeholders.

“We are hoping they will work with us to achieve this goal.”

He added: “We met with all the insurance companies together. We had frank and open discussions for several hours.”

Mr. DeSilva said: “Healthcare should not be regarded as a privilege of employment or as welfare for the poor.

“It must be a right endowed equally on every resident, based on need.”

Bermuda’s healthcare system was established by the Health Insurance Act 1970, but after 40 years reform is long overdue.

Initiated by the late Nelson Bascome, former Minister of Health, the National Health Plan 2011 will be implemented by the Ministry of Health, Bermuda Hospitals Board and Bermuda Health Council.

In the past 17 years there have been 15 reports on the state of the healthcare system.

Slow progress

Asked why reform has taken so long, Mr. DeSilva said: “First of all we had a previous government prior to 1998.

“It’s been a work in progress. This work in progress has been slow and we haven’t really actioned the most significant things that have affected our people.

“But with the team we have established (now) and goals we have in mind, we will achieve that.”

The recent report ‘Health in Review’ showed healthcare costs were “escalating too quickly”.

“The latest figures we have, healthcare is rising seven to nine per cent a year. With the rate of inflation, we can’t sustain it. We need to get it under control,” the Minister said.

The Public Consultation Paper on the National Health Plan 2011 is available at the Ministry of Health and can be downloaded here.

Feedback should be sent to the CEO of the Bermuda Health Council by April 30. Telephone: 292-6420.

National Health Plan 2011

• Major shake-up for health care
• Equality a key aim of sweeping health reform
• Low earners likely to benefit most from planned changes
• National Health Plan 2011: Public Consultation Paper