Roban: Health System On Verge Of Revolution

May 2, 2010

walter roban bermudaMinister of Health Walter Roban has released a statement on the state of the health insurance system in Bermuda, saying that concluding our health care system is close to failure and “alarming the public” is not constructive.

Health insurance has been at the forefront of conversation for the past few days in Bermuda, following the public concern expressed by BIU President Chris Furbert over planned health insurance premium increases. The BIU hosted a general meeting on April 29 to discuss these concerns, with Gerald Simons of Argus and John Wight of BF&M sitting on the panel.

Government’s basic monthly H.I.P premium went up by 24% as of April 1st 2010; going from $241.15 to $298.93. Private health insurance policies, which vary in the benefits agreed and paid for, are said to have increased by between 9% and 20% as of May 1st 2010.

Minister Roban’s full comments follow below:

I read with some interest remarks by representatives of the local health insurance industry. Whilst there certainly is cause for concern regarding the rising cost of healthcare, concluding that our health system is close to failure and alarming the public is not helpful or constructive and suggests that nothing is happening today to ensure sustainability into the future. That is certainly not the case.

The Government is moving diligently and deliberately to address issues within the local health system. In the 2009 Speech from the Throne, the Government announced the development of a national health strategy. The establishment of this strategy must consider providers, payers, financing, utilization, public health, acute care, overseas care, pharmaceuticals, access, affordability and cost containment. That work has already begun. The first phase sees Government related entities collectively looking at those key issues and establishing priorities. The second phase, which will occur in the fall, will see external consultation to test our conclusions and this work will include the general public and healthcare providers.

Each of us has a role to play in containing the escalating cost of healthcare; healthcare providers, health insurance companies, legislators and the general public. The Government must develop and implement policies and regulation that ensures access to safe services at an affordable rate.

The Ministry of Health, including its quango partners, has several regulatory proposals at various stages of completion. This work will determine more efficient ways to deliver services in Bermuda, and ensure that those who provide the services do so to the highest standard in a financially sustainable way.

The Government also has a responsibility to ensure that health services are available to all. At present, the Government does this through subsidies and social programmes for those who are unable to afford care.

One of the questions going forward is how much of this burden of care should Government carry and how much should be shared across the system? The introduction of diagnostic related group reimbursement at the Bermuda Hospitals Board in April 2009 has started a cost shift across the system. Although the insurers have had to pay a higher share of the burden this year, this did not represent an increase in costs within the system. Instead, it was a rebalancing of the costs to bring about equity amongst all payors.

Contrary to what it might seem, the Government, insurers and the Bermuda Hospitals Board have been in consultation throughout the year on matters impacting our health system. This is important if we are to ensure that the future of our healthcare system is sustainable. No one player has all the answers.

Bermuda has the minds and the resources to fill any necessary gaps to successfully determine our way forward. We know the issues and the Government is committed to addressing them. We are presently reviewing the Standard Hospital Benefit towards modernisation, reviewing the cost of pharmaceuticals in order to determine alternate sources and greater use of generics, regulation of insurers, healthcare providers and healthcare businesses and all of these initiatives will move our system into the 21st Century and beyond.

The first step in any change programme is identification of the problem and getting buy-in amongst stakeholders. The events of the last week suggest that although we have our work cut out for us, we are all in agreement that the work must be done. I look forward to engaging with the entire community to move this agenda forward. In my mind, our health system is on the verge of a revolution.

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