Revised National Health Plan Released

November 8, 2011

Following the release of the Consultation Feedback Report on the National Health Plan 2011 in October, the Ministry of Health has today [Nov.8] released the final version of the initiative which incorporates the consultation feedback, entitled “National Health Plan: Bermuda Health System Reform Strategy.”

Minister of Health Zane Desilva said: “The consultation feedback provided many insightful ideas and suggestions that the Task Groups can now use in developing policy options to implement the NHP Goals.

“The finalised plan that we publish today includes revisions based on feedback regarding conceptual, systemic and structural issues. In particular, the focus on assuring population health, explicit reference to enhanced service co-ordination, and the amendment to the proposals on financing structures were a direct result of the consultation feedback.”

The Minister added: “In addition, the consultation feedback indicated areas in the plan that required clarification. For example, the goal on overseas care now clarifies the importance of protecting patient choice, within a framework of equity and sustainability.”

“This mission statement is important as it highlights that the purpose of the plan is to assure a healthy population; and that this is to be achieved by ensuring that the health system facilitates and encourage people to attain the best health possible within our reach as a community, and as individuals.”

A statement released by the Ministry said, “The Consultation Feedback Report on the National Health Plan summarized the submissions from the public and various stakeholder groups regarding the National Health Plan [NHP] Consultation Paper that were collected during the public consultation period, which began when the paper was released in February 2011 and ran until May 2011.

“Overall, based on broad support for much of what was proposed in the Consultation Paper, the NHP has remained conceptually aligned with the original version. The revisions made are enhancements and clarifications, but the conceptual direction remains on track. The public expressed support regarding the general direction of the Plan; however, the consultation process indicated several areas which needed to be included or amended.

“The largest addition to the Plan is the inclusion of a mission statement to ensure the ultimate purpose of striving for healthy people in healthy communities remains at the center of our work. The mission statement is: Bermuda’s health system shall assure the conditions to enable the human capacity to adapt and cope in achieving optimal health and quality of life.

“The plan has also been updated with regard to newly available statistical information and more detailed information regarding the implementation process including reference to the Steering Committee and the Task Groups.

“Additional changes to the NHP resulting directly from the consultation feedback include assuring access to necessary medical care for persons with chronic conditions and an amendment to Goal 3 to now state that health coverage contributions shall be affordable to all, to ensure equitable access to healthcare (whereas previously it proposed contributions to be based on ability to pay).

“The revised National Health Plan and the Consultation Feedback Report will now form the foundation for the Task Groups to set to work in developing ways to implement the NHP Goals. This will be a community-wide effort, with further public discussion and consultation taking place on an ongoing basis.

“Later this month the Task Groups will convene to formally kick off this phase of the National Health Plan, and before the end of the year, we expect to have a dedicated web site up and running, to facilitate access to information about the NHP, and public involvement.”

The full 44-page plan is below, click ‘Fullscreen’ for greater clarity:

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  1. Mad Dawg says:

    There is only one certain thing about this. The cost of healthcare to the average person will increase exponentially.

    • FAN 4 LYFE !!! says:

      I am not sure how you can say that this will increase costs if when looking at the plan it clearly states that the two main objectives of the plan is to ensure equity and sustainability within the health system. As mentioned on pg 4 of the report:-

      EQUITABLE: Having equal access to basic healthcare and proportional financial burden.

      SUSTAINABLE: Spending growth in line with inflation and a health system resourced to be affordable for the economy, payors, providers, employers, individuals, and families.

      • Rick Rock says:

        You’re ‘not sure’ how it will increase costs? Are you living in a dreamworld? For a kickoff, how many government administrators will this take? 500? 1,000? Remember, we’re talking civil servants. Lots of them. Currently there are 600 people in the department of education, doing no teaching, just admin. That give you any guide as to extra costs?

        And how exactly do we measure this ‘proportional financial burden’? Income tax? How do you work out what people earn? Taxi drivers, people who get tips, or are paid in cash…how do we track all that? Rules, regulation, tax, administrators. That’s the end result of this. More and more cost.

        You think healthcare will ‘improve’ somehow? How? Will there be better doctors or more hospital beds with this? No. There will be government people telling us how long the waiting list is. Healthcare will be like TCD. Take a number and wait, like everyone else.

        You think government is the most efficient manager of resources? Why? They don’t exactly have a great track record. Can’t manage buses and ferries properly. Can’t get education right. Can’t do a darn thing about tourism. Yet you want them to take over the running of healthcare? It’s ridiculous to think this is a remotely good idea.

  2. astounded says:

    There is one other certainty apparently — International Business does not agree with it and will not like it.

  3. Portia says:

    Mad Dawg and Astounded – you are both right. This National Health Plan means increased taxes for everyone, count on it. How else does Zane expect to fund such an initiative? He knows that Government does not have a single penny to put toward a National Health Plan.

    It also means added taxes on those highly paid executives that we kept chasing out of here. Remember, the ones we didn’t want here, who we wouldn’t listen to? Now we want them to foot the bill when we get sick.


    • OMG says:

      HMMMMM – new Health plan, new hospital, over priced generic drugs – starting to smell like a fish

  4. Curious says:

    Typical Comments above.. Let me guess, you have a better idea right? Let costs continue to outpace inflation, more money spent, fewer results….

    Nice to see criticism, but come up with a plan and then maybe people will listen.

    • Portia says:

      Well, one suggestion I could make is, why doesn’t Government put a cap on the amount that insurance companies are allowed to charge people who enrol in their pension plans? Why don’t they regulate the monthly premium that you have to pay? Premiums go up every year.

      Bermuda has a commission that regulates the amount of fuel adjustment that BELCO charges its customers every month, so this in effect controls your electricity bill. We also have a Price Commission, I believe, that regulates the price of gasoline and other services. Why can’t we do this for health insurance to control the costs?

      My other suggestion is that people should be allowed to put their elderly parents on their health insurance, the same way you add on a spouse or your children. I think that many of these people who are not covered today are the elderly who are no longer working. HIP has increased its cost drastically, so not every elderly person can afford it. Yet, if they have a son or daughter who is working, why can’t they put mom or dad on their health plan? I can insure my spouse through my company’s health plan, at the cost of less than $350 a month. That is half of what you pay for HIP or buying private insurance on your own – for $650 a month.

    • Mad Dawg says:

      Well, “Curious”, you’re evidently concerned about “costs outpacing inflation, more money spent, fewer results”? They are your concerns? Those are the EXACT results you will get if this plan is implemented.

      They want to run a new national health service, but they can’t keep a fleet of buses running. Doesn’t exactly inspire confidence does it.

  5. GMS says:

    Doesn’t everybody in Bermuda already have access to care? If you don’t have insurance coverage, isn’t the Govt obligated by law to pay for the care you receive at the hospital.

    Market based reforms are needed. A change in the health insurance market to a more catastrophic coverage model is needed.

    These folks need to look at the funding issues that all nationalized health systems in the West are facing. Divorce the payment for service from the consumer of that service and you will have trouble. It’s basic behavioral economics.

    • Portia says:

      GMS, government is not obligated to pay your hospital care. They are only obligated to provide the facility (the hospital) but if you do not have insurance, you have to pay the bill yourself. I have a relative who is not covered and she is still paying off KEMH hospital bills from when she got sick.

      • alicia says:

        your relative can get themselves evaluated to see if they qualify to become an indigent and then receive their healthcare paid for by the government (and thus tax payers)

  6. I gotta be me says:

    There’s only one way this “Plan” will work and that is with Income Tax… .you watch… and that my friends will be Bda’s death.

    • Hello says:

      It is not even a plan, it is a set of goals, how to achive the goals has yet to be planned. Lovely.

  7. The problem is not with the Insuance companies, it is with the people that the insuance companies pay the claims to. I.e. the doctors, labs, hospital, pharmacies, all the various therapists etc. Doctors now charge $12.00 to FAX a prescription to a pharmacy. The only sector of our economy prospering at the moment is the Health care sector – why? Because they are all increasing their rates because they

    • “In 2009/10 Bermuda’s per capita health expenditure was BDA $9,734; which represented 11% of our national wealth. Comparison to OECD countries places ourhealth system as the second most expensive, while failing to achieve universal coverage.Indeed, all but four OECD countries provide health insurance coverage to more than98% of their population and spend less on healthcare than Bermuda. This highlights concerns about the high charges of our health care providers. A solution would be to have all major Health providers be made to publish annual audited financial statements and a list of all services and how much they charge for these services so that the Price Control Commission could determine if the these providers are providing value for the prices charged. The Health care Industry is one of he most “secret” businesses in Bermuda and it would be in the public interest if financial disclosure was made mandatory across the board so those charging higher rates and amking massive profits so the public could make informed decisions on which provider they can use to save money.. just saying…

  8. alicia says:

    In order to control costs we need to control usage of the system and that means putting measures in place to control what government and/or private insurers will or will not reimburse for. For instance, diagnostic testing such as ct scans and mri’s should be found medically necessary prior to them being done otherwise there is the risk that they won’t be paid for. Too many tests are being ordered before the old basic one’s are being done that can usually find the answer in a fraction of the costs and time.This isn’t saying that they won’t ever be found necessary to be done, but the expensive testing should not be the first line of testing to be done unless it is clinically appropriate. How many times does the clinics have to charge 56000 for a series of ct scans only to have no answer at the end of it, or repeat them in a month because the doctor lost the results (yes that has happened)

    • alicia says:

      correction to above… it should read $6000, not 56000 – this was a typo

    • Mad Dawg says:

      Are unneccesary MRI’s the means by which certain doctors get extremely rich in 3 years and retire to places like Martha’s Vinyard?