Proposal for Healthcare for All Residents

February 9, 2011

Yesterday Health Minister Zane DeSilva unveiled the National Health Plan, which would provide universal access to basic health coverage for all residents, including hospitalization, as well and primary care and prevention.

Minister De Silva unveils National Health Plan 2

The Minister 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. The National Health Plan lays the foundation for this global aspiration to become a reality in Bermuda.”

|In addition, the Plan seeks to ensure that health coverage contributions be based on an individuals’ ability to pay. This is the best practice globally. It is the recommendation of the World Health Organization and innumerable health system experts world-wide. Solidarity in financing must be a reality in Bermuda.”

Pictured below left to right: Chief Medical Officer Dr. John Cann, Chair of Bermuda Health Council Linda Merritt, Minister DeSilva, Bermuda Health Council CEO Jennifer Attride-Stirling, Permanent Secretary for the Ministry of Health Kevin Monkman.

Minister De Silva unveils National Health Plan 3

Minister DeSilva`s full remarks follow below:

Good Afternoon Everyone,

…And thank you for coming to what I believe is a pivotal moment in the future of healthcare in Bermuda.

It is my pleasure and sincere honour to be here today to announce the new National Health Plan for our island home.

In November 2009 the Government’s Throne Speech announced that a National Health Plan would be developed.

The Ministry of Health has delivered on this initiative and today we are publishing a consultation paper with our proposals for the conceptual and organizational reform of Bermuda’s health system.

The purpose of the plan is to reset the founding values and principles of our health system, so we can ensure that quality healthcare can be affordable and accessible to all residents. So we can have a health system befitting of 21st century Bermuda.

It has often been said that, “A community is measured by the way it treats its weakest members.”

This holds true in all aspects of physical, emotional and social well being.

For this reason, it is essential that we treat health and healthcare as fundamental human rights.

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.

The National Health Plan lays the foundation for this global aspiration to become a reality in Bermuda.

The vision for this plan was initially conceived under the direction of my good friend and colleague, the late Minister of Health, the Honourable Nelson Bascome. It was under his successor, the Honourable Walter Roban, as well as the then Permanent Secretary of Health Warren Jones, that the Plan was developed.

The privilege of completing the task and presenting it to the public falls on me and the team at the Ministry of Health, the Bermuda Hospitals Board and the Bermuda Health Council. Some of the team is represented here with me today, and I am honoured to be part of this effort.

The reforms coming from the National Health Plan will be wide-ranging and profound.

They are based on the core values of equity and sustainability in order to address the long-standing concerns with the escalating costs of healthcare, and the inequitable burden placed on too many individuals and families.

The backdrop and context of the National Health Plan is that we have had 15 healthcare reviews in the past 15 years which have highlighted some of the weaknesses in our health system.

In addition, the recent report, “Health in Review”, has provided evidence on some of our strengths and challenges.

The conclusion: our health system has served us well for 40 years, but it is no longer enough.

Healthcare costs are escalating too quickly for individuals, employers and the Government. We need sustainable growth.

And the cost of coverage is disproportionately high for those most in need: the sick, the elderly and low-income families. We need equity in the system if we are to prosper as a community.

We know from the ‘Health in Review’ report that we spend more on healthcare than almost any other developed country, yet we cannot provide an adequate level of coverage to ALL our residents.

This is in stark contrast to most countries of the OECD who spend less than we do and provide universal coverage.

Bermuda can do better.

The National Health Plan proposes that we provide universal access to basic health coverage for all residents, and that this access include hospitalization, as well and primary care and prevention.

In addition, the Plan seeks to ensure that health coverage contributions be based on an individuals’ ability to pay. This is the best practice globally. It is the recommendation of the World Health Organization and innumerable health system experts world-wide. Solidarity in financing must be a reality in Bermuda.

The Plan sets out eleven health sector goals, including the ones just mentioned, to bring about improvements in access, quality and efficiency in our health system.

Some of the other goals for reform include smarter use of overseas care, introducing an integrated health IT system, health promotion, and, most significantly, re-engineering the way we finance healthcare so we can be more cost-effective and get better value for money.

Lastly, I want to highlight a very important point that we have learned from our analysis of the international evidence: A quality, equitable health system does not have to be more expensive. It just needs to be smarter.

Looking at the evidence, it is clear that equity is not related to how much a health system spends. It’s related to how a health system organizes access to care. Equity, in fact, is often more cost effective.

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 situation in Bermuda is that five to ten percent of the population don’t have health insurance. This compares poorly to most developed countries which spend less than we do. Clearly, equity is possible without spending any more.

The proposals in the National Health Plan are profound, but I have to stress that they will not overhaul the health system. We have many strengths in place, and we intend to leverage off them to improve access, quality and efficiency.

To conclude, I would like to say that I hope the public and all the players in the health system will read the consultation paper and provide feedback. We need a community effort to get the reforms right for Bermuda.

The Plan is available on the web sites of the Ministry of Health and the Bermuda Health Council, or you can call for a copy.

The Bermuda Health Council will coordinate the consultation process, and feedback should be sent in writing to the CEO of the Bermuda Health Council by 30th April 2011.

Fellow Bermudians, the need for reform in our health system has been long identified. The time for reform is now.

The key is to dismantle our old assumptions about what works and look at the cold, hard evidence internationally.

We have to look at the facts objectively and without bias, to see what produces better outcomes; what produces better healthcare; and what produces fairer access.

The National Health Plan has set the stage for this, and I look forward to receiving input from all walks of life, to help us create better, fairer healthcare for Bermuda.

Thank you very much. We can now take any questions you may have for us.

The 43-page 2011 National Health Plan Public Consultation Paper is below, click ‘Full Screen’ for greater clarity:

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Comments (17)

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  1. Encouraged says:

    I hope this is successful. Healthcare for all. Tired of all aspects of life being about who has the $ and who doesn’t. Somethings in life should just be.

  2. Copy Cat says:

    This is something I can support. :)
    The 1st positive thing that the PLP has done in a long time.

  3. True Bermudian says:

    How do we intend to pay for this?!?!?! Sounds good in theory. We could ALL use health care here in Bermuda. But where is the money to pay for it going to come from?

    - We have over a billion dollar unaccountable debt.

    - International business is quickly fleeing Bermuda.

    - Tourism is dead. Hardly anyone comes here and we’ve lost most of our repeat customers/tourists.



    In the UK and in Canada they use income tax to pay for the health care.

    Is that what Bermuda has in store?

    INCOME TAXES?!?!?!

    Are we to start paying income tax to a corrupt pilfering regime who, if history is any judge, would take that money and not account as to where it went?!

    • Peace says:

      I agree. Where is the money going to come from. Considering they already offer free daycare and bus.

  4. RealisticApproach says:

    @ The Bermudian, I’m with you on this one. Although this is ideal and good thing for all, how do we intend to get there is the question?

    Agree, Tourism in a no show, Internatinal Business moving elsewhere so that leaves us with…..what? Lillies and Onions? Haven’t see those for a while.

    Seriously, where is the money going to come from to pay for this venture. Higher employment taxes, thats what’s driven Internatinal business away, although they may not honestly say this. There are redundancies more than ever before in the International Business sector because there isn’t a lot of money flowing like it use to.

    I have seen ads from other islands and countries and to be honest they have so much more than Bermuda has to offer right now? Better hotels, activities etc. It’s only so many times I would want to see the Aquarium and Caves as lovely as they are mind you. What do you get when you come to Bermuda, seriously. This is a conversation our family has had over and over.

    I would think wisely on how this is approached.

  5. Squeaky says:

    Regarding how this will be paid for: all will be made clear on Feb 18.
    If it eventually comes to be I’d like to see prescriptions included

  6. S says:

    Good job Mr. De Silva!!!!

  7. Alice Lorraine Boyle says:

    Sounds great on paper, but if experience elsewhere is any guide, forget it. For instance, both Canada and the UK have fantastic socialized medicine, just as long as you don’t get sick. Besides which, would you really trust this pal of Ewart’s with your hard earned money? Sorry to be the bearer of bad news but the best thing that could happen is that Zane loses his seat at the next election.

  8. sandgrownan says:

    Alice – I suspect you have no idea what you’re talking about regarding health care.

    That said, you are quite right that Zane is an idiot.

  9. Tired of nonsense says:

    Sounds like a admirable plan full of admirable intentions.

    However, I will not pass judgement until the actual funding logistics have been made clear. Especially in light of the FutureCare actuarial reports that this Govt still refuses to open up to the public.

    It will be very interesting to see how this scheme is funded. I foresee additional as well as an increase of existing taxes in the very near future!!

  10. Watching says:

    For those of you who think that Zane DeSilva is doing a great thing by introducing universal health care – think again!!

    True Bermudian and Realistic Approach have got it right. I can answer that question, “who will pay for this this”? YOU WILL! You and I and every hardworking Bermudian just trying to get by. I have read briefly through the report, and I find it disturbing. The public needs to understand some basic truths:

    1. Gov cannot afford to offer universal health care to everyone. Our government has spent more than it could afford to. They are broke.

    2. The way that gov intends to finance this is through a “proportional financial burden” so that “those can afford to pay will; those who can’t, don’t” That means that YOU will be paying the portion of health care for everyone who doesn’t work or have an employer’s health insurance plan. This can ONLY be achieved by raising the costs of what you are already paying if you DO have health insurance (because now you are not only paying for yourself, but for other people too). Government will look at your salary, and determine how much to take for health care. More taxes, people.

    So, I have a brother-in-law who doesn’t want to find a job; it’s been that way for years now. What, am I going to be paying for his health care, because he is “entitled” to it?

    2. This also means that, even though you are paying MORE, you will still receive the same standard of care and health services as those who aren’t paying into the system. So, if you are paying in $300 a month, you still are getting what the person who pays in, say, $10 a month is getting. How is that fair?

    3. The report says that health care will be offered to every RESIDENT, not merely every Bermudian. This means people who are here on work permits or decide to live in Bermudian for whatever reason. Why should Bermudians living here pay for health care for non-Bermudians?

    4. This program will only become more costly over time. Why? Because our population is aging, while the birth rates are falling. People are living longer, and having less children. The WHO estimates that soon you will have a situation where a smaller pool of younger, working people are carrying the financial burden of supporting the older retired population receiving social assistance programs. This means more financial stress on those who are still working and can pay.

    5. Gov intends to “streamline” the use of overseas health care. In effect, to discourage it, unless absolutely critical. Do you really want the gov telling when and where you can receive treatment? Isn’t that our right, as the patient, to make that decision.

    God forbid, I hope this never passes in the House…

    • Tired of nonsense says:

      “The system we have now is totally unfair. Why should someone who earns $5,000 a week pay the same standard health benefit as someone earning $500?”

      So the good Minister believes that forcing others to pay higher fees due to their higher income for the EXACT SAME services compared to others on a lower end of the pay scale somehow makes the system more fair?

      I might as well quit my job and let others pay my way. Seems to be the socialist road that we are heading down.

      Please explain to me how that is fair.

  11. JimmyJohn says:

    This is a program designed to win votes. Period. They will NOT be able to pay for this program and I am still not sold on the fact that health care should be a “RIGHT” for every citizen. I would agree for children under the age of 18 and possibly the elderly but after that ???? Charge the CEO of the company X and charge the potwasher 1/100X….so much for the incentive of working hard in life to get ahead:)

  12. Terry says:

    They say a picture speaks 60 thousands words.

    Kiss your rectum goodbye………..Betcha Ewart will be a consultant et al……..

    Stem Cell….bwahaaaaaaaaaa

    I see a stem comming and we’ll all get shafted……….

    High Oh Desilva…..away……………………………………

  13. Triangle Drifter says:

    This is just another serving of Kool Aid for the PLP voting sheeple who will guzzle it down not having a clue as how it will be paid for nor caring. Meanwhile that sucking sound you hear is what used to be the envy of every micro nation in the world rapidly going down the drain.

    Y’all voted for it. Y’all deserve it.

  14. S says:

    Listen to 89.1 today at 12pm. Mr. De Silva will be talking about the new health Plan!

    • S says:

      Bernews can you post this on your website so everyone who is concerned can listen in ?