Health Financing Summit Gets Underway

Good Morning,And welcome to the Health Financing Summit 2011.

It is indeed a pleasure and an honour to have you here today to launch the next phase of our National Health Plan.

This is truly an exciting time for healthcare in Bermuda.

The National Health Plan is making history – and all of you will play an integral role in writing that history.

Over the past few months I have grown very fond of the saying that “a community is measured by the way it treats its weakest members”.

We are here today to ensure Bermuda’s health system measures up to that high standard and provides everyone with equal access to basic healthcare. Anything less will not do.

To ensure this, we have been working tirelessly on the National Health Plan for almost a year.

In that time we have accomplished many things. We have:

- Published the consultation paper in February;
- Held 44 meetings with stakeholders to gain feedback and listen to any concerns;
- Received a great deal of verbal feedback and 100 written responses;
- Shared the results of the consultation;
- Published a revised National Health Plan as the blueprint for reform;
- Formed six Task Groups and a Steering Committee; and
- Engaged over 70 people from across Bermuda’s community on these Task Groups.

Today we have the rare privilege of gathering together the majority of task group members in the same room to launch the next phase in the National Health Plan.

This is, for me, a very significant milestone. It is, if you like, the “spring-board” for making the reforms happen.

Therefore, I want you to know that I truly appreciate the commitment you are making in helping Bermuda to bring health costs under control and make universal healthcare a reality.

We cannot do it without you, and it will be all the better for your involvement and contribution.

The NHP was started under the patronage of my dear friend and colleague, the late Minister of Health, The Hon. Nelson Bascome. He got the ball rolling in early 2009 just months before his passing, and I know he would be proud of the progress we have made.

Then in November 2009 the Government Throne Speech announced that a National Health Plan would indeed be developed.

The development of the Plan was continued under then Minister of Health, the Hon. Walter Roban, JP, MP throughout 2010.

And when I became Minister of Health in November 2011, of course the responsibility fell on me to complete the process. And I can say it has been a pleasure and an honour to do so.

I want everyone to understand that this is a personal passion of mine. And I mean that.

Long before I was Minister of Health, I had to witness my grandmother having to choose between groceries and prescriptions.

Long before the Health Plan came into being I had to watch my step-father choose between cancer treatment and a livelihood for his wife.

Those were some tough choices – choices people in Bermuda are making right now, as we sit here in this room.

So when I came to the Ministry of Health, I confess I had an agenda: that healthcare should be affordable for everyone in this country.

This is what I hope we can make happen in Bermuda. I believe we can, with your help!

I admit that when I first became Minister of Health everything felt like it was coming at me at 100 miles an hour. This was a whole new area for me and there was a lot to learn, a lot to do, and a lot of people to meet. Among them was the CEO of the Bermuda Health Council, Dr. Jennifer Attride-Stirling.

The first time I met with her she briefed me on the Council’s role and the health system issues they were dealing with.

At that point I think I stopped her mid-sentence and asked if there was anything we could do to make the cost of health insurance premiums relative to what people earn.

I told her how unfair I think it is that a cashier and a CEO pay the same price for the basic insurance package.

The response was: the National Health Plan. It was at an advanced stage of development at that point and only needed the final touches… and the political commitment to make equity a priority. A political commitment I am more than happy to give.

That was in November 2010. And the rest, as they say, is history.

In February 2011 we launched the National Health Plan Consultation Paper, and we are here today to kick off the next phase: working to make it happen!

So what are the things that led us to the Health Plan? We all know these well enough by now, but they are worth restating to reinforce the urgency of our discussions today:

First and foremost, our healthcare system is expensive – absurdly expensive.

In fact, it’s the second most expensive compared to all other OECD countries.

In 2010 it cost $628 million dollars; which amounts to 11% of our GDP! This is nearly $9,000 per person; nearly twice the average OECD country!

Health costs are rising much faster than inflation. And, if we do nothing, health costs will reach $1 billion in just five years.

Additionally, utilization of health services is increasing unsustainably.

In 2010 utilization on the Standard Hospital Benefit increased by nine per cent; local utilization increased by eight per cent, and overseas utilization increased by 14 PER CENT.
However, in that same year, the number of people insured dropped by 5.5 per cent.

This means that although the system provided care to 3,000 fewer people, hospitalization costs increased by $10 million between 2009 and 2010!

This is unsustainable – incredibly unsustainable!

Moreover, our healthcare system is unaffordable for those most in need, specifically:
- the sick
- the elderly
- and low income families. Ten per cent of low-income adults don’t have health insurance.

The National Health Plan aims to contain the growth in health costs and ensure health coverage is affordable for everyone. This is equity.

To those who ask, “What is the price of equity?” I say: “What is the price of inequity?”

We can pay for healthcare in a more equitable way to secure better health for all our people…… Or….. we can spend our money on the consequences of inequity.

I choose the former. Introduce equity, and we will improve quality of life for everyone.

As you know, 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 and we can boast of a health system befitting of 21st century Bermuda.

The mission of the Health Plan is simple: to create healthy people in healthy communities. We want a health system that can enable everyone to achieve optimal health.

To achieve this, the Health Plan is based on two core values: equity and sustainability – ‘equity’ to ensure everyone can afford coverage and have access to healthcare and ‘sustainability’ to ensure we contain health costs.

And, as you know, the plan has 11 goals which focus on improving access, quality and efficiency.

There are a lot of things we need to fix in our health system, and some of them we have already started. But now they all come under the strategic direction provided by the Health Plan. For example:
- Abolishing upfront payments;
- Making prescription drugs more affordable; and
- controlling hospitals costs.

And there are many others that are a priority and we need to turn around fast.

For example: Enhancing the Standard Hospital Benefit to include more than just hospital care. We are serious about the importance of prevention, and the minimum insurance package must reflect that.

Also, it is essential that we conduct the financial modelling to restructure the way healthcare is financed in our community to ensure it is fairer and accessible to everyone, in particular, to those who need it most.

And finally, we need to create financial incentives for people to achieve healthy outcomes on things like body weight, blood pressure, blood cholesterol, etc.

We are gathered here today to begin that work. It will not happen overnight, but it will happen as quickly as we can make it happen.

So, today we kick off Phase 2 of the National Health Plan, commencing the work of the various Task Groups.

Six Task Groups are convened here today. They are:
- The Steering Committee;
- Finance and Reimbursement;
- Benefit Design;
- Overseas Care;
- Health IT;
- Prevention; and
- Long Term Care.

All Task Groups are of crucial importance. And, as members, you are vital to the process.

You were selected for two simple reasons:

Firstly, because you represent a particular stakeholder perspective; be it medical, business, civil society, or public advocacy – all of them are imperative to health reform.

And, secondly, because we believe that you will act in the best interest of Bermuda to make the National Health Plan a reality, in achieving both its core values of equity and sustainability.

I am confident that with the brainpower and experience we have gathered in this room today, we will make this happen.

I want to now give a special thanks to the Task Group Chairs, who have volunteered their service above and beyond the call of duty.

The Task Group Chairs are:
- Kevin Monkman, for the Steering Committee;
- Jennifer Attride-Stirling, for the Finance and Reimbursement Task Group;
- Tawanna Wedderburn, for the Benefit Design Task Group;
- Michelle Jackson, for the Overseas Care Task Group;
- David Hill, for the Health IT Task Group;
- Virloy Lewin & DyJuan DeRoza, for the Prevention Task Group; and
- John Payne, for the Long Term Care Task Group.

Their contribution will be invaluable in driving forward the reforms.

You will see from the agenda that you will be put to work later today. You will hear more on your specific tasks later today, so for now I want to wind down by thanking you once again for joining in this great effort to make Bermuda a better place for all of us.

The need for reform in our health system has been long identified.

And the time for reform is now.

Thank you

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