Health Minister On ‘Health Reform Strategy’

Mr. Speaker, I stand before you and my Honorable colleagues today to discuss the National Health Plan.

In April, I took the opportunity to provide a full update on the progress made by the various Task Groups working on the implementation of the Plan.

Today I want to ensure that all my Colleagues are clear on what the Plan is and is not, and that you are aware of our continued efforts to keep the public and key stakeholders within the health system informed and involved in its development.

Mr. Speaker, despite our extensive consultation efforts during the development of the NHP, there remain some misconceptions of what the Plan is and why it is needed.

The National Health Plan is a health reform strategy.

It is a roadmap to change our health system so it can meet the needs of our community today and in the future.

The Plan is striving to achieve healthy people in a healthy community by ensuring our health system is both equitable and sustainable.

There are eleven goals within the Plan that focus on key areas that require strategic actions including long term care, health promotion, and health IT.

Three of the core reforms target the existing minimum benefit package that is required by law under the Health Insurance Act.
To remind my Honorable Colleagues, these specific reforms, set to be implemented in 2014, are:

• 1. to improve the minimum benefit package required by law, known as the Standard Hospital Benefit, to ensure people have access to basic health care services that promote cost effective care;
• 2. to ensure everyone is covered for this basic package; and
• 3. to ensure the package remains affordable.

Mr. Speaker, some questions we have heard while discussing these reforms are: why do we need to make these changes? Also, the system works for me, why change it?

Let me remind everyone that we have the second most expensive health system amongst all OECD countries – only the US spends more per person than we do – but our health outcomes don’t reflect the amount being spent.

In our present system, spending on healthcare is increasing each year at double the rate of inflation. This cannot continue.

We must take strategic and coordinated action to address the issues that are leading to these high costs, to ensure our system is sustainable and care is affordable.

It is not just how much we spend that is concerning but also the value for money we get from this level of expenditure.

Despite spending $9,734 per person each year on healthcare, our health outcomes are not as good as other countries that spend less!

In addition, most of these countries that spend less cover 100% of their population; we only cover about 94%.

And if you think that’s ok, let me remind you that only 4 of the 30 high income countries cover less than 98% of their population: Mexico, Turkey, the Slovak republic and the US. We are not in good company, Mr Speaker.

Universal coverage is a global standard that is promoted as a means of ensuring both better health outcomes and enhancing the sustainability of the health system.

We are confident that through strategic action and smarter use of our resources we can reach this standard of coverage for our population.

Furthermore, Mr. Speaker, for those able to afford their health insurance right now, the system may seem fine.

However, if you are a low income earner or are unemployed, obtaining the care you need within the current system can cause considerable financial hardship.

The 2011 Adult Health Survey found that 39% of people were not confident they could afford the healthcare they required if they fell seriously ill.

This is not good enough, Mr. Speaker.

According to the World Health Organization, World Bank and the OECD, having a system where people cannot afford coverage is both unfair and unsustainable.

As healthcare is a basic need for all persons, we must ensure all people in Bermuda can access affordable care.

Mr. Speaker, the National Health Plan is working to change these areas of our system that are a cause for concern. But we are not throwing the baby out with the bathwater.

The Plan clearly states that we will build upon the strengths of our existing system to create these reforms.

Accordingly, the Plan is NOT creating a nationalized health system, such as the NHS in the United Kingdom or the US’s Veteran’s Administration.

The health system will continue to be made up of a mix of private professionals, the BHB, overseas hospitals and the Department of Health.

The people of Bermuda will continue to have choice in their healthcare providers.
Furthermore, insurance coverage beyond the minimum package will be provided by private insurance companies.

Mr. Speaker, the solutions we are creating for the health system are focusing on the particular needs and context of Bermuda.

Although we can learn from the successes and failures from the many other countries working to achieve affordable health care, there are no cookie cutter solutions.

This is why I, as the Minister of Health, am strongly committed to ensuring the continued involvement of members of the health system and wider community in the development of the Plan’s implementation.

Over 70 members of our community, including healthcare professionals, insurers, and local and international business leaders are developing options on how to reach our goals through their participation on the Steering Committee and Task Groups.

We believe this approach puts us on the right track to create solutions that will benefit all of Bermuda.

Mr. Speaker, not only do we have a large number of community members working on the NHP, but we are also committed to updating stakeholders on a regular basis.

Over the last few weeks I have met with members of the Association of Bermuda International Companies, the Association of Bermuda Insurers and Reinsurers, the Bermuda Chamber of Commerce, the Bermuda Employers Association and representatives of the various healthcare professions’ Boards, Councils and Associations.

These meetings were to keep stakeholders abreast of where theNational Health Plan is to date and to ensure they have the continued opportunity to discuss the Plan with us directly. We will continue to hold such meetings in the future.

In addition, this week we have published our first quarterly electronic newsletter on the National Health Plan.

With an electronic distribution list of around 500 people, this is another way that we can provide updates and information on the Plan directly to stakeholders.

The newsletter can be found on our website, www.nhp.bm, and each Member of Parliament should have already received a copy.

Finally, the financial modeling for the core reforms is scheduled to be completed in the last quarter of 2012. Once available, we will have another round of public consultation on this important part of the Plan.

In conclusion, Mr. Speaker, with the rising costs of healthcare, doing nothing is not an option, and trying to fix things in a piecemeal manner can’t be the solution.

This approach got us where we are today.

Comprehensive reform is needed to be able to contain health care costs and ensure affordable coverage and universal access to basic healthcare.

The National Health Plan is our road map for reform that will benefit all of Bermuda.
Thank you, Mr. Speaker.

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