HIP & FutureCare Premiums Set To Increase
The Health Insurance Plan [HIP] premium is to be increased by 11.1% from $390 per month to $433.31 per month effective September 1st 2015, Minister of Health, Seniors and Environment Jeanne Atherden said in the House of Assembly.
“Healthcare system costs have risen to unsustainable levels, and we must continually review and remind ourselves and the residents of Bermuda that our goal of offering accessible and affordable healthcare is often a conundrum,” said Minister Atherden.
“Please know that we have gone through a comprehensive and exhaustive process to come up with these recommendations, in keeping with the expectations as set forth. Last year [FY 2014/15] HIP, FutureCare, and subsidy paid approximately $150 million dollars in health care claims.
The Minister said they “are pleased to introduce four new health benefits which have been added to the HIP and FutureCare Plans for 2015/16, with an effective date of September 1st 2015:
- 1. Personal Home Care Services: that supports aging in place, at home. Reduces hospital length of stays, and promotes healthy aging.
- 2. Increase in Specialist Visits for improved chronic disease management
- 3. Health and Wellness Benefit: for preventative care management to stay healthy and reduce disease and illness.
- 4. Youth Coverage [birth to age 21] to cover children for specialist, dental and overseas care
“As a result of escalating healthcare costs, a significant rise in claims, and an increase in the Standard Health Benefit [SPR] rate, it was necessary to increase the HIP and FutureCare premiums,” continued Minister Atherden.
“Let me first acknowledge that no one wants to hear the word ‘increase’ in this challenging economic environment; however, I believe that by offering additional incentives and proactive health insurance benefits that focus on improving health, reducing hospital stays and affording residents of Bermuda the dignity of remaining in their own homes, for as long as possible, is paramount.
“The premium changes were considered in conjunction with the new health insurance benefits which are designed to address the care needs of the populations served by HIP and FutureCare.
“The Health Insurance Plan [HIP] premium is to be increased by 11.1% from $390 per month to $433.31 per month.”
Chart provided by the Ministry:
“While there are many other benefits that we would like to offer, we are keenly aware of the fact that benefits cannot be provided without a corresponding increase in premiums,” added the Minister.
“As health system costs have risen to unsustainable levels, we must continuously review and remind ourselves and the residents of Bermuda that our goal of offering accessible and affordable healthcare is often a conundrum.
“Please know that we have gone through a comprehensive and exhaustive process to come up with these recommendations, in keeping with the expectations as set forth.”
The Minister’s full statement follows below:
Good Day Mr Speaker and Esteemed Colleagues:
Mr. Speaker, the proposed changes mark a strategic shift in our delivery of health services which is designed to provide better patient outcomes and population wellness in relation to the significant investment made by Government into the health of our citizens. Ultimately, our aim is to return the health system to a sustainable level with the appropriate level of accountability. Healthcare system costs have risen to unsustainable levels, and we must continually review and remind ourselves and the residents of Bermuda that our goal of offering accessible and affordable healthcare is often a conundrum. Please know that we have gone through a comprehensive and exhaustive process to come up with these recommendations, in keeping with the expectations as set forth. Last year [FY 2014/15] HIP, FutureCare, and subsidy paid approximately $150 million dollars in health care claims.
The healthcare system needs to move to a proactive approach with the emphasis of moving the care back into the community. We must look at the future and our future generations with a sharp focus on improving the health and wellness of our population now, identifying the chronic health issues that exist that can be improved upon if started early enough in one’s life cycle. You will have recently heard the results of the STEP’s to a Well Bermuda survey which found that 74.6% of our population is either overweight or obese. Another relevant finding from the survey was the number of individuals who reported 3 or more chronic disease risk factors which was 42% of the total population aged 18 and over. We must all work together to achieve a healthier Bermuda. In keeping with improving health at a young age these changes now offer health insurance coverage for Bermuda’s youth.
As a result of these worrying population health statistics and escalating healthcare costs across the board, I am here today to discuss four new supplemental health benefits and one enhanced benefit to HIP and FutureCare. These changes are in line with HID’s strategic vision of improving care coordination, more efficient utilization of services, improving diseases management, and promoting healthy lifestyle choices. .
Therefore, we are pleased to introduce four new health benefits which have been added to the HIP and FutureCare Plans for 2015/16, with an effective date of September 1st 2015:
- 1. Personal Home Care Services: that supports aging in place, at home. Reduces hospital length of stays, and promotes healthy aging.
- 2. Increase in Specialist Visits for improved chronic disease management
- 3. Health and Wellness Benefit: for preventative care management to stay healthy and reduce disease and illness.
- 4. Youth Coverage [birth to age 21] to cover children for specialist, dental and overseas care
Let me now expand upon each new benefit:
1. Personal Home Care Services: For HIP and FutureCare policyholders
“Aging in place” refers to living where you have lived for years. This benefit will provide services that assist in activities of daily living to be brought to you so that you have support to remain in your own home, even as your circumstances change. In other words, you continue to live in the familiar surroundings of the home of your choice safely and with as much independence and dignity as possible as you get older. Personal Care Services are determined according to your care needs, encourage self-care, and can be adjusted as your care needs change.
It is widely known that many people end up staying in hospital significantly longer than they need to. This is often because patients cannot afford to go home and receive personal home care services. By offering this benefit through HIP and FutureCare we are providing an alternative to an unnecessary long-term hospital stay or premature placement in a rest home or long term care nursing facility. Personal caretaking or adult day care services will allow a disabled person or a person with dementia to remain in their own home longer with appropriate supports.
Mr. Speaker, Personal Home Care will provide care support for easier transition back to your own home during any recovery or recuperation phase you may have. Additionally, in the unfortunate event that you have some functional difficulties, this will assist you with accessing care supports in your own home and in your community, so that you remain safe, and as independent as possible.
2. Specialist Care number of visits and fees for HIP and FutureCare Policyholders
Specialist visit fees coverage will increase to $565 per year and will be comprised of two initial visits at $170 each and three follow up visits which will be reimbursed at $75 each.
The increased coverage will enable you to see your specialist more frequently and provide better disease management, and decrease your co-pay.
When combined with the new wellness benefit, there will be a more comprehensive approach to the management of chronic disease through better management of chronic illness and a more focused approach on prevention, wellness and making better lifestyle choices.
Mr. Speaker, As we all know, better disease management will lead to more positive outcomes, and prevent complications of chronic disease which will reduce healthcare costs in the future.
3. Wellness Benefit- Health Promotion:
Due to the prevalence of chronic diseases, HIP and FutureCare policy holders will be able to utilize a new wellness benefit. This will assist with the cost of counselling for asthma, nutrition, diabetes, lifestyle habits, smoking cessation and fall prevention.This new benefit is an incentive for self-management of health and promotes health and reduces the risk of chronic disease. The goal is to make lasting, positive lifestyle and behaviour changes early on for those with non-communicable chronic diseases that improve health and well-being thus reducing complications of chronic disease later on in life.
The benefit will cover 80% of program costs subject to a maximum of $35 dollars per visit and maximum of 6 visits per year.
Mr. Speaker, A healthier population in Bermuda would be the most positive of outcomes. It is well known that prevention and wellness is a far more cost efficient and effective health management tool.
4. Youth benefit: For HIP Policyholders
Mr. Speaker, I would now like to discuss the important introduction of a Youth Benefit under HIP for children [birth to age 18, if youth subsidy eligible and to age 21 if enrolled full time at the Bermuda College].This benefit will offer paediatrician, GP’s, and specialist visits, to improve chronic disease management, and foster development of healthier children for the future.
Children would be covered at 60% of charges for overseas treatment, if medically necessary and the treatment is not available in Bermuda.
Therefore, we are pleased to offer our children HIP Coverage at a reasonable cost of $190 per month.
A Change in Overseas Care Benefit for HIP and FutureCare
HID has developed an Overseas Preferred Provider Network in response to the escalating cost of overseas treatment. The majority of policyholders utilize the United States for overseas care where healthcare costs are rising and inconsistent in pricing and quality.
Mr. Speaker, The overseas preferred provider network has been introduced to contain costs without compromising patient outcomes. HIP and FutureCare policyholders continue to have a choice in where they have overseas care. The preferred provider network continues to offer the overseas facilities that Bermudians are familiar with for their care. In network the benefit coverage is unchanged. If a policyholder chooses to go outside the network the benefit coverage reduces by 10%. Careful deliberations were taken to ensure that the preferred overseas network met the needs of the policyholders for quality patient outcomes, and, the best value. This benefit directs the policyholder to the best preferred facilities based on quality and value experience related to the medical condition and treatment needed, and offers choice in geographic location. Policyholders will be strongly encouraged to use the overseas preferred provider network to contain costs.
It is anticipated that substantial savings will result from this policy with no degradation in quality of care and patient outcomes.
Mr. Speaker, as a result of escalating healthcare costs, a significant rise in claims, and an increase in the Standard Health Benefit [SPR] rate, it was necessary to increase the HIP and FutureCare premiums. Let me first acknowledge that no one wants to hear the word ‘increase’ in this challenging economic environment; however, I believe that by offering additional incentives and proactive health insurance benefits that focus on improving health, reducing hospital stays and affording residents of Bermuda the dignity of remaining in their own homes, for as long as possible, is paramount. The premium changes were considered in conjunction with the new health insurance benefits which are designed to address the care needs of the populations served by HIP and FutureCare.
Mr. Speaker, The Health Insurance Act 1970 describes the programs as follows:
- HIP is a plan consisting of Standard Benefits and Supplemental Benefits, and is available to both Individual and Group insureds;
- FutureCare is a plan designed for persons over the age of 65 and provides comprehensive benefits for both Individual and Group insureds;
- The Subsidy Program consists of Age, Youth and Indigent subsidies and is targeted to provide relief to these vulnerable populations.
Under the Health Insurance Act 1970 and its Regulations, every employer and self-employed person must provide a minimum of standard hospital benefits for each employee and their non-employed spouse.
Mr. Speaker, It should be noted that the Standard Health Benefit [SHB] is the minimum benefit package that must be included in any health insurance policy sold in Bermuda. SHB covers the majority of local hospital costs and some non-hospital care; and insurers are obligated to pay all claims under SHB.
As you are aware, the fiscal 2015 Standard Health Benefits or SPR premium which makes up the basic benefits to our HIP and FutureCare supplemental insurance plans has been increased to $338.07 as of July 1st, 2015.Additionally, it should be noted that the Mutual Reinsurance Fund] MRF fee was increased to $63.74 from $29.18.
Mr. Speaker, as such , The Health Insurance Plan [“HIP”] premium is to be increased by 11.1% from $390 per month to $433.31 per month.
Mr. Speaker, This sums up the supplemental benefits and changes for HIP and FutureCare that I feel are most needed at this time. While there are many other benefits that we would like to offer, we are keenly aware of the fact that benefits cannot be provided without a corresponding increase in premiums. As health system costs have risen to unsustainable levels, we must continuously review and remind ourselves and the residents of Bermuda that our goal of offering accessible and affordable healthcare is often a conundrum. Please know that we have gone through a comprehensive and exhaustive process to come up with these recommendations, in keeping with the expectations as set forth.
You will know that premium revisions are calculated annually, based on information provided to us by The Health Insurance Committee [HIC] who commissions an annual actuarial review of the premiums, claims and expenses of the funds to determine an appropriate premium.
Mr. Speaker, the proposed changes mark a strategic shift in our delivery of health services which is designed to provide better patient outcomes and population wellness in relation to the significant investment made by Government into the health of our citizens. Ultimately, our aim is to return the health system to a sustainable level with the appropriate level of accountability.
I would like to conclude by thanking the Health Insurance Committee, the actuaries, the BHeC and HID for their hard work. We had difficult decisions to make, but I believe we have found the right balance at this particular time.
Thank You.
We need to call 911 to get emergency treatment for healthcare – when will people wake up that these costs are simply unsustainable? Would I favour things like sugar taxes? Would I favour precertification? Yes, I would. Why – because too many people will not be able to afford (cannot afford) to retire because of these costs ….
Get ready Bermuda – they are going to flat tax the little man into oblivion. Incomes have not increased by 11%. Cut the civil service or we are going to die a slow and painful death.
C’mon man.
Quo Fata Ferunt
Cut the B.T.A. too.
What is happening to my island home?
I will explain what is happening to your island home:-
1. Ageing population
2. Incredibly sick population with an emphasis on preventable but costly to treat diseases such as diabetes and hyper tension as well as the orthopedic consequences of being obese.
3. Government policies which have scared away the wealthy healthy and younger IB expats who paid into the healthcare pot but rarely took from it.
4. Massive hospital and over testing (eg Mammograms)
That is the harsh reality.
example: saw a man grossly overweight bareable able to walk after having his second knee replacement surgery. where is the logic in this when a regime of pushing away from the table would have helped.
*barely*
None of the above just a bunch of greedy people arus,bf and. M
You can. Pay for most of your life. But. Make. One. Claim. And. Bam up goes your
Policy
ok, is there a long time solution to bring health care costs down? Both Political Parties ..
The OBA has tried that, pre-cert, reduction of mammography over-utilization, constant reminder for people to take responsibility for their own health, constantly asking people to not use the ER as a clinic, tried to close do they could repurpose the costly and under utilized east end facility.
The trouble is, nobody wants to accept what has to be done
More costs to affect the little guy!
5,000 less foreign workers on the Island= less tax revenue and higher healthcare premiums.
Commercial immigration is the most immediate answer, yet the combined opposition don’t want anyone here accept the born and bred Bermudian.
Not to mention the huge bill the PLP left us for the hospital, due to their poorly managed RFP process.
Question: Why can’t a reduction in H.I.P or FutureCare Premiums be giving to them that don’t claim as often, (if at all)annually?
This can also apply to them that register their cars with T.C.D.and their Insurance Company.People who try to avoid making any claims find themselves paying as much as them who are careless…There ought to be a Law!
Because Raymond that’s not how insurance works. The unhealthy are completely dependant on the healthy to pay their bills. If they subsidised the healthy then the ill would see their costs absolutely sky rocket!
people who take preventative care should be rewarded with lower premiums and not have to pay for those who act irresponsibly with respect to managing their health ie hypertension, cardiac issues, obesity and diabetes all of which are preventable or at least mitigated through lifestyle choices.
when are people held accountable for their actions?
When it comes to health insurance the relatively unhealthy are never held to pay according to their real risk of loss. If they were, they would never be able to pay their premiums. So there is pretty much no chance that healthy people will get a discount.
Following a survey showing 75% of Bermudians were overweight or obese is anybody really surprised to see the costs of healthcare skyrocket?
Unfortunately all of us have to pay for those who can’t be bothered to take care of themselves whether it’s the obese and their kidney failure, the gangstas and their gunshot wounds or the idiots that flip their cars or ride into utility poles at 3:00am on a Saturday.
What is needed is a government negotiated fee scale for all practitioners, and insurance companies. It is not just Hip, private insurance is sky rocking and I still pay $120 out of my own pocket for the hygienist to clean my teeth and the dentist have a quick look. $70 for a normal Dr. appointment, while he gets from the insurance his portion. Mind you I have 100% cover.
The OBA government refuses to bring forward real tax reform; instead it will continue to give it’s friends tax breaks and unearned bonuses while it continues to tax the small man and take away the social benefits of the people.
Well Alvin you are making some very serious allegations there. Are you sure that is your real name?
What Tax reform do you recommend Alvin? You sound like you are recommending a move away from Low tax at income and corporate level which is a risky strategy as we then would not have IB which contributes over 80% of our GDP.
Doesn’t matter how you reform it if such a large population are overweight then costs will continue to spiral.
How the **** do they think these seniors are going to afford this To live I am paying one if my parents future care now because he can’t afford it. What are these damn people up there in the house thinking!!!!!
Do they not realize that more seniors are going to give up their health care which in turn is going to cost Govt more in the end… !!!!
While I sympathize with you (and increases in insurance premiums affect me as well) who exactly do you expect to pay?
And yet any attempt at curbing unnecessary and expensive medical tests is met with complete derision.
I noticed they only mentioned the 11.1% increase for HIP but neglected to state the 12% increase for FutureCare.
One simple solution is to stop patients from being sent to the hospital for tests which are offered in the community at only a fraction of the cost.
So, what is going to happen to the seniors that have the FutureCare premium taken from their Social Insurance cheque were the cheque is less than the premium?
This is absolutely crazy. How are the seniors (who by the way paved the way for us), suppose to survive? When their checks are just over $1,000.00 a month, you are now asking them to pay out over 1/2 for insurance. So now, do they eat, pay the rent or buy medications? Instead of the parties nit picking each other, put your heads together and find a better solution to this always increasing problem. Stop paying these BTA people the outrageous salaries and bonuses.
Believe it or not,there are a number of Government departments etc. that receive bonuses.
Maybe the Finance Minister should have this ridiculous situation investigated!
Maybe my socialism is showing but I’d rather pay a bit more to make sure that the “at-risk” members of our community are taken care of. Why not make a flat fee for all Bermudians (25+) who partake in Government healthcare. Sure, it’ll be a bit more expensive for me but at least, unlike a retiree, I actually have an income.
Then the government needs to focus on wellness programs for the community. Do you know that in public parks in Europe they not only have playgrounds for children but exercise equipment for adults? We need to educate people about proper diet and nutrition and encourage our communities and families to be more active…in part by giving them time to do so…by funding education…so Bermudians can get better paying jobs…and feel connected to their communities…thereby lowering crime rates…increasing the GDP…and overall mental (and physical) health of the country.
It’s all a circle.
I agree @Alvin Williams. We need an overhaul of the entire tax structure with a fairer sliding scale. We can’t keep using the same old formulas. Cigarettes should be taxed to the max. Insurers should cover a wider range of overseas care providers like Cuba and not the current blood suckers we have who love the profitable sick Bdians flying to them on a regular and have whole wings dedicated to us. Insurers should cover natural medicines and remedies 100%. Reduce dental premiums if you demonstrate regular flossing. Reduce premiums for demonstration of regular exercising. Yes tax the junk food and the sugar as much as 3x! There are lots of ideas. The MOH should sponsor education in how to grow your own vegetable garden. But of course the current family chain grocery stores will hate that.
These increases in Insurance costs may be necessary but one finds it difficult to justify when the past four years of BHB Financial Statements have yet to be audited and made public – in addition to the BHB Executive salary disclosures that were promised by the BHB Board and originally by Mr. Zane DeSilva. Further there has been no disclosure officially of the Acute Care Wing actual building cost nor the situation arising from McAlpine’s additional provision of $75m.
One is therefore left with the impression that there is an enormous cover-up continuing – thus the need to not only increase Health Insurance premiums but also the Mutual Reinsurance contribution. Come on, Madam Minister- own up and tell the people the whole truth and nothing but the truth – please. In the meantime Seniors in particular are going to suffer more than they are already. Who cares?
Next election everyone vote for me, I am just sick of this. I am pro-OBA and against PLP but I am just plain sick and tired, fed UP with Capitalism which erodes society!
I am coining this phrase now, so remember it:
“Capitalist Decanter Effect”
Capitalism can work fine, but not when you don’t have all the right rules in place. What the earth today has in almost every capitalist nation is the “Capitalist Decanter Effect”.
As with a decanter, the bits that sink to the bottom are forever on the bottom. They are submersed still in the same liquid, but will not rise again unless agitated (oh my the irony of words).
The decanter is designed to work like this. It leaves the “unwanted” particles at the bottom, out of the way from our precious mouths.
Capitalism, without proper rules, causes the Decanter Effect. What I will enforce and make law are new rules for Capitalism, so that the “decanter effect” will no longer occur.
Shall I explain further?
The liquid in the decanter in our allegory here is society, with all of its different members. The particles which sink to the bottom are those who serve to function as thus in the decanter. Had the decanter effect not been present, this sinking and remaining at the bottom would not occur.
Pouring more liquid in the decanter does not work if the decanter is full at its capacity (sustainable population). In a nation where there is room, you could pour more liquid in (influx of ex-pats, increase/encourage more children). But what you cannot change is that sediment forms in the decanter, because it is the nature of the liquid put into it. You cannot change that nature. There will always be sediment. But how you manage this sediment is crucial.
The Capitalist Decanter Effect causes the end result of a heavy layer of sediment on the bottom which does not rise up without a form of agitation. How do you solve the enigma? Do you mix the sediment around in the liquid so it is well-mixed? Do you remove the sediment totally? No, what you do is POUR THE LIQUID OUT. The liquid is our society, all of us – everyone. The liquid by nature has sediment in it. But the problem here is the decanter, which causes the decanter effect. If you DO NOT STORE the liquid in a decanter, you will not suffer the “Capitalist Decanter Effect”.
What can you pour the liquid in? Pour it in any shape vessel and it will still decant. The problem is in the act of decanting, which is what happens when you let the liquid settle undisturbed for too long. Why decant? Why let there even be sediment? What if you could re-write the recipe for the liquid so it had no sediment and therefore needs no decanting? That is where our hope lies.
Instead of designing a liquid which has sediment, create a liquid (society) without sediment. Then there will be no need for decanting.
Our political parties only work with the Decanter, and we will never escape the “Capitalist Decanter Effect” unless we create a NEW society which has no sediment. Why the need for any to sink to the bottom?
Anyone who says that sinking is destiny for some, is a fool. There is no need for anyone to sink to the bottom. Capitalist Decanter Effect is what causes “the rich to get richer by the poor getting poorer”.
The richer the rich get, the poorer the poor get.
I will sum up my wonderful confusing allegory with the following perfect illustration from current international news:
Whilst the nation of Greece, once the stronghold of earth, and the inspiration for maths, art, and philosophy, writhes in poverty and misery and bankruptcy , Warren Buffet just purchased an entire Greek island for his amusement and luxury.
While millions of Greek retirees have no money for food or medicine, and lay crying on the streets without hope or help, you have the Capitalist gluttons stuffing as many truffles in their greedy mouths as possible – because you cannot find truffles without stuffing your nose in someone else’s business.
Had Warren Buffet not lusted over the “Capitalist Decanter Effec t” which the nations of earth justify and fortify, and had there been NEW RULES IN PLACE GIVEN BY THE WISE, then perhaps Warren Buffet would have spent all that money on the GREEK PEOPLE!
But a Decanter works like a Decanter. And until you stop the decanting, you will always have that sediment on the bottom. But you see, it is designed like this, because by the “Capitalist Decanter Effect” the rich get richer as the poor get poorer. So Warren Buffect rather enjoys seeing more and more sediment sink to the bottom. It means that everything is going according to plan. Wake up and smell the coffee, people! Next election, watch for a NEW PLAN! A NEW HOPE!
(Before any of you think of sayinng how this has nothing to do with the article, read it over and let your brain stew it a while and maybe the light bulb will turn on for you.)
You must be Johnathan Starlings wing man.
Greece has nothing to do with Bermuda.
That is just piss poor governance for the investors and the rich.
OBA is trying to resolve grevious mismanagement by previous.
Shalom.
Ps.
If your so right, why are the EURO nations so ……..about Greece.
I can only bail you out of jail for so long.
Stop doing this sheet son.
you wanted a PLP Government and this is a lingering result….Brown wanted Sven to train Johny…Sven was healthy and paid lots of insurance premiums and tuition and rent, etc…Brown and Burch made to make Sven uncomfortable so they drove him out leaving the job to Johny…Company did not want to lost the service of Sven so they sent his job with him and poor Johny lost his job too..because we are so special and friendly and nice ….and people should pay us to be here instead of the other way around….the solution is simple..commercial immigration will get Johny a job and not take it away from him…in the words of Ewart Brown we need Sven to be here to help Johny.
Getting greedy…
How many women who had mammograms recently were called and told that they needed further testing because “something” showed up on the test? Then after further testing the scans were declared perfectly normal?
What they should do is impose a health tax of sorts on unhealthy/junk foods, candies and confections, in addition to an additional tax on cigarettes and liquor. This tax in its entirety would be aggregated and used to evenly subsidize everyone’s health premium. This would lower health insurance premiums for everybody. Those that indulge in more tobacco, alcohol, and unhealthy foods would be paying more for health insurance indirectly through this tax.
Here is a suggestion, If you are healthy contributor, give a credit back annually. It’s also an incentive for those who are unhealthy to get healthy so they can get a credit on the high cost of unhealthy life style. Remember, every time you put a fork to your mouth with poor food choices, you ‘for’ out more money. My comment is not meant for people who are unfortunately sick due to unforeseen circumstances, terminal illness etc.