Column: ‘Halloween Nightmare Of Policies, Tax’

[Opinion column written by OBA Senator Marcus Jones]

As a child growing up, Halloween was my least enjoyable celebration. Although candy and chocolates were part of the bounty accumulated during a night of Trick or Treat, it was those fun-loving children masquerading as witches and ghosts that scared me the most.

But the good thing about this annual event is that it can be endured for one night a year and its practice is merely a fantasy, a horrible nightmare, if you , that will not re-occur or have a devastating impact on one’s future wellbeing.

This PLP government is doing their best to create a Halloween nightmare by policies and tax increasing measures that ultimately burden its residents with a higher cost of living, specifically within the realm of its Healthcare Reform Plan.

Unlike Halloween, it has the potential to be a re-occurring nightmare and can have a devastating impact on one’s future wellbeing.

The Government and its detractors can agree on a few things;

• The cost of healthcare is presently high and is trending up with no end in sight

• Our senior population represents the highest healthcare costs and persons over the age of 65 will make up 25% of residents by the year 2026.

• The number of working population and the birthrate is shrinking which places the burden of cost of healthcare on a declining number of people.

• With a faltering economy and immigration legislation that is protectionist rather than pragmatic to address the declining number of working-aged residents contributes to a shrinkage in able-bodied persons that can undergird the healthcare sector.

• The Standard Premium Rate remains unchanged from last year but holds no guarantee that it will stabilize or not rise exponentially over the coming years.

• Government’s promise to control costs in the Healthcare Sector has not been realized and this re-distributing of the funding does not address that fundamental challenge.

• The proposed Healthcare Reform does not guarantee its users the same level of services and products they enjoy under their existing plan

These are just a few issues that have arisen from discussions held at town hall meetings sponsored by the Government and held at the kitchen table of Mr. & Mrs. Bermuda.

On September 16th, 2019 I attended a Town Hall meeting at the St. James Church Hall, in Sandys, and the questions of the attendees reflected the concerns of the wider population of residents on the Island.

The Minister of Health, the Honorable Kim Wilson and her team did their best to provide answers but to be honest there were more questions left hanging to make anybody feel uneasy about the remedies for an out of control healthcare system that needs reform not total re-structuring to cure what ails it.

Here were some of the questions;

Question: Why were there no plans for under/non-insured person?

Answer: Too expensive because no risk-pooling. It would marginalize the poor as second rate.

Observation: At the beginning of the night the number representing the under/non-insured was at 8,000. By the end of the night that number had crept up to 12,000. Which number is it?

How many of the under insured voluntarily chose the HIP option of health insurance as they did not deem themselves needing a comprehensive, major medical scheme?

All four major healthcare insurance providers are on record as being willing to consider a plan to underwrite those who are not insured due to unaffordability or unemployment. Why was this proposal not explored by the Government?

Question: Will there be different levels of coverage?

Answer: No difference in tiers, any further coverage consumer will need to purchase additional private coverage.

Observation: The mere fact that consumers require supplemental coverage and who can pay for it or their employers provide additional medical services creates a two-tiered system of healthcare.

Question: Does the new insurance plan cover you when unemployed?

Answer: Financial assistance was remedy in old plan and in reform, subsidy included if people unemployed.

Observation: Not everyone made redundant or unemployed in the old plan could qualify for financial assistance and there was no economic impact assessment presented that would demonstrate the potential cost to the taxpayer to underwrite that demographic of the population.

When considering the consultation invested by this Government to get as much feedback from industry professionals and the residents at large, there is a fundamental flaw in its approach.

Like its attempt to drive through legislation that would reduce the authority of the Corporations of Hamilton and St. George, consultation was merely a gratuitous attempt to show the appearance of seeking feedback, when its ultimate plans were already etched in stone.

The public sees through this phony quest for gathering advice and input from stakeholders and have had it with going through the charade.

As an act of good faith, the Government should inform the electorate that their buy-in for major structural change in the healthcare system is not needed or valued so just fall in line.

Socialized healthcare is the long-term goal of this Government and no matter how one dresses it up, increased taxation to underwrite this future reformation will be the order of the day.

Even this first step towards this goal proposed to be implemented in a soft launching in August 2020, in the words of the Bermuda Medical Doctors Association [BMDA] “would not lower healthcare cost without negatively impacting the quality of care and waiting times of services”.

So, this Government’s promise to lower cost while increasing service is a fallacy.

Another consideration that the Government has been silent on is the unintended consequence that will result in this single payer system that they will be introducing.

Wisely, the Government has confirmed that it will not be taking on the responsibility of collecting premiums but will outsource to another entity who have the expertise to administer this system.

But that private company will be interested in turning a profit, in addition to the layer of governmental oversight and administration will be factored in resulting in additional cost.

But what is universally more troubling is that this reformed system will eliminate the private insurers from the bulk of their healthcare business.

How many international businesses will opt to get healthcare coverage from overseas providers, arrange for Doctor’s visits, purchasing of pharmaceutical products, specialist visits, etc. overseas thus leaving the local providers with a smaller piece of the healthcare pie.

With reduced business there is a reduced need to provide healthcare related products and services resulting in a reduced need for employees. Do I see redundancies in the healthcare industry’s future? It is inevitable.

An economy that is in serious decline, a working population in decline reducing the number of persons able to carry the burden of an ever-increasing cost of healthcare makes for a formula of disaster.

But rather then end on a sour note, there is hope for the average Bermuda resident looking for relief in his monthly costs.

The Government should look to halt its fast train ride to universal healthcare and solve its original overarching problems related to healthcare.

Those problems are twofold.

1. Solve the under/non-insured persons challenge and lower the overall cost of healthcare. They can do this by having an honest discussion with the four major healthcare providers on the island and challenge them in concert with the government to underwrite the healthcare costs of the under/non-insured.

2. Conduct a comprehensive Island-wide review of those that fit in this category [that number could be closer to 8,000 than 12,000] so that an accurate plan can be formulated to take care of their needs. Secondly, plow through the hard work of regulating the cost of products and services provided by practitioners. Put stricter limitations on the overseas referrals and ordering of diagnostic testing that are big ticket items on this country’s healthcare bill. Regulate and put a ceiling on co-payment requirements for doctor and specialist visits. The Government has proposed a $25 co-pay ceiling but that may be unrealistic. Don’t come up with an arbitrary price point for co-payments but negotiate with the key stakeholders such as the Bermuda Medical Doctors Association, so that there are charges consistent throughout the entire industry.

We can avoid the Halloween-like scares within Healthcare Reform that can be a recurring nightmare and a devastating effect on the country’s future well-being.

- Marcus Jones

-

#BermudaPolitics #Health #MarcusJonesColumns #OpinionColumns

Category: All