Column: OBA MP Ben Smith On Health Plan

[Opinion column written by Ben Smith]

Reform to the healthcare system is one of the single biggest topics in Bermuda right now. If you haven’t heard about the proposed changes, please start to look and understand what could be coming your way.

In Bermuda, we all have a bad habit of not paying close attention to changes when we don’t think they will have an impact on us. Healthcare, and the cost of healthcare, affects all of us – and needs to be a focus for all of us.

The Government is proposing to change the system so that there will be one provider for the new basic plan – which will be forced upon us.

In Bermuda we have one company that controls our electricity known as BELCO and soon we could have HELCO as the provider of the new basic plan. But think of what control we have over increases in the cost of electricity and what impact a smaller population is having on the cost of power to Bermuda. HELCO will have similar issues.

The numbers that are being used to determine the cost per person for the new system are based on the full population of the Island now – the problem is that we are seeing an exodus of people.

Young Bermudians, overseas for education, are increasingly choosing not to return home, our people who are struggling to survive in our economy are choosing to head to the UK and we have the potential for more expats to leave due to immigration policies.

What impact will this have on the HELCO figures?

When HELCO needs to increase the rates to cover any losses will this come from taxes? Everyone must be aware – and agree – that the cost of healthcare is too high in Bermuda, but does Government’s enforced basic plan fix the problem or simply move pieces around the board?

If you are uninsured because you are unemployed or can’t afford HIP how will you be able to afford the new $514? This group would still have to be subsidized or covered completely by HELCO without making any payments. It seems the insurance companies have already offered a plan to cover these vulnerable members of our population. Why is their solution being ignored?

In order to get the price of $514, we will have to accept the level of coverage imposed on us. But what about the physiotherapy, occupational therapy and many other important health providers in this new system? Many of these services will not be covered even though their services are extremely important to recovery and getting patients back to normal as soon as possible.

Under the new system will these be added or left out? How do we pay for all the extras that are left out? We will have to pay for increased coverage, that’s how. This will increase the divide between the two Bermuda’s, the two Bermudas the PLP promised to unite.

The Minister has just announced that KPMG has been recruited to help with updating the health strategy and I welcome this move – but will it go far enough?

We want to fix the cost of health care so why are we not urgently, and comprehensively, tackling that issue? Here are some of the reasons for our high healthcare costs:

• Using the hospital as a doctor’s office at urgent care rates

• Overutilization of tests and scans, such as MRIs

• An unhealthy and overweight population

• An aging population

As a population we complain that cost of electricity is too high. Some people have put timers on the hot water heater, solar panels on their roof and monitor their usage in order to bring costs down because they are trying to control their household usage.

Some people are eating healthier and exercising to lower their healthcare costs, but the difference with healthcare is your cost is attatched to your unhealthy neighbor. So, when HELCO takes over without a change in our sick population the cost will continue to rise.

When our national drink is fruit punch with ginger beer and an extra shot of grenadine, and when we consume a plate with mostly starch and not very many vegetables, are we helping to reduce the cost of healthcare?

When we spend most of our days sitting down and rarely exercising are, we helping to reduce healthcare costs?

The sugar tax concept was aimed at forcing the population to reduce sugar consumption. The impact would be greater with a reduction in the cost of healthy foods and an education campaign aimed at children on the health benefits of healthy eating and exercise.

Here are some solutions:

• Tax breaks to companies that implement staff exercise programmes

• Insurance rate savings if you join a group, or course, to exercise, reduce weight and eat healthily

• Increase in physical activity in school along with a good nutrition program. This is key – good habits need to be encouraged early in life.

• It would be a great initiative to see MPs lead by example – taking the stairs instead of the elevator, cut out the sweet drinks and overconsumption of starches.

The system being proposed by Government exists in countries with much bigger populations that absorb the high costs of the sick portion of the population and the uninsured into the overall system.

Our issue with a low birthrate, high aged population, high number of high cost sickness and a shrinking working population means the group that is left to absorb increased costs is smaller.

At first look, $514 if you are paying $1,000 now seems like a great saving and a great plan. But what is being left out from what you have now and how long before the rate will change?

Before HELCO is forced on Bermudians let’s instead work together to change our health behavior which will reduce our healthcare costs without the need to take the choice out of healthcare.

- Ben Smith, OBA MP and Shadow National Security Minister

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