OBA, Argus & Minister On Practice Acquisition

July 3, 2020 | 3 Comments

“The acquisition of two medical practices by a major insurance company has raised questions in respect of conflict of interest,” Shadow Health Minister Patricia Gordon-Pamplin said, while Argus said “there is no conflict of interest here; instead, there is an alignment of patient interests.”

Shadow Health Minister Patricia Gordon-Pamplin’s Statement:

Ms Gordon-Pamplin said, “The announcement of the acquisition of two medical practices by a major insurance company has raised questions in respect of conflict of interest.

“It does not seem to be the perfect marriage for someone who is paying the bills to have under their thumb the person who is providing the service for which the bill is being paid. Quality and standards may be compromised. Why was the Bermuda Health Council not consulted?

“In light of this major variance from segregation of responsibilities, we would have expected that the Minister of Health on behalf of the Government would provide a statement to the public so that there is clarity. Does it mean that any patient who is covered by the insurer will be required to attend the offices of the physicians who are part of this conglomerate?

“Is there an attempt to minimize choice? What happens to the practices of other doctors who have not been embraced within this new arrangement? How will premiums be impacted?

“In the absence of information, it appears that we are on a major collision course between quality and standards. Surely, an explanation is needed.”

Health Minister Kim Wilson’s Statement:

Speaking at last night’s press briefing, Health Minister Kim Wilson said, “By now the majority of Bermuda would have heard of the merger that took place between Argus Insurance and the two medical practices, Island Health Services and the Family Practice Group.

“This merger within the private sector took place privately and without Ministry of Health or Bermuda Health Council knowledge or involvement – this is not unlawful, as the law currently stands. Nevertheless, it is an important development in our small health system and so it merits comment.

“You would be aware that as a result of this pandemic, much of our worst fears and anxieties about our health system have become a reality. We have businesses that cannot afford health insurance, workers who are unemployed and now uninsured, families who are going without treatment, medications that are out of the reach of seniors.

“Argus and the medical practices took it upon themselves to try to smooth out some of these rough spots for their specific clients by investing in one another. Though that may be of benefit for their piece of the pie, its impact on the overall health system needs to be considered.

“We will continue to pursue a better health system that works for everyone, in good times and bad, and will work with all individuals, businesses, and all sectors to make that a reality. Universal health coverage remains this Government’s goal.

“We will not squander the lessons that COVID-19 has taught us: that we are much better as a country when we do things in a unified manner and will not neglect what we have lived each day for the last 4 months, which has highlighted the importance of putting the health of our residents first and foremost.”

Pete Lozier, Chief Executive-Americas, The Argus Group’s Statement:

In response to Bernews queries, Pete Lozier said, “While insurer-owned healthcare facilities have been long-established in many jurisdictions worldwide, we understand this is a new model for Bermuda and that the community has many questions.

“With 70 years’ experience in healthcare in Bermuda, our unique position has given us the benefit of witnessing trends over time, and what we are seeing is that healthcare costs continue to rise while people contend with chronic and crippling illnesses such as diabetes. We’re spending more on health than ever, but we’re not seeing health outcomes that are significantly positive enough to bend the trend of escalating costs.

“Ultimately, we all want the same thing: quality, affordable healthcare for our community. The system won’t change if we all keep working in silos. There is no conflict of interest here; instead, there is an alignment of patient interests. It is in the patient, doctor and insurer’s collective best interest to ensure the patient receives quality care at every stage of their treatment. To restrict treatment in the immediate term, would lead to further complications down the road and lead to more costly and complicated care, which serves no one.

“The doctors at Island Health Services and Family Practice Group will continue to provide the best care possible for all their patients, no matter their insurer. That’s their job. Argus will continue to pay claims at all healthcare facilities. That’s our job. Patient choice and care will not be compromised and there is no attempt to minimise choices. All Argus-insured may attend any practice they wish, and those claims will continue to be paid.

“Argus will not have access to patients’ data. We will only have access to what is typically shared when the patient or doctor submits a claim and only if you are insured with Argus. There will continue to be rigorous separation between health provider and insurer in this regard.

“What we’ve been hearing is that people want lower cost, higher quality and more transparency around their choices. This new partnership aims to put the patient’s needs at the centre. This is just the start of a multi-pronged approach to reach that goal. In the short term, it’s business as usual, but in the coming months more details will be shared about changes to improve services and reduce costs, which will add benefit, not restrict treatment.

“We are committed to the wellbeing of all of Bermuda’s residents and want to invest in Bermuda. Argus is, and always will be, compliant with all the necessary laws and regulations required in all the jurisdictions in which we operate.

“We pledge to drive openness and transparency in the way we operate – we want to ensure that patients and health member shave the best available information to make informed choices about their health and wellness.”

Dr Basil Wilson, GP, Island Health Services Statement:

Dr Basil Wilson said, “Our patients have always been our priority. That has not changed and we will continue to provide the best possible care to our patients with the support of all our trusted, caring staff. We entered this partnership because we know it will lead to better health outcomes which will benefit not only our patients, but Bermuda as a whole.”

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Comments (3)

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  1. Andrew Paul Scaife says:

    Mr.Pete Lozier….This is a timely reminder to those who are not in the know, watch how you butter your bread. Yes, Bermuda may have a Diabetes problem but those diabetics and other hard working Bermudians are lining your Company with the monies and profits enabling you to aid such acquisitions. Fair is fair, you say you are going to be transparent and meet all the regulatory standards of better practice, nice words, just words though.
    As I stand here on this beloved rock I call home “the rich seem to be getting richer and the poor getting poorer. In a pre or post pandemic Bermuda(not too sure where we are at yet) I see the moves are being configured for that big chess game we call life. The upper echelons of the business world will survive I’m sure, but how about the middle class and unfortunately the lowest classes. It seems they are defragmenting as we speak and there will be a revised set of players(pieces) on this tiled square. I believe we will have the Kings and Queens(profiting) in this game and just the lonely pawns(scraping by the wayside.) There will be no middle class. The divisions will get greater and your profit margins smaller. This is why you are hedging your bets with this announcement to be on the insider level of play. Hindsight is 20/20 I guess. Good luck and fair game I say.

    #kingtakespawn #queentakespawn #ichoosenottobeapawn
    #AndrewPaulScaife
    #gameon #yourmovebermuda

  2. Go for it! says:

    Go for it! These politicians are all shook up because this happened without their say so or ability to line their own pockets!

  3. If the shoe fits says:

    Some Bermudians don’t think that taking over the Corporation of Hamilton is in the best interest of the island. Even the Senate didn’t think it was a good idea. Regardless of this the government will push ahead with their plan to take charge. I wonder who will be given the job to run the City?

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