Against the backdrop of healthcare costs in excess of $770 million for an island populated by “roughly 65,000” people, Health Minister Kim Wilson announced that the Bermuda Health Plan 2020 “would replace Standard Health Benefit coverage”.
Speaking at a news conference on Thursday (August 9), the Minister said the Government’s “decision to fundamentally reform the basic health insurance plan, and to provide it through a unified system” will be a part of the basic plan.
“Most importantly, a new essential benefits package will be designed to help make us healthier and result in real savings to Bermudians by placing caps on co-payments while ensuring healthcare businesses can be financially stable.”
The objective, she added, is to make health insurance more affordable by expanding “access” to “improve health outcomes”.
“This is a journey. No single step is going to get us everything at once, but changing the way we pay for healthcare is fundamental to making sure everyone can access it,” said Ms Wilson.
“We believe every Bermudian should have better access to services like regular doctor’s visits, primary care and essential medication.
“Therefore, it is clear that Bermuda’s basic health insurance plan needs to include more than what is currently covered by the Standard Health Benefit [SHB] which does not include doctors’ visits, prescription drugs, overseas care, dental or vision care.
“The Bermuda Health Plan 2020 is how we will provide better coverage.
“This journey is one that we believe you must be able to participate in, share your views and let your voice be heard.
“We want the input of the community, doctors, nurses, employers, insurers, the business sector – everyone – to decide what the Bermuda Health Plan should include.”
While noting that the proposed unified system “is best suited to achieve efficiencies, economies of scale and cost savings”, she said a unified system “means that all residents will be in the same basic insurance pool, sharing health costs”.
The new benefits package “will be designed to help make us healthier and result in real savings by placing caps on co-payments while ensuring healthcare businesses can be financially stable”.
The new draft plan for public consultation includes “access to doctors and specialists, home-care services and basic coverage for medicines, dental, vision and overseas care”, she added.
The estimated the BHP could be provided for $514 a month for adults and $178 a month for children.
The proposed model would keep the supplementary benefits covered by private companies.
A four-month consultation with doctors is now underway, which is open to the public and healthcare insurers, to determine the scope of the benefits plan and a “road map” for its implementation.
Members of the public will be “invited to look at a mock benefit plan” with healthcare providers and employers moving forward, to to give their input on benefits, including medical care abroad.
Ms Wilson also said the Bermuda Health Council had undertaken its own consultation.
“It’s complicated, and the road map will help us derive how we’re going to get there, but we are looking at a soft launch and a phased implementation for fall, 2020.
“We will know by the end of consultation what full implementation period we should have, whether it’s two or three years — that will be determined.”
She also compared health insurance benefits paid by large companies as opposed to smaller businesses.
“If you have a small business with, say, five employees, and one of them gets a catastrophic illness, then they all have to share the risk, because they all have to pay for it. Whereas if you’ve got 65,000 people pooled, the risk is shared.”
The model, she said, would not interfere with supplemental insurance rates offered by private insurers.
Under the new model, public insurers would cover standard benefits, while Government-led plans like the Health Insurance Plan (HIP) and FutureCare.
On that note the Minister said private insurers could sell supplementary coverage.
But she maintained the unified model was deemed best suited to a jurisdiction similar in size to Bermuda.
“To break down inequity and create a fairer, better, more affordable healthcare system,” the Minister emphasised four points:
- Government wants to make sure that everyone can be healthier
- The country needs more prevention and access to healthcare for all
- We want to make sure that the basic health insurance plan includes the essentials to keep Bermudians healthy and catch treatable illness early
- We have to make sure that this new basic essential health plan is affordable to all and available to all
“The cost of healthcare is causing real hardship to many families,” said Ms Wilson.
“Today, our healthcare system is too expensive and Bermudian families are struggling to survive. We were elected to change that.
“Inequitable access to healthcare should not exist in such a wealthy society like ours. Access to quality and affordable healthcare is a Universal Human Right.
“Unfortunately, inequitable access is what we have….that inequity impacts us all negatively and we are all paying for it dearly.
“We all pay for care that comes too late when it is most expensive. And we pay in societal costs when a family is left without a breadwinner who succumbs to a treatable illness that was detected too late because they lacked insurance.
“We pay for years of productive lives lost due to unmanaged chronic diseases that lead to amputation, permanent disability or daily reliance on complex, costly technologies like dialysis.
“We pay in unnecessary pain and suffering for children who lose parents.
Moving forward, she said: “There is a great deal of discussion to be had in order to develop, together, a road map to healthcare for all.
Consultation document will be released “over the coming weeks”, for a period of four months.
“I look forward to working with stakeholders, including our global insurance sector, who have offered their assistance to ensure that Bermuda’s system of health insurance is the best in the world,” said Ms Wilson.
“We are the world’s risk capital, and with their assistance and expertise I am confident that following this period of consultation we will emerge with a clear vision of the future of Bermuda’s health care system.
“This is transformative change. And we intend to do it openly through consultation and dialogue.”
But she said: “I must caution Bermudians. There will be members of our community who will be content with the status quo, not wishing to advance the reform measures I have just spoken about, and who think that the fundamentals of our healthcare system in place for the last 50 years should continue.
“This government does not agree.”
Mandated by the people in July 2017 for change, she added: “We know that Bermudians are not satisfied with a status quo that is hurting so many of our people.
“Ultimately, this is about our health. About your newborn baby’s health. About your grandmother’s health. It’s about the well-being of every young person and parent in the country. And about our need to look after each other. Because in my Bermuda, we are all each other’s keeper.
“Imagine with me a Bermuda that provides access to healthcare at a price that is affordable within a system which is sustainable.”
The Minister concluded: “Together I am certain that we will achieve more affordable health care for all of Bermuda and her people. I look forward to writing these next chapters with you. This is the healthcare we all deserve.”