Health Minister Kim Wilson

Health Minister Kim Wilson MPs on Friday that the Government has already “decided to adopt a unified model of health financing – that is a single payer system – for the basic insurance plan”.

In a Ministerial Statement she said the decision was made “following extensive considerations”.

“This decision was taken with careful consideration of the health financing reform options developed by the National Health Plan Finance and Reimbursement Task Group in 2010,” she said.

But her statement drew questions from Opposition MPs, including Scott Pearman, the Shadow Minister of Legal Affairs, who referred to the town hall meeting held in Sandys earlier this month to discuss the Bermuda Health Plan 2020.

Mr Pearman noted that the Minister had told people at that meeting that the Government had already decided to proceed with the reform plan and that public consultation was limited to the benefits to be included in the plan only.

He stated: “Given the expressed statement that you made in Somerset, would you agree it is misleading to suggest to this House that you have begun a consultation on any other ways to ensure affordable healthcare for all?”

Ms Wilson replied: “Absolutely not.” The consultation process was two fold she added.

The first part was to “ascertain from the public the nature of the benefits to be included” and the second part would determine the road map to make the transition from the current “disjointed, ineffective” plan to the new plan.

Scott Pearman, OBA MP – Shadow Minister of Legal Affairs

But Mr Pearman countered the Minister’s explanation saying: “If the only scope of the consultation are various permutations of your single option, that is not a full and proper consultation, is it?

“What would you say to members of the public who don’t want your basic plan at all?”

The Minister said the Government was elected to provide “for the basic human right of affordable healthcare”.

“And that is exactly what we are going to do,” she added.

Opposition MP Michael Dunkley wanted to know what other similar jurisdictions had adopted the unified model, and what if any analysis had been done by the Government to gauge its success.

He also asked when the cost of the BHP would be known.

The Minister referred to the Bahamas, where she said she believed the model was launched “within the last several months”.

But for Bermuda, she said the cost would be based on public feedback on what benefits they wanted included.

“The more benefits that are offered, the more expensive the plan. So until we have an opportunity to gauge the public’s sentiment as to what benefits will be included, we can’t cost anything,” she said.

“You would think the wish to give people care when they are at their weakest would be totally acceptable. And who would
challenge the desire to get rid of inefficiency and duplication in an ageing, expensive health system?
I accepted the honour of leading the Ministry of Health because I believe that despite detractors and despite disagreement on details, at the end of the day Bermudians want to take care of one another.
“I believe this. And I have every confidence the Honourable Members on the other side of this House agree with this as well.”
To achieve that goal she said “we need”:
  • More prevention
  • Access to healthcare, for all, and
  • A decent basic plan with benefits to keep us healthy

“To be clear, health coverage will not fix all of our health problems, but without it, we cannot fix any of our problems,” said Ms Wilson.

“This is why ensuring health coverage of a decent package that is affordable and available to all is fundamental. And to do this, we have to change the way we pay for healthcare.

“This is part of the broader goal to make Bermuda healthier through prevention and healthy living , because a decent package must include prevention, screening and disease management.

“To be clear, our health system has some exemplary strengths, but also some challenges,” she added.

  • We are the third most expensive health system but rank 13th in life expectancy
  • Health costs consume 11.5% of GDP
  • 75% of adults are overweight or obese
  • 54% of adults have one or two chronic disease risk factors
  • 12% of adults have diabetes, and
  • 10% of all our health spending ($78 million) is on just two preventable conditions (chronic kidney disease and diabetes)

“Our system needs to change direction to combat this reality. We need systemic changes to incentivize good health behaviours and better health outcomes. This means reforming the basic insurance plan, and the way we pay for it.

I want to stress that the public consultation is four months during which working groups will be established so that dialogue and collaboration with key stakeholders can continue beyond November and throughout the reform process.

“The point to stress is that this is the beginning of the journey, with a goal to develop a transition plan and begin a phased implementation in Autumn 2020.
“This is a seismic change and we don’t intend to do it overnight or in isolation. That is why we are consulting publicly.
“So, as I said in my opening, health can be controversial – but only if we want it to be.
“If we believe that everyone should have access to healthcare, that every child deserves an equal start in life, and every senior an affordable health plan, then we are all on the same side.
“Ultimately this is about making Bermuda healthier. And now is the time to drive this goal forward.”