The original article can be found in: The Royal Gazette By Ceola Wilson
Health Minister Zane DeSilva confirmed yesterday that he will be examining the legality and whether it is ethical for local insurance companies to deny someone coverage due to obesity.
The disclosure came in response to questions by The Royal Gazette during the Minister’s announcement that a 70-member task force to tackle the issue of health insurance coverage for Bermuda’s unemployed and low income residents.
After stating that he is in favour of health insurance incentives for individuals who keep themselves in good shape if it follows that people who are obese should pay extra under the new National Health Plan.
The Minister replied: “You may be directing that question at me because if you look at the body mass index formula I am actually over weight, and everyone says no you can’t be overweight but I actually am, I could lose five or six pounds and I’m working hard to do that by the way.
“Its funny you ask that question because I did receive an e-mail in the last couple of days from someone who had requested insurance from an insurance company locally and they said if you lose 40 pounds we’ll consider it.“I’ve just received that, they have asked me to look at it and I am doing so but obviously its out there already so Bermuda get in shape,” he said.
When asked for clarification later a Government spokeswoman said: “It would be accurate to say that the Minister has received one query whereby a person may have been refused insurance because of their weight.
“It is our understanding that it is not illegal for private insurers to deny coverage for pre-existing conditions, including obesity.
“The issue of access to health insurance is being addressed by expanding the standard hospital benefit to include some services outside the hospital.“This benefit would have to be sold as a stand-alone product, and nobody could be denied access to the ‘Standard Health Benefit’ based on pre-existing conditions.
“People would still be free to purchase supplementary coverage (or major medical) which would provide benefits additional to the SHB, as they are now,” she said.
It was also noted that “Bermuda, like many countries around the world, has healthcare costs that are rising at a pace that is unsustainable”.
“This rate of increase will only get worse as our senior population grows to 25 percent of the population by 2033, as seniors have greater healthcare costs than younger people.
“We must improve the design of our system to be able to deal with this growing challenge,” said Mr DeSilva.
“Despite the amount that we spend on healthcare, our population is less healthy than in countries that spend less.“Therefore, we need to not only slow down the rise in healthcare costs but also improve the value for money in our system in order to keep our economy and our people healthy.
“The National Health Plan has 11 goals that together will address the challenges facing our health system,” he added.
To that end, more 70 people from a broad cross-section of the community have been assigned to six task groups to develop solutions to achieve these goals.
“The Benefit Design Task Group was tasked with proposing benefits to be included in an expanded Standard Hospital Benefit — what we are calling the Standard Health Benefit. The Task Group has produced options which have been turned over to the Finance and Reimbursement Task Group.
“Finance and Reimbursement have tasked our actuaries with determining what those options would cost; how to make an expanded minimum package available and affordable to everyone through the smarter use of our resources; and what impacts such changes will have on everyone involved in the healthcare system,” said Mr DeSilva.
Public meetings will be held on the proposals, including costs and the overall impacts of proposed plans near the end of the year.
“These core reforms are supported by the work being undertaken by the other Task Groups in areas such as long term care, health promotion and Health IT,” said the Minister.A general meeting is planned for November of all the task groups to update each other on their work and “continue a process of networking” to develop solutions”.
The Minister stressed that the implementation of the National Health Plan “is an open process”.
But he said: “We must think boldly and broadly to ensure that the improvements which we make to the healthcare system benefit all of us, today and into the future.”
“Our health system works well in many areas and for many people. But if you are unemployed or your income is low, it does not work well.
“Making sure that all people have health coverage and that they can afford this coverage is a basic standard promoted by health experts worldwide and we are committed to achieving that standard.
“However, even those that can afford good health insurance right now will face challenges in the long run if we don’t contain costs,” he said.When asked if people who keep themselves in good shape should be given incentives for cheaper health insurance premiums he said: “We had 44 meetings as you know on the National Health Plan during the consultation phase and one of the things that I certainly put out there, and I still put out there to the insurance companies is incentives for those who look after themselves.
“I think that somewhere, somehow we’re going to fit that in, we have to because I think at the end of the day if we as a country change our eating habits, we exercise more we’re going to go to the hospital less, we’re going to go to our doctors less than that will obviously help us decrease the overall cost of the overall healthcare system,” he said.
No provisions will be made for the unemployed but what this plan will do he said “is to make sure that everybody is covered”.
“The big question is how much and what benefits. Those are the two key elements of the National Health Plan and that’s what everybody wants to know — how much is it going to cost and what benefits will I get.
“And those are the two exciting parts of the National Health Plan that we will unveil by the end of November.”
