Cayman: Health insurance costs come under political fire

(CNS): The problems people in the Cayman Islands are facing with health insurance were at the centre of debates in the LA last week when the opposition leader presented a private member’s motion to tackle some of the challenges the uninsured face and the premier steered through some amendments to the law. The government accepted parts of a motion brought by McKeeva Bush that will see the ex-wives of seamen get access to CINICO cover and is considering premium assistance for people on low incomes who are struggling to meet high healthcare costs.

The opposition leader dropped some heavy hints that the matter is likely to become part of the forthcoming election campaign and he said he was considering some ideas about the entire regime and the need for change. Falling short of admitting it might be time to consider a single pay system, he made it clear that he did not think it was socialism to try to help the people.

“We are going to have to come to grips with health insurance,” he said, adding that he believed in free enterprise and did not want to “hamstring business” but even if the parliament was labeled as socialist, there had to be a better way. He said it was all right for those in the private sector earning $20,000 a month to criticise social welfare, as they can afford their health insurance, but the government had to help its own people who were struggling.

Bush acknowledged that the economy was improving but he said there was still a problem with the “trickle-down effect” as not everyone was benefitting from the economic growth. He also raised concerns that the law was not being properly enforced and that people were being dropped by insurance firms when they should not be.

He also said that the $167 per month basic premium for the SHIC plan fell far short when it came to the benefits people get and the premiums were often higher for retired people who are on fixed incomes and really struggling. He pointed to average earners with a monthly income of around $4,000 paying a premium of over $1,200 per month to cover a family of four. Bush also spoke about people losing their jobs where they have existing conditions that are driving premiums so high employers can’t cover the employees and are forced to let them go or be in breach of the law.

Those who are self-employed were also struggling, Bush said, adding that growing numbers of people face real difficulties trying to get mandatory health insurance when insurance companies are pushing up premiums.

Bush suggested CINICO could provide the necessary cover for everyone who was struggling because of existing conditions. He said that the government health insurance company should be “racked up” and given the tools it needed to help more people.

He raised concerns about those who have retired who only get three months of insurance from their former employers after they leave a lifetime of work. They are then left looking for private sector cover at a time when they are getting older and likely to have existing health concerns and so are either being turned down or offered premiums that are far too high. In the end, government picks up the tab for people who are not properly insured when they turn up in the emergency room and can’t pay.

Premier Alden McLaughlin, who is the health minister, acknowledged the myriad problems and said there were concerns about people who are not considered indigent in every other sense of meeting their monthly needs but struggle with health insurance, especially if they have a health issue “as it is very expensive”. He said government had agreed that the costs to cover the ex-wives of seamen via CINICO would be relatively small, so the government would move on that. He also said there should be some form of assistance from government to help people cover the cost of monthly premiums

A point raised by several MLAs was the fact that the pool of people was very small but there are around nine private health insurers selling policies. This plus rising healthcare costs were pushing premiums beyond the reach of many people, the politicians believed, and it was clear that some form of top-up was needed. CINICO already covers more than 40% of local population, including members of the civil service, the indigent, those that are uninsurable and retired seamen and veterans.

Finance Minister Marco Archer said he believed the government would have to find a new solution to the current health insurance regime but he agreed with an interim measure of subsidising premiums for people on low or fixed incomes.

Ezzard Miller (North Side) said government needed to take a much more holistic review of the health insurance regime but it could at least start with a modern efficient verification system to get real-time clearance and payment at the point of treatment. He said providers should have electronic clearance to say who has what and help avoid the major problem with insurance companies who always want to “deny, deny, deny and delay, delay, delay”.

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