[Opinion column written by BTUC President Senator Jason Hayward]
Health protection is a human right for everybody. However, the world is facing a severe health protection crisis. In the absence of health protection, care is often not accessible, available, affordable or of acceptable quality. This is a tragedy for the 40 per cent of the global population that is excluded from this right. ILO: Social Protection Department
At the end of January 2019, the Bermuda Health Council [BHeC] published the 2018 National Health Accounts Report, detailing the Island’s health system costs for the fiscal year ending 31st March 2017.
The report highlighted that healthcare expenditure increased by an additional $20m year-over-year to $723m. The BHeC reported that the financing from private insurance declined while their revenues increased during the same period. The report revealed that more people are now paying for their healthcare out-of-pocket [up 23.3% year-over-year] and from donations [up 47.5% year-over-year]. These figures should cause alarm to all.
While Bermuda spent $723m on healthcare, residents still do not have a healthcare system that is affordable and accessible. Recognising that the exorbitant cost of Bermuda’s healthcare creates unnecessary hardship to Bermuda’s residents, the Bermuda Trade Union Congress [BTUC] has consistently championed for affordable and accessible healthcare for all.
The BTUC will continue to advocate for a sustainable and improved healthcare system and as such, we appreciated the invitation to participate in the stakeholder meetings to determine a suitable healthcare financing structure. We believe that all stakeholders need to make a concerted and deliberate effort to ensure there is universal healthcare coverage in Bermuda. To this end, it is important that stakeholders work together to ensure that:
- all residents have access to basic health insurance coverage
- healthcare coverage contributions are affordable
- all residents have access to quality healthcare services.
To achieve these desired outcomes, systematic changes must be made. As reported by the actuaries who propose alternative financing options for Bermuda, there will need to be modifications to the financing structure; the current system does not ensure financial risk protection. In addition, a significant part of the resident population remains uninsured or only partially insured; addressing this inequity must be a key priority. The current system is complicated, fragmented and unsustainable, resulting in further disadvantages, inequities and undue burdens for residents.
After an analysis of the two  proposed financing options presented by the actuaries commissioned by the BHeC, the BTUC supported a unified system which we understand to be:
- one system that covers everyone
- a single insurance pool to spread insurance risk
- a uniform and comprehensive benefit set for everyone
- a single network of all licensed healthcare providers
- a uniform and streamlined enrollment system
- uniform pricing, payment rules and payment methods
- financing related to the ability to pay
- healthcare coverage de-linked from employment
It is further understood that a unified system will significantly reduce the $64m in administrative expenses of our current system. A unified system will uniform benefits and payment rates, using a single payer and claims administrator which could significantly reduce total health spending. This will result in a much greater proportion of healthcare dollars being spent on providing healthcare.
If implemented, it is anticipated that there will be pushback by various stakeholders who want to preserve their current profit margins, however, too many Bermudians are struggling to cope with the high cost of healthcare or do not have access to healthcare. Our children and relatives should not have to open GoFundMe pages to have access to critical healthcare services. The current system is not working for many and it is time that we make a concerted effort to ensure that Bermudians have the health protection they require.
– Jason Hayward
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