Notorious healthcare bills climb to new high

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(CNS): The public purse will be picking up a record-breaking tab by the end of this year to cover the hospital bills both at home and abroad for people who are either under- or uninsured. Although the 2021 Census suggested that 93% of Cayman Islands residents have health insurance, in 2023 the government is expecting to pay hospital bills of around CI$78 million.

When members of parliament met Tuesday in Finance Committee to vote for another CI$68.8 million in public spending for this year, that vote included an additional CI$32.2 million for healthcare, on top of the original CI$33.5 million and a further CI$13.5 million approved by Cabinet in July. Split over two appropriations, one for the Health Services Authority and the second for private sector hospital bills here and abroad, the supplementary expenditure led to a number of concerns from the opposition benches.

Sir Alden McLaughlin (RED) pointed out that the government pays around $3 million per month in medical bills for the indigent at the George Town hospital alone and said it had to ensure that a more realistic amount is budgeted in the first place. He said the line item for the “notorious NGS55”, the provision of non-HSA tertiary health care for indigents, seamen and veterans who are referred for treatment locally and overseas, was more than double the original budgeted allocation of just under CI$21.6 million at over CI$52.4 million.

Chris Saunders noted that 93% of the population is paying over $300 million in premiums to private health insurance companies. According to CIMA, at the end of 2022, the health insurance sector had collected US$403 million in premiums. Saunders said we had “privatised the profits and socialised the losses”, and at some point, the government had to “put its foot down”, as he pointed to the need to expand CINICO.

“We have to take care of our people, but the people can’t continue being burdened by the fact that people have inadequate insurance in this country and are resorting to the government to make up the difference,” Saunders said. He added that bringing more people under the CINICO umbrella could help spread the risk.

According to CIMA’s latest figures, private healthcare companies earned over CI$403 million in premiums last year.

Panton said these two appropriations had been a challenge for all governments, and it was the same challenge for PACT. He said that the increasing focus on preventative care would help mitigate the continued increase in this budget.

MPs also voted for additional funding of CI$8.8 million to cover premiums for civil servant pensioners and their dependents for the last part of the year. Gloria McField-Nixon, the chief officer of the Portfolio of the Civil Service (PoCS), said this was to cover premium increases as well as an increase in the number of people insured.

The amount of money the government spends on healthcare for those who cannot afford adequate or any insurance has increased every year, and there are major concerns that the current system is not working for anyone except for the insurance companies that are making a profit, which has been in excess of $50 million in the past and was over CI$48 million last year.

Health insurance is mandatory in the Cayman Islands but most people working in the private sector have the Standard Health Insurance Contract (SHIC) plan, which currently costs $167 per month for a single person and around $600 for a family, but can be much more for older dependents and is extremely limited in its cover.

As a result, as well as paying for people who are unemployed or retired and cannot afford their own health insurance, the government is picking up the tab for those who have maxed out their SHIC plans because of a serious medical incident or long-term health problem.

While the idea of making CINICO, the government-owned insurance company, the universal insurance provider has been discussed over the years, no government has been willing to take on the insurance companies to make that change.

However, with the current rate of spending, by the end of next year, the cost to the public purse for hospital bills could be as much as $100 million.

See the appropriation request in the CNS Library.

Watch the Finance Committee proceedings on CIGTV below:


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