Bermuda Health Plan

8 August, 2019

Good Morning,

The cost of healthcare is causing real hardship to many families.

We have all heard the stories….

The story of the families who have been driven into debt because their insurance coverage ran out or because they were uninsured to begin with.

The story of the Unemployed Bermudians unable to afford health insurance relying on  hope and prayers that they do not get sick until they find a new job that will provide then with health coverage.

The story of the seniors who had to choose between medication and food.

The story of the young mother who had to choose between paying for child care or insurance.

The story of the parent who has denied their own medical needs in order to ensure that their children’s health needs are covered.

The story of the neighbour, colleague or school friend who came down with an unexpected illness, was left with mounting medical bills, forced to fund their healthcare with bake sales, community fund raisers and GO Fund Me pages.

The story of the health care professional who was forced to try and figure out how to provide help to patients who cannot afford the test, medicine or other treatments they need. 

Today, our healthcare system is too expensive and Bermudian families are struggling to survive

We were elected to change that.

Today, we begin the next step on our journey as a people towards a new healthcare system that will help Bermuda become healthier and reduce the cost of healthcare, thereby making it more affordable and accessable for all.

I believe that as a society we will be measured by the way we treat our weakest members.

Inequitable access to healthcare should not exist in such a wealthy society like ours.

Access to quality and affordable healthcare is a Universal Human Right.

Unfortunately, inequitable access is what we have....that inequity impacts us all negatively and we are all paying for it dearly.

We all pay for care that comes too late when it is most expensive. And we pay in societal costs when a family is left without a breadwinner who succumbs to a treatable illness that was detected too late because they lacked insurance.

We pay for years of productive lives lost due to unmanaged chronic diseases that lead to amputation, permanent disability or daily reliance on complex, costly technologies like dialysis.

We pay in unnecessary pain and suffering for children who lose parents.

So today, as we begin to break down inequity and create a fairer, better, more affordable healthcare system , there are some key take a ways that I feel must be emphasised:

  • Government wants to make sure that everyone can be healthier;
  • The country needs more prevention and access to healthcare for all;
  • We want to make sure that the basic health insurance plan includes the essentials to keep Bermudians healthy and catch treatable illness early,
  • We have to make sure that this new basic essential health plan is affordable to all and available to all.

Therefore, today I am announcing the Government’s decision to fundamentally reform the basic health insurance plan, and to provide it through a unified system where all residents will be a part of the basic Bermuda Health Plan.

Most importantly, a new essential benefits package will be designed to help make us healthier and result in real savings to Bermudians by placing caps on co-payments while ensuring healthcare businesses can be financially stable.

The Government is committed to reforming healthcare to make it more affordable, expand access and improve health outcomes.

This is a journey. No single step is going to get us everything at once, but changing the way we pay for healthcare is fundamental to making sure everyone can access it.

We believe every Bermudian should have better access to services like regular doctor's visits, primary care and essential medication.

Therefore, it is clear that Bermuda’s basic health insurance plan needs to include more than what is currently covered by the Standard Health Benefit (SHB) which does not include doctors’ visits, prescription drugs, overseas care, dental or vision care.

The Bermuda Health Plan 2020 is how we will provide better coverage.

This journey is one that we believe you must be able to participate in, share your views and let your voice be heard. We want the input of the community, doctors, nurses, employers, insurers, the business sector – everyone – to decide what the Bermuda Health Plan should include.

We have put together a draft package to open public dialogue and consultation on what the Bermuda Health Plan should look like. Your ideas, suggestions and contribution will help us to shape to expand basic health coverage to give you more than what you are getting today, for less cost overall.

The new plan we have drafted for public consultation includes access to doctors and specialists, home care services and basic coverage for medicines, dental, vision and overseas care.

Coverage for screening, early intervention and proper management of chronic diseases can prevent conditions like asthma or diabetes from worsening and becoming debilitating and expensive.

We estimate that the Bermuda Health Plan could be provided for $514 dollars a month for adults and $178 for children. This would be $257 each, when shared between employer and employee. It would replace SHB and therefore includes everything already in SHB as well. Most importantly, this “mock” basic plan is designed to help make us healthier and will result in real savings to individuals because it proposes caps on co-payments while ensuring healthcare businesses can be financially stable.

I am very excited about the national dialogue we are about to embark on to improve the basic insurance plan and create the Bermuda Health Plan 2020.

In addition, the Government consulted previously on how our country should organize the financing of healthcare and two options were considered in depth. I am grateful to the Health Financing Reform Stakeholder Consultation Group who provided the perspectives of a full range of community stakeholders to inform the Government’s decision on how Bermuda should finance healthcare.

We have determined that the Bermuda Health Plan should be provided by a unified system as this is best suited to achieve efficiencies, economies of scale and cost savings, given Bermuda’s small size. A unified system means that all residents will be in the same basic insurance pool, sharing health costs throughout all of Bermuda’s residents.

Of course, the Bermuda Health Plan will not be everything to everyone. And we welcome the important role private insurers play in providing supplemental benefits above and beyond what a basic package will offer.  However, this government’s intent is that the Bermuda Health Plan should aim to cover essential services we need.

I want to remind us also that this is all about containing health costs as well.  Making us healthier as a community and as individuals is a necessary part of containing health costs but there are other drivers that we have to tackle as well.

In discussing how to get Bermuda to a unified system providing a Bermuda Health Plan, we will have to tackle other difficult issues that drive health costs: fee levels, copays and utilization.

With good lifestyle choices, proper treatment and investment in ourselves, we can all age healthier. We can have better quality of life and prevent our health costs from continuing to escalate.

We are addressing the goal of making Bermuda healthier from a lot of different angles. We are making healthier environments through initiatives like the sugar tax. We are educating students on nutrition and healthy living through the Healthy Schools Programme.  We’re promoting screenings and vaccinations as the most fundamental preventive measures. We want everyone to have affordable access to essential services through a Bermuda Health Plan. And we’re inviting every sector of the public to be part of this transformation to make Bermuda healthier.

So if today is another step forward, what happens next?

Dialogue. Consultation. And building consensus on how to get us to achieve affordable healthcare for all.

Over the coming weeks we will be releasing consultation documents on the Bermuda Health Plan 2020, and starting a four month period of consultation on what Bermuda’s basic health insurance plan should include and cost. Is $514 affordable? Should dental be included? What level of overseas care? How should co-pays be capped? We have a lot to decide together.

How should our current fragmented and expensive health financing system be transitioned into a more efficient health financing system? How should a unified system work in Bermuda? Who should administer the plan, the government or the private sector? How will the plan interact with existing private insurers? Who should benefit from subsidized premiums?

Again, there is a great deal of discussion to be had in order to develop, together, a roadmap to healthcare for all.

Over the next few months I look forward to working with stakeholders, including our global insurance sector, who have offered their assistance to ensure that Bermuda's system of health insurance is the best in the world. We are the world's risk capital, and with their assistance and expertise I am confident that following this period of consultation we will emerge with a clear vision of the future of Bermuda’s health care system.

This is transformative change. And we intend to do it openly through consultation and dialogue.

Before I close, I must caution Bermudians. There will be members of our community who will be content with the status quo, not wishing to advance the reform measures I have just spoken about, and who think that the fundamentals of our healthcare system in place for the last 50 years should continue. This government does not agree. 

In July 2017, this Government received an overwhelming mandate for change, and based on the stories this Government is hearing from the community  we know that Bermudians are not satisfied with a status quo that is hurting so many of our people.

Ultimately, this is about our health. About your newborn baby’s health. About your grandmother’s health. It’s about the well-being of every young person and parent in the country. And about our need to look after each other. Because in my Bermuda, we are all each other’s keeper. Imagine with me a Bermuda that provides access to healthcare at a price that is affordable within a system which is sustainable. Together I am certain that we will achieve more affordable health care for all of Bermuda and her people.  I look forward to writing these next chapters with you. This is the healthcare we all deserve.

Thank you.

Additional information regarding the Bermuda Health Plan can be found at www.gov.bm/healthplan

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