OBA: Govt ‘largest driver’ of skyrocketing health costs
Hospitals financial statements will be released this month
Financial statements for the Bermuda Hospitals Board are ready, and will be printed this month, a BHB spokeswoman said.
Responding to One Bermuda Alliance calls for the overdue statements to be produced, she said the figures for the fiscal year 2010/11 had been audited.
“The auditing process took longer than expected, and was completed at the end of March 2012. The annual report with the financials and commentary on the year’s activity will be printed in August. We have already commenced the process for auditing our financials for the fiscal year ending 31 March 2012.”
She added that the Board welcomed any interest in controlling the Island’s healthcare costs.
“As an employer of 1,800 people, we too experience the pressure of rising premiums.
“Over the last two years BHB has introduced memorandum of understandings with private insurers and Government that essentially help control the cost to the healthcare system.
“By way of clarity, at the moment the MOUs work through a rebate system. At the end of the fiscal year, any amount paid by an individual insurer over the cap set by the MOU will be returned by BHB via a lump sum rebate.
“We also are collaborating with the Bermuda Health Council, Ministry of Health, and all the major insurers to look at further ways to control costs.”
The Board also refuted the suggestion from Shadow Health Minister Michael Dunkley that the Island’s hospital had shifted toward profitmaking.
“We certainly remain and always will be a not-for-profit organisation, working within the framework of the Hospitals Act,” the spokeswoman said, adding that surplus funds are always invested back into patient care.
The hospital’s shift to a new charge system, based on diagnoses rather than daily charges, she said, reflected a shift to “a fairer, more transparent” scheme.
The Ministry of Health also responded to Opposition claims that the National Health Plan meant that Government would assume control of the Island’s healthcare.
“The NHP explicitly states that healthcare will continue to be delivered by both private and public providers,” a spokeswoman said.
“Nowhere does the NHP propose that the basic healthcare plan will be administered by Government. The Health Insurance Act already requires every health insurance plan to include a basic package of healthcare covering hospitalisation. The NHP does propose to expand this basic package, to include non-hospital benefits.”
Useful website: www.bhec.bm.
Government is the top culprit for the Island’s “skyrocketing” health costs, the Opposition has charged.
Shadow Health Minister Michael Dunkley also accused Government of stalling on the release of financial statements from the Bermuda Hospitals Board.
Audited reports for the 2010/11 financial year are now 10 months overdue, Sen Dunkley said.
“We were told in April the report was at the printers, and then earlier this month that they were still gathering information,” he continued, branding the situation “totally unacceptable” and suggesting Government was withholding essential information.
The last statements, tabled at the final session of the House of Assembly, went only as far as the 2009/10 financial year, which the One Bermuda Alliance MP said was in contravention of the law.
Seniors spokeswoman Louise Jackson said Auditor General Heather Matthews had assured her that her audit for the 2010/11 financial year had been handed in.
Calling the delay “reprehensible”, Ms Jackson said the requirements under the Bermuda Hospitals Board Act also include a report containing the salaries paid to BHB officers.
Senator Dunkley said the latest National Health Accounts Report, released last week by the Bermuda Health Council (BHeC), gave “a very disturbing picture of soaring health costs”.
“From 2009 to 2011, spending by the Ministry of Health and the BHB has risen 26 percent compared with a rise in private sector spending of just eight percent,” he said. “In other words, Government health costs rose at a pace three times greater than those in the private sector.”
Andrew Simons, the OBA candidate for constituency 17, said the report showed the BHB accounting for “43 percent of total health expenditure in Bermuda, and two-thirds of the increase since 2009”.
Mr Simons added that Government possesses “the tools to effect good governance at the hospital, and the OBA would use those tools to provide oversight, to ensure that costs don’t get so far out of control”.
The OBA noted that Health Minister Zane DeSilva had called the annual rise in expense “unsustainable”, but rejected Government’s assertion that the National Health Plan, due for 2014, would curb costs.
“Government clearly needs to get its own house in order before making any dramatic changes to our overall healthcare system,” Sen Dunkley said.
Hospital spending was singled out for pointed criticism.
Suggesting a shift to a “for profit” model at the hospital, Sen Dunkley said costs had taken flight with the 2009 introduction of the Chargemaster accounting system.
An appendectomy that cost $2,000 in 2008 shot up threefold in cost by April 1, 2009, he said, and “anaesthesiologists saw fees increase from $25 per unit to $125 per unit”.
Ms Jackson also criticised the use of hospital specialists instead of general practitioners for incoming patients at the hospital, and renewed the Opposition pledge to reopen the Medical Clinic for the poor.
In response to questions, Sen Dunkley said there had been “strong allegations” and rumours in the wake of the suspension of BHB Chief of Staff Donald Thomas.
“It’s vital that we have full confidence in our hospital,” he said, vowing “open, honest and upfront” management of the BHB by an OBA government.
A Ministry of Health spokeswoman responded last night that the public sector clearly was “not the largest driver” when it came to costs.
Rather than seeking a profit, she said, the BHB was required to generate revenue to cover its liabilities, and maintain a reserve, with a six percent surplus in revenue over expenses.
Hospital fees, meanwhile, had to be proposed to the Minister and then approved by both the Lower and Upper House — making them the responsibility of the legislature as a whole.
“This year, the fees went up two percent, and the hospital has agreed to revenue caps with all payers,” she added.
On the issue of BHB spending, the spokeswoman said that a raft of services, including anaesthesia, obstetrics and cardiology, had been transferred over from the private sector.
“These benefit the whole population, and ensure the cost is community-rated.”
Health Accounts have “consistently shown that overseas care costs have more than doubled since 2005”, the spokeswoman continued.
“We were pleased to see that in 2011, this rise was curbed due to the efforts of public and private insurers, and the BHB’s efforts to repatriate services.”
The Opposition’s remarks also drew a swift response from the Progressive Labour Party.
Mr Simons had observed that in the Pembroke Central constituency, the jobless were reduced to “tough choices they make between high HIP premiums, rent, food and childcare”.
PLP candidate for the area Walton Brown said the OBA needed to be reminded of the PLP’s “landmark DayCare programme to provide quality, affordable child care to Bermudians who need it the most. Hundreds of families, especially the jobless, are benefiting from this welcome relief”.
The FutureCare seniors’ insurance plan had replaced HIP for many patients, he added, asking if the Opposition intended to cut it to bring costs down.
“If not, what do they plan to cut?” Mr Brown asked. “The Bermudian public deserves an answer.”
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