Patients 1st is a weekly column where the Bermuda Medical Doctors Association answers your questions about the proposed Bermuda Health Plan 2020 and how it may impact you and your familyToday’s question on healthcare reform reflects on what could happen next. The medical/dental community stance remains strong on not supporting a unified system, with a growing support from allied health and pharmacies on the island also vocally not supporting the unified health scheme. The Government stance on unified as a “done deal” is clear. There is an elephant in the room — and it is not moving.The Royal Gazette this week reported that the Government’s insistence that corrections officers pay into the Government Employee Health Insurance scheme was unlawful.What does this have to do with the medical community being at a crossroads with the Government on healthcare reform?A lot. A lot of potentially wasted time and money on efforts to sway the public on a unified health system that, based on this court ruling, has a whole lot less expected financial contributions.So what could happen next? If you have less funds paying into the healthcare scheme then the Government has to recalculate the mock plan benefits. This is a problem with a single-payer system. What happens if people do not pay? Let’s stop and pause and reread that again. If an expected portion of GEHI is not paying into a unified system, how can the new system possibly provide the same level of benefits proposed at the same price? Do we really want all of our eggs in one basket?Let us hope that what happens next is that our government is fiscally responsible and reconsiders the other options on the table. The BMDA believes that the focus in 2020 should be covering the 3,329 residents without insurance — about 6 per cent of the population — and identifying the citizens who are sick or vulnerable and getting them the healthcare that they need while continually striving for excellence within our framework. This does not require moving to a single-payer government scheme.So what is next? Legal action like the prison officers? Speaking to your MP? Speaking to your employer? What is next is actually up to you, the patient. Your doctor can guide you to good health, but in the end you need to make the choices for your own health.• The Bermuda Medical Doctors Association is a local body of physicians that represent the concerns of community physicians working directly for the welfare of the doctor/patient relationship. Over the past five years the BMDA has grown to more than 75 physicians, which represents the majority of community doctors on the island