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BHeC: healthcare system at breaking point

Health spending reached $701.4 million between April 1, 2015 and March 31, 2016, according to the Bermuda Health Council (Image from the Bermuda Health Council)

A cultural and policy shift is needed to cut unsustainable healthcare costs, the Bermuda Health Council said yesterday.

The watchdog warned that the healthcare system had reached “breaking point” with spending topping $704.1 million between April 1, 2015 and March 31, 2016 — an increase of $13 million from the previous year.

Tiara Carlington, BHeC policy analyst for data and research, said: “We need a cultural and policy shift to really see a decrease in the cost of healthcare.

“Premiums and the cost of care will continue to rise if we spend money in the same places.

“Unfortunately, focusing heavily on curative care comes at the expense of programmes that target other areas such as preventive and promotive care, which could improve the overall health of the population.”

The BHeC put the increase down to a $10.2 million transfer to support inpatient services and increase in cost and use of services from community providers.

These include laboratory services, allied health services and diagnostic imaging.

A statement said: “Our healthcare system is at a breaking point. We cannot continue with the status quo and we must make bold moves to change this course.”

It added: “As a community, we are investing the majority of our healthcare dollars in curative care. This category includes care provided after you have been in an accident, after a diagnosis has been made or, after an emergency event has changed your life.

“When compared to other countries, on average, Bermuda’s residents spend more but are not healthier.”

The BHeC said changes were necessary to increase people’s quality of life and grow the economy. It added: “Our population is ageing which means there are less working people to fund the health system.

“If we do not make impactful changes soon, the younger generations will be paying for our inaction in the future.

“This demographic shift, coupled with overindulgence, unhealthy diets and sedentary lifestyles means that patients will end up seeking more complex and emergency care to fix or manage preventable health issues. “To overcome these real and pending problems, we, as a society, need to spend our money more wisely.”

The BHeC added that a national discussion was needed about how the island could invest in short and long-term sustainability of the health system.

It said: “This change requires hard work and commitment.”

The following facts were provided by the BHeC:

Total health expenditure in FYE 2016:?

• Total health expenditure was $701.4 million, a 1.9 per cent increase from the previous year

• Health expenditure represents 11.5 per cent of GDP

• Health expenditure per capita was $11,362 an increase of 2.2 per cent

Where did the money come from??

• 27.4 per cent ($192 million) of financing was from the public sector

• 72.6 per cent ($509.4 million) of financing was from the private sector

• Health insurance premiums accounted for 62.3 per cent ($436.7 million) of health financing

• Individual out-of-pocket payments accounted for 9.7 per cent ($68 million) of health financing

• Donations to non-profit organisations 0.7 per cent ($4.7 million) of health financing.

How was the money spent??

• 51.4 per cent ($360.6 million) of health expenditure was in the private sector entities

• 48.6 per cent ($340.9 million) of health expenditure was in the public sector entities

• Of the total expenditure on public sector entities, 89.7 per cent ($323.3 million) was spent on the inpatient and outpatient care services provided by Bermuda Hospitals Board

• Overseas care accounted for 12.1 per cent ($84.7 million) of total health expenditure

• Local community providers accounted for 21.5 per cent ($151 million) of total health expenditure

• Prescription drugs accounted for 6.3 per cent ($44.2 million) of total health expenditure?

• Health insurance administration accounted for 8.7 per cent ($61 million) of health expenditure

The 2017 National Health Accounts Report can be found at www.bhec.bm/national-health-accounts