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Public urged to stop health plan reforms

Patients First: Stephen Kenny, a paediatrician on the pressure group’s panel, with Henry Dowling, head of the Bermuda Medical Doctors Association (Photograph by Jonathan Bell)

A rallying cry went out last night from opponents of the Bermuda Health Plan 2020 to shelve the Government’s proposed reforms.A packed house at a forum by the pressure group Patients First was urged to join a petition turning down “rushed” changes that would lead to a government-enforced “monopoly” on health.Henry Dowling, president of the Bermuda Medical Doctors Association, revealed the petition after a cancer patient in the audience asked: “How are we going to stop this from going through?”Saying she had cancer diagnosed twice, and that “most insurance companies won’t touch me”, she added: “If other people can march and stop things from going through, why can’t we all do something to stop this?”Dr Dowling told the forum that the physicians’ group had met two weeks ago with David Burt, the Premier, to air its concerns.The BMDA head added: “He believes this is in the best interests of the people — so the people need to speak and let him know they do not believe this is in their best interests.”The panel also included Janie Brown, a dentist, Jamie Burgess, an optometrist, and Stephen Kenny, a paediatrician and economist.Nearly 300 gathered at St Paul AME Church Hall, with the December 8 deadline for public consultation on the health proposals drawing near.Dr Dowling repeatedly described the proposals for a unified healthcare payment system, revealed in August by health minister Kim Wilson, as a monopoly.He added: “We know that any one thing having all the power is a dangerous system to have, and I don’t care who it is.”Dr Dowling said the proposal failed to address the $730 million spent annually for about 60,000 people, adding: “This system does not fix that. All it does is shifts who pays for it.”He called on patients to “take back control” and make their voices heard, while Dr Kenny warned that in a system without competition, “the product becomes worse”.Dr Kenny also cast doubt on the minister’s suggestion this summer that the plan could be delivered at a cost of $514 a month per adult.He told the forum: “Some higher amount than that will only be disclosed when there’s two weeks of consultation left — soon, I hope.”He said there was “overwhelming opposition” to the plan among the BMDA, even though physicians would not lose out in payments.“Our opposition is not a financial one,” Dr Kenny said. “Our opposition is that we think it’s bad for patients.”But the meeting also heard of pitfalls to earlier healthcare payment changes that were approved by Parliament in May.The change mandated that the Bermuda Hospitals Board would receive a $330 million annual lump sum from the government.The grant replaced the previous fee-for-service arrangement under the Health Insurance Amendment Act.Dr Brown said this switch had “wreaked havoc” at the hospital, causing the closure of two operating theatres because BHB was “trying to save money”, and leading to delays in elective surgeries. She said the grant had been given without guidelines to the hospital on “how to manage the money or spend it”.One audience member told the panel: “Anything we should be concerned about, it’s got to be healthcare. How broad is the conversation? It doesn’t seem broad to me — it’s Government and doctors.”Dr Burgess said that in spite of three months’ consultation, including three town hall meetings offered by the ministry, many patients still “do not have a clue what’s going on”.She added: “There is, unfortunately, a lot of confusion.”Dr Dowling said the Government had failed to heed doctors’ concerns.He added: “You need to listen to us. We represent the soldiers on the ground. You have to just listen to us before you get the whole war lost. That’s all we are saying here.”A woman retiree complained about inconsistencies in the copays that seniors were having to cover, telling the forum there was “a total disconnect between the medical industry and the patients”. She described getting charged a copay of more than $200 last month “just to have a doctor look inside my mouth”.She said: “It’s very humiliating to have to say you can’t afford it and you can’t pay this. It’s just got to get better. I wish we as consumers could be involved more.”She added: “There seems to be a huge disconnect between customers and the industry as a whole. Government is acting as Government — they are not taking the responsibility that they need to take.”The forum closed with a call for the public to petition the Government over the Bermuda Health Plan via the Patients First page on Facebook.A petition was also online at www.change.org.By 9pm, it had been signed by nearly 200 people.The article has been update to correct Dr Kenny’s name.