Dear Sir,A multifaceted universal healthcare plan that brings down the cost of healthcare and makes us healthier, needs to implement all parts of the plan in unison. Instead, the Permanent Secretary of Health, the Bermuda Health Council and the Minister of Health have split up the plan by first singling out how we the taxpayer pay for it, with their push for a single-payer (unified-payer) system. That might be okay if we knew what we were paying for or, even more important, whether what we are paying for will make us healthy.If single-payer proceeds without meaningful attention to health-related issues, then we will be no better off than we are today, and very possibly, worse.They want you to think that you will be paying less, but unless we manage healthcare to make us healthier, we will be paying more, whether we are paying one entity (unified payer) or several.Pushing through a unified payer plan, without serious regard for the critical, health-focused facets of a healthcare plan fails the overriding goal of healthcare reform, which is to make Bermudians healthier.This approach does not make sense.It’s like paying for your groceries before you pick them out and, in this scenario, when you do pick them out, there are no prices on anything.It becomes even more nonsensical, when you consider that the grocer doesn’t even know what to stock.The implementation of universal healthcare needs to be a concerted, co-ordinated effort if it is to succeed, addressing the three essential components for effective reform: improving people’s health, expanding access to care and lowering costs.Patients 1st has been asking Government to take the unified-payer plan off the table not because it is wrong, but because we have no way of knowing if it is right.We won’t know what is the best way of paying for healthcare until we know what is being paid for. Without that knowledge, the Government is playing roulette with Bermuda’s healthcare.The question is: why? Why are the Permanent Secretary, the Bermuda Health Council and the Minister of Health just pushing the financing part of the 2020 reform plan when it has no bearing on the challenge of actually bringing down the cost of healthcare or addressing the issues that affect the actual health of people?Bermuda will be better served by a comprehensive approach to healthcare reform.Not this one-dimensional piece of reform that can’t deliver on what is being promised, which is lower cost, access to all and healthier lives. DR RONDA JAMESPaget