When treatment is required

  • Arthur Hodgson

    Arthur Hodgson

Wealth and life expectancy


1 Liechtenstein $139,100 (2009 est)

2 Qatar $124,500 (2017)

3 Monaco $115,700 (2015)

4 Macau $111,600 (2017)

5 Luxembourg $106,300 (2017)

6 Bermuda $99,400 (2016)

Life expectancy

1 Monaco 89.4

2 Japan 85.3

3 Singapore 85.2

4 Macau 84.6

5 San Marino 83.3

6 Iceland 83.1

7 Hong Kong 83

8 Andorra 82.9

9 Guernsey 82.6

10 Switzerland 82.6

11 Israel 82.5

12 South Korea 82.5

13 Luxembourg 82.3

14 Italy 82.3

15 Australia 82.3

16 Sweden 82.1

17 Norway 81.9

18 Canada 81.9

19 Jersey 81.9

20 France 81.9

21 Liechtenstein 81.9

22 Spain 81.8

23 Austria 81.6

24 Anguilla 81.5

25 Bermuda 81.4

Source: Central Intelligence Agency

This is the third of a four-part series looking into health policy under the Progressive Labour Party

When the United Nations was established, it formed the World Health Organisation as one of its specialised agencies whose remit is to promote universal healthcare. The primary concern of the UN is to deal with health after a person becomes sick. The biblical concern is dealing with the health of a person so that they do not become sick.

The Progressive Labour Party’s main concern is to deal with a person’s sickness, but if the PLP were to fulfil its mandate it would include in its education curriculum a full programme that would ensure that, in so far as is possible, our citizens do not become sick.

Article 25 of the provisions of the UN Declaration of Human Rights provides as follows;

1, Everyone has the right to a standard of living adequate for the health and wellbeing of himself and of his family, including food, clothing, housing, medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control

2, Motherhood and childhood are entitled to special care and assistance. All children, whether born in or out of wedlock, shall enjoy the same social protection

Not surprisingly, some countries had already begun the process of providing universal healthcare before the advent of the UN declaration. During the decade of the 1930s, both New Zealand and the Soviet Union had introduced a national plan for healthcare. On July 5, 1948, Britain implemented its universal National Health Service.

Universal healthcare was next introduced in the Nordic countries of Sweden (1955), Iceland (1956), Norway (1956), Denmark (1961) and Finland (1964). Universal health insurance was then implemented in Japan (1961) and Saskatchewan (1962), followed by the rest of Canada (between 1968 and 1972), and twice in Australia (1974 and 1984). Universal national health services were then introduced in the southern European countries of Italy (1978), Portugal (1979), Greece (1983) and Spain (1986), followed by the Asian countries of South Korea (1989), Taiwan (1995) and Israel (1995).

In the decades of the 1970s through 1990s, the Western European countries of Austria, Belgium, France, Germany and Luxembourg expanded their social health insurance systems to provide universal or near-universal coverage, as did the Netherlands (1986 and 2006) and Switzerland (1996). No one would have thought that countries as wealthy as the United States or Bermuda would not have universal healthcare as late as 2019.

The single greatest impediment to good health is economic. The attached sidebar shows first that Bermuda is one of the richest countries in the world, but later in the sidebar shows that in terms of health — rather, sickness — Bermuda is much farther down the line.

According to the Central Intelligence Agency’s website, Bermuda is the sixth-richest country in the world, surpassed only by Luxembourg, Macau, Monaco, Qatar and Liechtenstein.

In 1963, when the PLP was formed, three of the most prominent members were Arnold Francis, Walter Robinson and Lois Browne-Evans. These three lawyers were trained in Britain during the period after England’s introduction of its NHS in 1948. They had imbibed the concepts of social justice from the British Labour Party. From the very beginning of the PLP, we were committed to a national health plan in the image of the British model.

Because the US is so close to Bermuda, and has such influence on Bermudian culture and social expectation, it is worth noting that it did not ratify the social and economic rights sections of the UN Charter, which included Article 25’s right to health.

Different countries use different names to describe their health system, but the idea is that everyone in the community comes to the aid of those who get sick. Sickness does not come to us all, or at least not all at the same time. The question then arises as to how do those of us who are well care for those of us who are sick? Or how do we make preparations when we are well to care for ourselves when we get sick?

Different communities or countries use different models to achieve this. The first model in the Soviet Union was a part of a much broader ideological concept of communism, which in turn was caught up in geopolitical conflicts. However, basically it was a state enterprise whereby the consumer could obtain treatment free of charge paid for by the Government. In spite of the demise of communism and the Soviet Union, the basic concept is a Judeo-Christian model, which continues in most countries.

Even though the United States did not sign the UN protocol, no one expected that 70 years would pass without the foremost country in the world covering its entire population with healthcare. This was particularly unfortunate for Bermuda since we are so heavily influenced by American social policy. It is also unfortunate that as an Overseas Territory, Britain did not encourage her colonies to follow any of her progressive policies.

While Bermuda has not implemented anything approaching the vision that the PLP had in 1963, the country during the intervening years has not been completely idle. While there seems to be no underlying ideology behind Bermuda’s healthcare development, there were certainly a few basic principles that were the aim of the PLP:

1, As in the case of education, there would have been medical treatment available to all citizens

2, The cost of the medical treatment would have been paid for by the Government through a proportional system of taxation

Bermuda’s healthcare system can best be described by a couple of quotes attributable to Jennifer Attride-Stirling, then the chief executive of the Bermuda Health Council:

“Bermuda’s health financing is a staggeringly complex arrangement — especially for a comparatively small jurisdiction”

“ ... advisers, who have experience of different health systems around the world, have claimed that this is more complicated than what exists in other jurisdictions. In particular, for a population of our size, it is highly complicated.”

It is clear from these quotes that Bermuda’s health system is in need of reform if it is to reach the ideals of the founders of the PLP. Rather than trying to analysis Bermuda’s existing system, it is a better approach to simply outline the principles on which a new system should be based.

Arthur Hodgson is a former Cabinet minister, Rhodes scholar and graduate of Oxford University in England, where he studied philosophy, politics and economics

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Published Jul 2, 2019 at 8:00 am (Updated Jul 2, 2019 at 7:31 am)

When treatment is required

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