The Health Insurance Association of Bermuda this week shot back at accusations from Dr. Ewart Brown that they are largely to blame for the poor financial situation of Bermuda's hospital and that they restrict their coverage to the most healthy segment of the population.

Dr. Brown made the comments during the Budget debate on the Health Ministry last week.

"The insurance companies have operated such strange and contorted schemes in the way they have compensated the hospital,'' he said.

"They escape treating the most at risk section of the population by being allowed to choose and refuse their customers in their selective cherry picking.'' But yesterday, Judy Panchaud White, president of the Health Insurance Association of Bermuda (HIAB), struck back at Dr. Brown pointing out that Hospital Board fees are governed by the Ministry of Finance.

"It is our understanding the Ministry of Finance acts upon the advice received from the Hospital Insurance Commission, a Government appointed Board,'' she noted, "which does not have any representation from the health insurance industry.

"All hospital services paid for by the Health Insurers of Bermuda are in accordance with the Hospital Insurance Act and the Hospital's fee Schedule that is approved by the House of Parliament on an annual basis -- April first of each year.'' In an attempt to refute Dr. Brown's assertions that local health insurers engage in "selective cherry picking'', Mrs. Pachaud White noted: "The Hospital Insurance Commission provides a facility for persons to apply for health insurance certain times of the year without medical questions being asked.

"The Health risk of this group is subsidised via the overall health insurance premiums that are paid for by all insured persons,'' she continued.

"This is done with the Mutual Reinsurance Fund (MRF).'' According to Mrs. Panchaud White all health insurers are required to add this government surcharge to their health premiums, collect it on behalf of Government and pay the funds monthly to the Hospital Insurance Commission.

She explained that the Mutual Reinsurance Fund is used for the overall pooling of risks for long in-patient hospital stays, chronic dialysis treatment and kidney transplants.

The government surcharge is currently $11.60 per month, per adult insured.

Supporting her argument Mrs. Panchaud White pointed to the HIAB's readiness to run the MRF.

"The HIAB offered many years ago to take over the Hospital Insurance Commission's health insurance portfolio and manage the mutual reinsurance fund,'' she said.

"We would be happy to offer such services again if Government wishes to withdraw from their current involvement in this area.'' In response to the Hospital's in-patient pricing system which both Dr. Brown and Health Minister Nelson Bascome contended was not reflective of actual costs, Mrs. Panchaud White pointed out the HIAB has "on numerous occasions'' held that the system should be changed.

"We support the Bermuda Hospitals Board's request for a multi-tiered pricing structure for in-patient hospital care,'' she said.

And she noted that such requests have always been turned down by the "government appointed Board, Hospital Insurance Commission and /or the Ministry of Finance''.

Head of Argus Insurance, Gerald Simons noted: "Our health care system is one of the best that you can have and we have been very fortunate that it has not been a top political issue, because it has served us well.'' Both Mr. Simons and Mrs. Panchaud White agreed that improvements could be made to the present system and they each voiced support of the health care review currently being carried out for Government by Arthur Andersen Health Care Consultants.

`Strange schemes': Government minister and physician Dr. Ewart Brown.

Setting the record straight: Health Insurance Association of Bermuda president Judy Panchaud White and Argus Insurance Gerald Simons.