Households with an annual income of less than $40,000 will suffer a "significant challenge" if health care costs continue to rise at their current pace.

According to the Bermuda Health Council (BHeC) incomes below the poverty line could experience further hardship if health care costs continue to outpace national wealth.

The organisation recently released the National Health Accounts Report 2010 detailing how funding and spending on health rose rapidly between 2004 and 2009.

According to the report, residents spent $8,661 on health care each year more than nine percent of the previous year's per capita income of $92,818.

For the 11 percent of households with an annual income of under $36,605 in 2008 "the cost of health care may be a significant challenge", the report stated.

BHeC chief executive officer Jennifer Attride-Stirling said the Island is not alone in its struggle — many countries in the world are dealing with the issue.

"Health care costs are increasing everywhere and it is very important to keep that context in mind that we are not talking about specifically or only about Bermuda."

"It is also an issue here and we must accept that it isn't going away on its own which is why it is important to have the figures on health care costs in the public domain. [It's important that] there can be an informed debate about it and we can, together, think about what it is we want to do going forward."

She said the Island's health care system is thriving in many areas and responds well to residents' health care needs.

But according to goals set out by the World Health Organization, the system is weaker in its ability to provide a fair financial burden for all members.

Dr. Attride-Stirling said: "Are we producing good outcomes? Yes we are. Do people have access? Largely they do, but we want to do better. Is the system financially fair? Not as much as it can be, and we need to get a better balance on those three things.

"No one should be impoverished by paying for health care and that is where the weakness is in Bermuda.

"That some people, in particular those living below the low-income threshold, could be left in hardship due to a serious health problem is very significant."

The BHeC is now looking at ways to bring about more equity, she said.

"We are working with the Ministry of Health on developing a national health plan. There's a desire to minimise the risk for individuals and the risk for the community.

"Fortunately people don't get turned away from hospital care in Bermuda. The hospital has a mandate to provide care for individuals but these things cost money and the money doesn't materialise from thin air. Those are the risks we're are trying to minimise."

But these are risks for just about any community, Dr. Attride-Stirling added.

"That is why we talk about the health system not being sustainable. Costs are increasing faster than national wealth and some sectors of the population may struggle to afford health care.

"If segments of the population are left without health insurance or have to pay for health insurance that they can't afford and are left in hardship, then that is worrisome.

"We are not there yet. We are not in a situation that is so dire that we have lots of people left without health care. Every single individual matters, of course, but we need to keep in mind the big picture.

"And we want to make sure that everyone in the health care system who has a role to play in it is fully engaged. We want to make sure we minimise the number of people at risk or who face financial hardship, or are impoverished by paying for health care. And to make those negligible, so we have a system that is fair and that is sustainable."