Poor Bermudians are spending almost 20 percent of their incomes on health care versus only three percent for the wealthiest.

In 1993 the difference in health care spending between the wealthiest and poorest Bermudians was not as extreme the richest spent 2.8 percent and the poorest, 7.6 percent.

The dramatic increase in spending by poorer Bermudians is due to our expanding economy, according to Bermuda Health Council head Jennifer Attride-Stirling.

"Health care and insurance cost the same for everybody, or more or less the same for most people, but the income for households varies greatly," she said.

"Therefore health care expenses eat up more income for poorer households. In the last decade the economy grew a great deal but that growth was not experienced equally by all sectors of the population.

"However health care costs grew pretty much the same for everybody. Everyone pays about the same to see a health professional or buy insurance, so it follows that low income households have to spend proportionately more of their income to receive health care."

Part of the reason the Bermuda Health Council was created and is now working arduously to collect statistics about health care on the Island was to ensure there is a sustainable model, said Dr. Attride-Stirling, the Council's chief executive officer.

In a presentation to the Hamilton Rotary Club this week, she said Bermuda spends about $6,982 per capita on health care about 7.6 percent of the Gross Domestic Product (GDP).

These statistics place Bermuda second in a list of countries in the Organisation for Cooperation and Development (OECD) on health care spending.

The Island is second to the United States, which spends more than $7,000 per capita, or 16 percent of its GDP — a number that, Dr. Attride-Stirling said is prompting reform in America.

Dr. Attride-Stirling also provided a comparison in the number of health care providers here and in OECD countries.

For every 10,000 residents: Bermuda and the US each has 24 physicians; Canada has 22, the UK 25 and Singapore, 15

• Bermuda has 72 nurses, the US 84, Canada 90, the UK 65 and Singapore 45

• Bermuda has seven dentists, the US has eight, Canada 12, the UK five and Singapore three

• Bermuda has 13 pharmacists, while the US has nine, Canada eight, the UK six and Singapore three.

Overall, Dr. Attride- Stirling, said Bermuda is doing very well, but more statistics and better data needs to be collected to ensure a sustainable health-care plan for the Island.

She added: "What we are working on is measuring and benchmarking key indicators. Currently there is limited systematically collected data.

"One of the things we are focusing on is enhancing the data available, so we can advise the Minister of Health on evidence-based policy objectives, and work with other stakeholders to identify reforms needed in our health system.

"We are working towards a health care system that is sustainable for the providers, the patients and the payers. That's really what it's about — to ensure the health care system is sustainable."