Every year the LCCA spends every penny it has to help residents meet their overseas medical costs.

That's right, they completely run out funds.

And the Lady Cubitt Compassionate Association is also facing a growing problem with patients failing to repay their loans – meaning other patients will not get access to funds.

Executive director Veronica Harvey admitted she calls local medical practitioners and alerts them when funds have run dry.

One doctor I spoke with was surprised to get such a call and said he would continue to refer patients who are in need of financial assistance.

"What else can I do? It's ridiculous to tell me that there's no more money," he said.

Mrs. Harvey said the same thing has been happening for years.

"We always let them know of our situation, but doctors have a code of ethics and so they still refer them here. We understand and accept that," she said.

How does this happen? The LCCA – The Lady Cubitt Compassionate Association is a local charity, which in addition to their charity arm, manage a $1.7 million fund for Government.

"We manage a fund on behalf of Government to assist patients going overseas for medical treatment,' said Ms Harvey.

"Through the fund we provide interest free loans," she added.

The main focus is on children and the elderly. But the funds provided are a loan and like all loans that means the money is to be repaid.

The repayment rate, however, has become so bad that patients requesting funds are asked to pay at least half before they even have the treatment. (Of course sensitivity is used and in dire emergency cases treatment is not held up to wait for half the funding to come in.)

Such demands are necessary to enable other people who require the same type of help to receive it. Yet Mrs. Harvey said many people are surprised to learn when they request a loan that it has to be repaid.

"They figure because it's a charity, they don't have to pay the money back,' said one local man who feels strongly about the issue.

"It's terrible really," he said, "or else they feel that Government will pay for it. Some people just decide from the beginning that they are not going to pay it back and that cannot be right.

"Imagine if they would just stop to consider that by not paying the money back there will be no money for the next people to borrow and one of them might be a close friend or relative. Imagine if that same person needs to return to the LCCA for another loan."

Ms Harvey said the LCCA spends a lot of energy trying to recoup funds loaned. Each loan is considered on a case-by-case basis.

"We look at the family, their income and expenses and we work with them to set up a repayment plan," she said. Many patients require others to sign on as guarantors for the loan they need. Mrs. Harvey said several people can sign on in connection with repaying a single loan.

"It's not uncommon to have all the children of patients come in and assume responsibility for a portion of the loan. There may be five guarantors for one loan," she said.

Despite all the financial planning, at the time of this interview, Mrs. Harvey said the fund was about $1.7 million in debt. In the February Government Budget the fund got another grant of $1.7 million. That means in April the LCCA will be able to offset the $1.7 million debt, but only a bit. The grant is paid in four instalments each year.

Patients who receive loans may have repayments scheduled over seven years. When seven years have elapsed the bad debt is often written off. But Ms Harvey stressed the importance of people honouring their promise to pay.

"The minute we get the Government grant it is gone," she said. "It really puts us between a rock and a hard place. There are some cases we cannot say no to. We just beg Government for more money especially in critical cases," she added. That begging is done with the Ministry of Health, where Ms Harvey said, the Chief Medical Officer has to search for areas that are operating under budget, and reassign those funds to the medical loan programme.

"The LCCA seem to perform remarkably well and I cannot remember the last time that someone was denied financing for cardiac care overseas," said local cardiologist Dr. John Doherty. "Dr. Cann, (Dr. John Cann, Chief Medical Officer) in particular, makes himself available 24/7 to discuss urgent cases, and is always helpful," he added.

But with the Government grant too low year after year Ms Harvey agreed that the best scenario would be for an increase. She said a conservative estimate is 110 people requesting an average of $75,000 each year. Based on those figures an annual grant of $8.25 million is what's needed.

Body & Soul asked several physicians for their views on the topic. Only a few would speak and only Dr. Doherty agreed to have his name used.

A family practitioner said: "I think that Government gives a lot to Bermudians already. For example, HIP insurance is about $230 monthly or $2,700 a year, and they are given $1,500 in medications not to mention all the other benefits.

"Bermudians, I believe, need an education on healthcare and need to think about saving for such a time when they need healthcare. It is ridiculous that we travel so much and spend so freely on material things, and think that we shouldn't have to spend our hard earned savings on healthcare, whether that is doctor's visits, medication, treatment or nursing home care.

"So in a nutshell, I do not think that limitless monies should be provided to anyone that requests it.

"Someone has to pay for it, and my belief is that other than basic care, which all should have access to, that cost must come from the client.

"Hard line, maybe, but practical."