Next Monday the sticky topic of rising healthcare costs will be the focus of a full-day seminar at the Fairmont Hamilton Princess. The Health Financing Summit, hosted by the Ministry of Health will run from 8am to 6pm and is free to the public. For more information on the summit visit www.hfs2010.gov.bm or e-mail hfs2010@gov.bm

As part of the effort to spur dialogue on the topic Body & Soul has featured the views of two of the local participants. This week we feature David Hill CEO of the Bermuda Hospitals Board in our third and final piece in the series.

What do you see as the main reasons healthcare costs are increasing on the Island?

Healthcare costs are rising globally and Bermuda is not immune. New technologies and treatments can increase the costs of providing services, as do increases in certain chronic lifestyle diseases such as diabetes. Additionally, we are living longer and often utilise more services as we age.

These are common factors internationally, but in Bermuda this is compounded by travel overseas. This is an increasing cost for all Bermudians. Perversely in Bermuda, competition on the Island does not always reduce costs either, it can, in fact, increase costs in a small population because there are economies of scale that are lost in small, multiple businesses in which people have to charge more in order to cover costs.

What are the main factors driving an increase in costs? What were the total operating costs figures for each of the hospitals for the last ten years (or five if ten is too much)?

Increases in costs at BHB hospitals are in and of themselves not a direct indicator of rising healthcare costs in Bermuda. An increase in costs could be because we are offering a new service on island, reducing the need to travel. Additionally, as we now hire anaesthetists and obstetric services that were previously private, an increase in costs might indicate a simple redistribution of cost. Factors that do increase the cost of providing healthcare services would include increasing global healthcare supply costs, new technology and staff salary increases.

A better indication of how rising hospital costs have impacted the local market is our increase in fees, which impacts healthcare premiums. Increases in costs are covered by our fees and our fees are set by Government in line with inflation. The hospital makes up about half of all healthcare costs in Bermuda. This year, for example, our fees rose by 2.5 percent. This means we will cause an increase in premiums of about 1.25 percent. The previous year's uplift was five percent and prior to that it was 7.5 percent.

What can the average person do to help reduce the increase in costs?

The best way to control the increase is to improve your wellness by living healthily, this includes keeping active, eating well and not smoking. This will reduce the need for services used by people with conditions as diabetes, cardiac diseases, cancer and respiratory diseases. How you access services also impacts costs, though.

Using on-island services is much more cost-effective than going abroad, for example. Additionally, while visiting the Emergency Department with a cold or minor ailment might feel like it gets you more immediate attention than visiting your family doctor, it also costs more to the healthcare system.