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Health insurance premiums ‘unaffordable’

Claudette Fleming(Photograph by Akil Simmons)

The rising cost of health insurance premiums is unsustainable and unaffordable for the Island’s seniors, according to Age Concern.

Claudette Fleming, the charity’s executive director, said that “across the board” hikes including new increases to HIP and FutureCare that take effect today could produce a “sicker older population”.

The charity’s concerns about the rise in premiums prompted it to hold a public information session yesterday that was attended by more than 100 seniors.

“The rising cost of health insurance premiums are a growing concern for us,” said Ms Fleming.

“Furthermore they come at a time when the employment environment is fierce and the economy is struggling.

“There is a trend of offering people packages before they would normally retire and there are no laws to protect people in their jobs passed retirement age. More retirees have reverted to FutureCare where the responsibility is on the individual to pay for their own medical insurance.

“The average Bermudian is 42 to 44 according to the last census so in approximately 20 years from now the majority of the population will be 65 so we clearly have to do something different.

“Government may feel they are making real changes by shared sacrifice but if we continue this there will be more people under insured or with no insurance. We will have a sicker, older population.”

In July, the Minister of Health, Jeanne Atherden, announced that four new benefits and one improved benefit would be introduced for HIP and FutureCare policyholders, but also revealed that premiums would go up for 2015-16.

From September 1, the HIP premium will be raised from $390 to $433.31 and the FutureCare premium will increase from $450 to $504.21.

Ms Atherden previously said that premiums had to increase because of escalating healthcare costs, a significant rise in claims and an increase in the Standard Health Benefit rate.

She told MPs: “Please know that we have gone through a comprehensive and exhaustive process to come up with these recommendations.”

However, Ms Fleming told The Royal Gazette: “We need something more affordable and more proactive. We need agreement on what the Standard Health Benefits should be, whether they should be financed by the public funds and they should be accessible to all. It seems we are avoiding how this standard health benefit is paid for and we need to address that.

“We need a solution that everyone is happy with and we need more consultation.

“On the other side there have been benefits added to health insurance policies giving people support in their homes and day care. That is important. But if people can not afford to pay their premium then that is going to be a big problem.

“Age Concern will continue to stay at the table and ensure that our seniors understand the changes and what the potential implications are.”

A spokesman for the Ministry of Health, Seniors and Environment maintained the department had engaged in dialogue with “many of the parties who would benefit from the additional benefits”.

He said: “Numerous meetings have been held with the Department of Financial Assistance, National Office of Seniors and Physically Challenged and the Department of Social Insurance on behalf of the war veterans, and the hospital.

“In addition we have met with a collective group including Age Concern representatives to go through their concerns and answer questions and offer clarification of the various additional benefits.

“It should be noted that the changes under the Standard Health Benefit and Mutual Reinsurance Fund — for example expanded coverage for certain hospital and ambulance services, increased artificial limb coverage, a pilot programme to manage chronic conditions — are also captured within FutureCare and HIP. It should also be noted that the SHB and MRF benefits constitute a significant part of the claims expenditure under both FutureCare and HIP.”

He acknowledged that the changes to the supplemental benefits represent a “fundamental shift in the way healthcare is viewed and provided within the system”.

He continued: “The intent of these changes is to move the system towards sustainability by providing the appropriate care in the appropriate setting at an appropriate cost. Experience has shown that over the long term this strategy lowers system costs. Currently, system financing drives care to an acute care delivery setting, however, the main driver of system costs is chronic illness, much of which can be effectively managed and, in some cases prevented, by funding a different care delivery model.

“The increased reimbursement rates for GP visits, additional specialists visits, the enhanced care pilot are all designed to provide for better management of chronic disease, thereby reducing the substantial costs of hospitalisation due to complication from poorly managed chronic illnesses.

“The new wellness benefit is directed at encouraging individuals to take responsibility for their health and by so doing enjoy a better quality of health.

“In addition to chronic illness, Bermuda is faced with the challenge of providing for the needs of an ageing population. The personal home healthcare services is designed to promote ageing in place. The availability of personal caretaking, assisted living, nurse’s aides and nurse visits to the home will allow our seniors to maintain dignity and continue to be engaged with the community as long as possible.”