‘Irresponsible’ merger concerns health council
Disparities in health options between the rich and poor could be widened by a merger involving a major insurer and two medical practices, the health watchdog's chief executive warned.
Ricky Brathwaite, head of the Bermuda Health Council, said Argus Group Holdings Ltd's acquisition of Island Health Services and the Family Practice Group last week, without the backing of health officials, was “irresponsible”.
Dr Brathwaite said: “This type of deal is not new to the landscape of global healthcare, but to Bermuda, and within a small community, such a move is unprecedented and potentially destabilising.”
He said the health council did not have the power to strongly regulate health businesses and added: “This insurer-practice move has the potential to further segment the population into good and bad risks, and further create disparities in the resources that are available to those who have and those who do not.”
Writing in an opinion piece, Dr Brathwaite said the Government carried a lot of adverse health risk without adequate funding to counteract it, while the private sector has more flexibility and lower levels of risk.
He said: “This type of potential social imbalance of resources and inequitable availability of treatment options is at the core of the frustrations seen globally in social protests and movements.
“A ‘dismiss unintended consequences' approach to creating a pie with two distinct halves never works out well for a country as a whole — although it does typically greatly benefit a few.”
Dr Brathwaite noted the partnership could bring some benefits, including improving the relationship between patient and insurer, and better management of patient care.
But he said similar structures in the United States had limited patient choice and forced some physicians to deny care for patients with illnesses where costs outpaced insurance premiums.
He added the health council was committed to a comprehensive and integrated health system that “seeks to put people first and elevates the health of not some, but every one of our communities”.
“Covid-19 has taught us that the status quo of our health system is not sufficient, and that change must occur so that we can be in best positions to face whatever shocks may come next,” he said.
Health minister Kim Wilson said last week that the merger was lawful, but that neither she nor the health council had known in advance
She said over the weekend that Argus and the medical practices had “taken it upon themselves to try to smooth out rough spots for their clients” by investing in one another.
Ms Wilson said: “As this deal was done within the private sector without the view of the health insurance regulator [the Bermuda Health Council], the Government, and even other medical professionals, we are still in the process of information-gathering and hearing the same details that the public is hearing.
“In fact, as the Minister of Health, I was made aware of this development on the evening of June 30.
“As a government we will examine this more closely to see if it is in the interest of the patients and is fair to other parties.”
She emphasised that the deal must be “in keeping with the overall philosophy of universal access to quality healthcare that is affordable”.
Ms Wilson said the Government was committed to pursuing universal health coverage.
“Bermuda is a small jurisdiction and our health-financing system is unduly complicated, expensive and unsustainable,” she said.
“We have to create a viable platform to improve access and contain costs. We have to find ways to minimise co-payments, improve access to primary care, and offer benefits to restore people's health.
“As a result of this pandemic, much of our worst fears and anxieties about the status quo system have become reality.
“We have businesses that cannot afford health insurance, workers who are unemployed and now uninsured, families who are going without treatment, medications that are out of the reach of seniors.
“The Government is committed to addressing this issue and the status quo will simply not do.”
Shadow health minister Patricia Gordon-Pamplin also spoke out against the move in the House of Assembly on Friday night.
Ms Gordon-Pamplin said during the motion to adjourn: “It appears to me there's been total disregard and disrespect for the processes we have and the people in charge of those processes.”
She said she could not believe “a company would have the temerity to have such a reshuffle” without discussing it with the minister or the health watchdog.
An Argus representative said on Friday night that the company was preparing a statement in response.
• To read Kim Wilson's statement in full, click on the PDF link under “Related Media”