care costs to an unsustainable level.

As chairman of a Government-appointed health care committee, Sen. Alf Oughton this week warned health care costs could soon "get out of hand'' unless a better structured health care system was put in place.

An aging population, rising medical malpractice insurance and operating costs and expensive treatment for long term illnesses have also contributed to medical costs that have escalated in recent years.

"People are far more health conscious today than say 20 years ago,'' Sen.

Oughton said in a speech to the Hamilton Rotary Club.

"They want the best services and the best doctors. And they want their doctors and medical facilities to use state of the art technology regardless of how high the cost might be.'' But, he said, there was "an increasing price to pay''.

Consumers, he said, should take more responsibility for decisions regarding health care.

Because insurance companies foot the bulk of medical bills, patients remain blissfully unaware of the size of their medical expenses.

As a result -- "neither the patient nor the health care provider has much incentive to control costs,'' Sen. Oughton claimed.

Unnecessary visits to the Emergency Department for treatment of minor ailments, over use of laboratory and diagnostic facilities, an increasing preference for specialist care over general practitioner care and preference for expensive overseas treatment further all helped push up costs.

"The Bermudian consumer needs and wants to believe in the local health care system and the system needs the support and faith of the consumer if it is to grow successfully,'' he said.

Sen. Oughton claimed it was up to patients to make healthier life style choices and become more aware of medical costs by using health care services more selectively.

"With the high standard of living that Bermudians have come to expect, this quite naturally includes their health care. More emphasis today is placed on the quality of life and the demand for first class medical services,'' he said.

The committee was also concerned the present health care system was too fragmented.

At present no central body exists to oversee the numerous organisations.

"There is no central body in place that can monitor all of these groups and in turn present a clear picture of just how well the overall system is being managed,'' he said.

The committee will also be making cost-cutting recommendations including: Moving the elderly from hospital beds to outside nursing homes. It is estimated up to 20 percent of extended care beds are occupied by patients who could be housed elsewhere; Stepping down nursing care; and Promoting private enterprise to extend additional nursing homes; Reviewing hospital costs -- the largest contributor to health costs; Reviewing the escalating costs of prescription drugs.

Sen. Oughton pointed out the Committee would not be recommending cuts in current health services.

Instead, it would suggest how the system could be better managed overall.

SEN. ALF OUGHTON -- Warned that health care costs could soon "get out of hand'' unless a better structured health care system was put in place.