Bermuda's health care industry ? doctors, the hospital and insurers ? are pinning their hopes on the new Bermuda Health Council to stem soaring costs.

They hope that the council will be a ringmaster bringing order to the current chaos and in doing so, preserve the insurance benefits that patients have come to expect.

But that will only come if it is given sufficient teeth to make its influence felt, health insurers said.

"Right now, it's a bit like a circus," BF&M CEO and president Glenn Titterton said. "You have competing interests, all trying to do the right thing, but clashing, and there's no central organisation taking charge."

Doctors' offices, which are far more business-like than in days gone by, want to increase their fees; drug companies want to make a profit; the private sector sees the potential for profit and begins to offer services which become competition for the hospital. Unlike in other sectors, competition in health care usually results in costs going up. The hospital in particular, Mr. Titterton said, needs support. Some services at the hospital, such as out-patient services, are used to subsidise some in-patient services. If the private sector began drawing out-patients away from the hospital, the cost of in-patient services would increase.

The newly-legislated Bermuda Health Council could become the force to lead the industry, he said. "But it has to be given teeth by Government."

The Health Council could ensure methods of charging are kept up to date, and mediate between competing interests like doctors and insurers. It could also regulate the amount of doctors setting up practice in Bermuda for certain services.

"The Health Council could take over the watchdog role," Mr. Titterton said.

"We have to do a gradual pullback from the rather extreme situation of the moment," he said. "We are such a small Island, we should be able to get it right.

"It has worked well for the last 30 years, but it's been difficult these last five years. If everyone's in it for the right reasons, however, we should be able to work out a system."

Something will have to be done soon, insurers agreed ? before costs leap too high for employers. Currently all seem afraid to take the first step of decreasing benefits for their employees for fear that employees will leave and go to other companies where benefits like dental plans and eyeglasses are still offered.

Even so, "employers are beginning to ask how we can strip out these things... It probably won't decrease costs much (for employers), but it will prevent increases," BF&M technical services vice president Gina Bradshaw said. "I wouldn't say anything is right around the corner, but there certainly is a lot of thought."