Bermuda can follow the example of other countries in making health care more accessible and less expensive, Health Minister Zane DeSilva said yesterday.Mr DeSilva delivered a stinging attack on the way health care has been funded in Bermuda as he launched a debate on the National Health Plan he unveiled this week.“It is no longer enough for us, as a wealthy country, to continue to treat health coverage as a privilege of employment or as welfare for the poor,” the Minister told the House of Assembly.“It is unacceptable that, although we spend more on health care than almost any other developed country, we cannot provide an adequate level of coverage to all Bermudians.“It is not appropriate that we should call ourselves a humane and civilised society, but expect the weakest among us to pay the same for health coverage as our wealthiest relatives.“It is time to change, or we will perish and the weakest among us will be the first to go.”Mr DeSilva said he doesn’t think anyone in Bermuda wants such a system.“I refuse to believe that Bermuda intended that our health system leaves disadvantaged people behind,” he said.“I refuse to believe that we intentionally created a system that would be impossibly expensive for the poor, the sick and the elderly.“Our system does not have to be this way. And now is the time to change it.”Releasing the plan on Tuesday, Mr DeSilva promised 100 percent of residents will be provided with basic and essential health care by 2013.Bermuda Employers Council responded by warning resulting cost burdens to businesses could put more jobs under threat.Yesterday, Mr DeSilva stressed the health system would be financed in the most cost-effective way available.“The international experience has demonstrated empirically that health care access and cost are determined greatly by the way in which coverage is financed,” he said.“Indeed, countries that rely less on voluntary health insurance can be less expensive and provide better access to health care.”He said individuals would face “proportional financial burden”, while several options are being explored to finance health care.One would be to continue to rely on private insurance, but introducing “risk equalisation mechanisms” to enable universal coverage and proportional premiums.Another would be to create a single pool run by Government, a quango or a private entity.Shadow Health Minister Louise Jackson said the United Bermuda Party supported the proposed plan as it was “not a contentious matter” but would have liked to receive it earlier than Tuesday afternoon.“That was two days ago, giving us two days to absorb this document. We have not had time to caucus on this plan or to speak to our constituents.”She said the big questions, which were only partially answered in the plan, were how it would be implemented and who would pay.Mrs Jackson said before Government could hope to put in place a National Health Plan it needed to ensure its FutureCare senior health insurance programme was properly working and available to all.“FutureCare was a promise made to this country,” she said. “It was made without a plan. I’m still waiting to hear a concise plan.”She said if Government couldn’t “get it straight” for seniors, how would it handle the whole population. “I don’t have much faith in what’s going to happen, I can tell you.”Mr DeSilva responded that as of April this year “every senior in Bermuda will be covered by FutureCare” and that a phased roll-out was always the plan.Mrs Jackson was highly critical of Government’s use of health consultants and the cost to the taxpayer. She said millions of dollars was spent every year and it was “absolutely obscene”.“You can’t run a Health Ministry using consultants in this way,” she said.She later asked: “Are we going to do something about the bloated salaries at that hospital [KEMH]? Are we going to do something about the bloated salaries of consultants?”Referring to Kurron Shares, the New York-based company given a five-year $13.5 million contract in 2007 which has now been axed, she asked: “What was the real cost of Kurron? I know about the $13.5 million but what was there beyond that.”Mrs Jackson urged Government to improve rest homes for seniors, arguing there were only two equipped to deal with dementia. She said care homes for the elderly were expensive but many provided poor food, not enough activity and “locked down” their residents at night, which could be dangerous in the event of fire.“This is something I would have liked to have seen a little more of in the health plan,” she said.She asked Government how it expected to sustain the cost of health care and warned of a “tsunami” of seniors needing medical treatment in the future.During her hour-long response to the plan, Mrs Jackson chided Government MPs for laughing and heckling her. “This is not a laughing matter,” she said.A spectator in the public gallery clearly agreed. The man, whose identity is unknown, was escorted from the House just after 4.30pm by the sergeant-at-arms after shouting: “Stop laughing at that lady. Don’t laugh at her. She has a right to speak.”Wrapping up her contribution, Mrs Jackson accused Environment Minister Walter Roban, a former Health Minister, of stupidity for suggesting it was the fault of private companies that some seniors had no health insurance cover.Mr Roban described the health plan as a consultation paper and conceptual plan and said all members of the community would have the opportunity to offer feedback.He described it as an “historic” document and said he couldn’t remember a similar plan ever being produced in Bermuda.“It was begun by the late [Health Minister] Nelson Bascome. He started this process. I found it when I joined the Health Ministry and was happy to be a part of it.” He said the best minds in health in Bermuda had contributed to it.Mr Roban said two private health insurance companies had expressed support for the plan and queried why a third had not.He talked about US president Barack Obama’s attempts to get health care for all and how many had rejected the idea. “We have a plan,” he said. “God bless Bermuda, that’s all I can say.”Opposition MP Grant Gibbons said the plan was more of a green paper than a definitive statement on how Government would execute its ideas.“It’s not a real plan yet because it doesn’t tell you how it’s going to get there,” he said.He said the objectives it contained were “all very nice” and it was well-written but there was little in the way of a concrete timeline.Shadow Education Minister Dr Gibbons said goals such as improving access to care and the cost of care were contained in a previous report produced by consultants Arthur Andersen.“So far, all we have had is talk about it,” he said.He said many European countries and Canada were able to provide health care for citizens because of income tax. He questioned whether the National Health Plan was a “roundabout way” of bringing in income tax to cover health care costs.Bermuda Democratic Alliance MP Donte Hunt said the plan was a good one and a “great start”. But he urged Government to give more detail as to how it would enact the scheme.Mr Hunt said Mr and Mrs Bermuda like what they’ve seen in the plan because it says they’ll be able to afford health care, but he questioned how it could be established for all.“I was disappointed that I did not hear from the Minister specifically addressing the cost of this,” said Mr Hunt.Progressive Labour Party backbencher Wayne Furbert, the former UBP leader, criticised the Opposition for failing to lay out its own plan on health care.Mr Furbert praised the Japanese model for its low costs, efficiency and commitment to equity and said the plan Bermuda has right now is not working.He said the public could keep Mr DeSilva on his toes regarding the time scale of the project.Education Minister Dame Jennifer Smith applauded the hard work which has gone into the plan for many years, dating back to the days of Mr Bascome.She said people could now come forward and suggest how the plan could be improved in a consultation period.Former Health Minister Michael Scott, the Attorney General, said it would be wise to wait before announcing details on cost, but said there would be no mystery where the money would come from: surcharges and hospital fees.Mr DeSilva concluded the debate by saying Government would provide details on how the scheme will operate after the consultation.He added that Mrs Jackson, who is retired, had 68 hours to read the plan in the time between its release and yesterday’s debate.