Healthcare funding inadequate for most vulnerable
The most vulnerable people in society, that is, those with mental illness, the elderly and neonatal babies, are not adequately covered by their health insurance and neither are those people working in the public sector. This is according to a new report just published by the Health Insurance Standing Committee, which was formed by the Cayman Islands Insurance Association.
The first part of this report – the Gap Analysis and Reform Proposal for Healthcare Funding in the Cayman Islands - has just been released, with three further reports coming later this year. It was created following a review of Cayman’s system of healthcare funding throughout last summer. The Chair of the HISC Annikki Brown, explained:
“The HISC has spent the summer of 2019 identifying gaps in the current systems of healthcare funding, assessing the financial and social impact of these gaps, and creating proposals on how to close these gaps. Healthcare is important to us all, and we have determined that it is in everyone’s interest that the expertise of every member of the HISC be brought to bear in providing solutions that better serve our clients and the wider Cayman Islands community.”
Ms Brown said that the most vulnerable people in society were their first priority groups of people who they were focusing on as being under served in the community. Their research found that mental health care was not sufficiently defined and not treated as any other illness as far as health insurance was concerned. Retirees and elderly care and coverage, public-covered populations such as Cayman’s seamen, indigent population and the Civil Service, neonates and newborns with congenital defects and dependents after death of primary insured were all also under-served as far as health insurance was concerned.
The committee also found that the healthcare insurance system itself had infrastructure gaps with regard to the laws regulating it. These included missing categories of codes for Standard Health Insurance Fees (SHIF), irregular review of SHIF and irregular review of SHIC standard premium rates. Ms Brown said that, as a result, “there are parts of the current regulatory framework that are either outdated, under maintained, or defunct. These are resulting in glitches and malfunctions in the current system of healthcare funding.”
Ms Brown went on to say that the Committee found many significant gaps in the way in which the delivery of healthcare was regulated in the Cayman Islands that they believed was having a direct effect on the rising cost of healthcare and, as a result, on the rising cost of health insurance.
Such issues included the fact that there were no standards of transparency of billing, no accountability for complaints and no induction into Cayman’s healthcare system was required for new healthcare providers. They also found that the system lacked any quality standards for public safety, there was insufficient due diligence on new providers, healthcare providers ignored HIC surveys and there were no national pharmacy formulary or guidelines in place.
“The HISC has spent the summer of 2019 identifying gaps in the current systems of healthcare funding, assessing the financial and social impact of these gaps, and creating proposals on how to close these gaps. Healthcare is important to us all, and we have determined that it is in everyone’s interest that the expertise of every member of the HISC be brought to bear in providing solutions that better serve our clients and the wider Cayman Islands community.”
Ms Brown said that the most vulnerable people in society were their first priority groups of people who they were focusing on as being under served in the community. Their research found that mental health care was not sufficiently defined and not treated as any other illness as far as health insurance was concerned. Retirees and elderly care and coverage, public-covered populations such as Cayman’s seamen, indigent population and the Civil Service, neonates and newborns with congenital defects and dependents after death of primary insured were all also under-served as far as health insurance was concerned.
The committee also found that the healthcare insurance system itself had infrastructure gaps with regard to the laws regulating it. These included missing categories of codes for Standard Health Insurance Fees (SHIF), irregular review of SHIF and irregular review of SHIC standard premium rates. Ms Brown said that, as a result, “there are parts of the current regulatory framework that are either outdated, under maintained, or defunct. These are resulting in glitches and malfunctions in the current system of healthcare funding.”
Ms Brown went on to say that the Committee found many significant gaps in the way in which the delivery of healthcare was regulated in the Cayman Islands that they believed was having a direct effect on the rising cost of healthcare and, as a result, on the rising cost of health insurance.
Such issues included the fact that there were no standards of transparency of billing, no accountability for complaints and no induction into Cayman’s healthcare system was required for new healthcare providers. They also found that the system lacked any quality standards for public safety, there was insufficient due diligence on new providers, healthcare providers ignored HIC surveys and there were no national pharmacy formulary or guidelines in place.
