Health insurance in recovery

| 21/09/2010

(CNS): Insurance firms will no longer be able to cherry pick who they insure as a result of amendments to the Health Insurance Law passed in the Legislative Assembly recently. The road to recovery for the country’s health insurance regime is likely to be a long one but the health minister has made a number of amendments to provide for increases in fines, improve the administration of the law, as well as bring wider and more comprehensive coverage for all. The first step in what Mark Scotland said would be a comprehensive overhaul of the system and improvements to the basic health package, the changes will hopefully address the myriad complaints received about the sector. Scotland said that in the last year alone the Health Insurance Commission received over 1400 complaints.

Eventually, the minster will be introducing a standard health insurance policy that will provide more adequate coverage and meet the actual costs of care as part of the regulations that will go with the law. The minister explained that a final figure on the value and premium of the basic package had not yet been confirmed but the goal will be to balance an affordable premium with adequate cover.
 
The amendments are a first step on the health insurance regime’s road to recovery and provide for increases in fines to both employers and insurance providers who break the law and hold violators more accountable. Importantly, the changes will also close some of the loopholes which had allowed insurance companies to refuse coverage to people for one reason or another.
 
“Government has been working diligently to improve the delivery of health care,” Scotland told the Legislative Assembly as he presented the amendments. He said the amendments would improve access to health care in particular, for those in lower income brackets and those at higher risk.
 
One of the many problems surrounding the current outdated law, the minister said, was that it allowed for too many people to fall through the cracks and be under or uninsured. This in turn had led to higher incidences of chronic diseases.
 
Scotland said that, aside from improving access to health care coverage for a greater number of people, it would reduce the burden on government, which has been picking up the slack for failures in the private sector. He revealed that government spent just under $20 million on health care for under and uninsured people locally and overseas over the last twelve months, a level of expenditure which, he said, was unsustainable.
 
“The number of uninsured persons will decrease and level of under-insurance will improve significantly … as a result of the amendments,” Scotland added. He stated that amending the legislation had not been an easy process and acknowledged that work on the amendments started back in 2007 but what he believed were objections from the industry had delayed their implementation.
 
“There are numerous loopholes in the law that allow insurers to cherry pick and deny insurance to various individuals. These amendments propose to eliminate these,” he said.
 
He warned, however, that when the new and improved basic coverage was set it would mean monthly premiums would increase but in return policy holders would have far better health benefits and the country could move toward a healthier population.
 
Scotland admitted to the LA that the amendments won’t make the law perfect but would go a long way to improvie the current situation. Scotland pointed out that getting health insurance laws and coverage right was not a simple process, as demonstrated by the continuous battles over the subject in the United States.
 
The amendment bill received wide and welcome support from both sides of the Legislative Assembly and the amendments past unopposed.
Print Friendly, PDF & Email

Category: Headline News

Comments (28)

Trackback URL | Comments RSS Feed

  1. Slowpoke says:

    While better than a sharp stick in the eye, this is simply not good enough. How can this pass unopposed when even the proponents admit that there are flaws?  Too much effort to get it right?

    As poster "Adam Smith" commented, this will get very expensive.  Last year, the US had enormous health insurance premium raises AND record health insurance company profits (in a recession).

    The only way to effectively control insurance costs on this sort of scale, is by having a single, not-for-profit insurance provider, at least for primary care.

    The role of private insurance should be restricted to perks and additional services. 

  2. Anonymous for Cause says:

    I am pleased to see some postings acknowledging the work of former as well as the current Health Minister and other Cabinet /Exco Ministers which culminated in these modest, but important steps towards reforming the local health insurance industry.

  3. Beltan Brayces says:

    Cor, is that Frankie Howerd and Kenneth Williams? I had no idea they had status. Do I get a t-shirt CNS?

  4. Adam Smith says:

    It makes no sense for Cayman to adopt the most expensive form of health care model, ie the American model.  That model will only result in ever spiralling costs because of the small Cayman market leading to limited insurance options without economy of scale and the higher prices of providing health care on a remote island.  Sadly this spiral will make our businesses far less competitive as they foot and every increasing bill for insurance premia.  The only real way out is a nationalised system paid for by direct taxation and perhaps supplemented by private coverage.

  5. Anonymous says:

    This is certainly a step in the right direction however….I am sure we all can remember when health insurance was not manditory….the cost for service was much cheaper. Mark….please regulate the medical industry! If they keep on robbing the insurance companies, rates will keep going up and they no one will be able to afford health insurance…..and while you are regulating the industry, please check to ensure that the Dr’s actually went to medical school and that they are competent.

    The other option which I have suggested before: run CINICO like all other insurers, offer cover on par with Aetna, Britcay etc where people have options including going overseas. Compete and take most and eventually all market share. We are too small for so many health insurers. Imagine the bargaining power CINICO would have with overseas providers and the local market.

    Lastly, if this is not possible with CINICO as a Government entity, maybe it should be sold or handed over to a private entity that can run it. Great way to get rid of all those pockets being lined!

     

     

  6. Anonymous says:

    Put everyone on a government contract. Voila, you have universal health care.

  7. anonymous says:

    Excellent work to all involved….especially to Mr. Anthony Eden, Mr. Alden McLaughlin, Mr. Mark Scotland and Mr. Ezzard Miller as i know you have all worked very hard at this legislation to do what’s right….even with most in the Insurance Industry against it.

    And to all the others also!

    This is indeed an excellent example of both Political Teams working together for the people. Hoping we can see more of same.

     

  8. Anonymous says:

    Please include that doctors AND dentists have to accept your insurance card and can not demand that you pay out of pocket and then claim back from your insurance.

    • Anonymous says:

      And, Tue 16:24, when it turns out you weren’t really covered for the procedure you received from the doctor and dentist, and the insurance company will not pay them as a result, you will rush back to reimburse them wont you?

      Please think issues through before posting rubbish.

      • Anonymous says:

        That’s why the medical offices should check with the insurer to confirm coverage first. All of the offices I have been to recently have done so via phone or internet/email in a matter of minutes.

      • Anonymous says:

        The doctors should have systems in place to check that insurance is valid and that the procedures are covered … what’s so difficult about that 17:59? Are you a part of the medical profession and hence your reluctance?

      • sleep walker says:

        Tue 17.59

        A quick call to the relevent insurer named on the cardwould sort that out in a jiffy, so dont be rude to poster Tue 16.24 saying he/she was talking rubbish.Maybe you should think things throughbefore you post.

      • Anonymous says:

        Physician heal thyself, 17:59! You should take your own advice: T-H-I-N-K!

        Now tap your head and get those dormant brain cells roused from stupor and "tink":

        If I could afford to pay out of my pocket for any but the most simple treatment I would not need health coverage.

        It is not a problem in Space-time Relativity for the health care provider to work with the insurer to pre-qualify the treatment beforehand so the claim will be handled properly. The law could be rewritten to govern claims and make such pre-qualification mandatory for health care providers, and binding on the insurer.

        Please think issues through before posting rubbish!

  9. Anonymous says:

    If monthly premiums increase any more it will be cheaper to self-insure. Health insurance premiums are my biggest cost after rent. The few times I’ve been to the doctor it has still cost me a fortune and my annual dental cover is exhausted as soon as the hygenist says good morning. Plus my insurer is rude, slow to respond and incompetent. What’s the point?

     

     

  10. Anonymous says:

    Goodness me, let me barder my eek. Is that Kenneth Williams and Frankie Howerd in the photo? Carry on up the L.A.!

  11. anonymous says:

    A Big step in the right direction.

  12. Anonymous says:

    CNS: Sometimes your choice of image cracks me up. Please “Carry On”.

    • durrrr says:

      I disagree. why try to make a joke out of something as important as this?

       

      yours

       

      scrooge

      • noname says:

        durr 19.08 21sept

        Aghh lighten up scrooge un- knitt that brow for a few minutes and smile.

        love and light x

  13. Anonymous says:

    Well done Minister Scotland for carying forward the amendments that was sarted in 2007, it will be a great improvement, and amuch less burden to the HSA.

  14. Anonymous says:

    I am please to see that the insurance companies can no longer "dump" you if you have prior conditions or because of age.  I will be interesting to see the final bill. I hope it is a true step forward I know that I have had two insurance companies try to drop me, or not accept me because or prior conditions. 

    A good step forward I hope.

     

  15. Anonymous says:

    Hmmm  I’m interested in seeing this clause that no longer allows the insurers to cherry-pick who/what they insure. 

    I believe I am not the only one now stuck with an unreasonable exclusion on my policy for something that has never troubled me in my entire life.  Something which was diagnosed when I was a young child, but which has never required medical attention – just because I was honest enough to inform them I had the condition on my insurance application. 

    I’ve never had a problem obtaining insurance without restriction elsewhere with any of my employers insurers.  But, I come to Cayman and bang, now I am landed with this.  And of course, I now have to declare the exclusion and suffer it on any policy I take out in future – all because Cayman’s insurers deal with their health policy applicants differently to insurers elsewhere.

    I have paid almost US$10,000 on a health insurance policy I’ve been forced to take out for the last 4 years, to an insurer of my employers choice (not mine) and its not worth the paper its written on.  I’ve had a grand total of about US$400 benefit out of that policy for the same term.

    Further, I think insurers should be forced to consider giving ‘No Claims Discounts’ for persons such as myself who do not milk their policies for everything that can be claimed upon them.  This kind of action, in turn, would hopefully encourage others do use their policies more sensibly in the future, in the hope of obtaining some kind of reduction on their premiums in return.

     

    • Karyll Iton says:

       That’s a pretty novel idea. A NCD for health insurance. 

    • Anonymous says:

      12:57

      Same here. I waited several years to leave a miserable job where I hadn’t had an increase in over 6 years. When I finally did, the next insurer wasn’t a problem but 3 months later the next one gave me exclusions.

      I fought and argued and even had my doc write a letter and I WON!!

      Obviously I don’t know your circumstances and I hope you didn’t take it laying down…

      NO ONE should take them at their word without an argument!!!!

      Good luck!

       

       

  16. Anonymous says:

    Mark, be sure to include the ability to switch employers and still be able to retain your insurance. At present, employees with pre-existing conditions are held hostage by their employers as they can’t afford to change jobs and lose their insurance coverage since the insurance companies then would re-evaluate the employee and/or spouse/family member and exclude their pre-existing condition. Thank you for looking after the people.

    • Anonymous says:

      One solution that can work for some expatriates is to is to buy catastrophic insurance coverage overseas with a large deductible, and then fulfill the the requirements of Cayman law by buying the cheapest available insurance here, which works out at about $65 per month.

       

       

      • Anonymous says:

        Thought of that.  Did all the research.  ExPats can actually buy specific insurance policies, including medical for when working abroad, with much more cover at much more competitive prices.  I would definitely encourage those who can, to try this option.  It didn’t work for me – me opting out of my employers group policy would put their group premium at risk… and I need my job… so I am up the proverbial creek with no paddle – stuck with their shitty insurance policy (and exclusions too).