Free healthcare has to stop, says minister

| 09/09/2011

(CNS): One of the biggest obstacles for providing affordable and sustainable healthcare in the Cayman Islands is the prevalent entitlement culture, according to speakers at a press briefing launching the island’s second annual healthcare conference, which is to be held later this year. Health Minister Mark Scotland said that government policy had been to blame, which allowed everyone healthcare, regardless of whether they could pay or not, and regardless of whether that healthcare required expensive overseas medical care. Chief Officer in the Health Ministry Jennifer Ahearn said that Cayman needs a cultural shift.

“One of the biggest challenges is the culture whereby patients expect that they should be treated and not have to pay for it. The bad debt the Health Services Authority has been dealing with is significant and a lot of it is due to patients not taking responsibility for their healthcare,” she said.

Scotland confirmed that the cost of healthcare to the government was $90 million and rising, with around $25 million of this covering those who could not afford to pay for medical bills themselves, along with healthcare for civil servants, seaman and veterans and pensioners.

Scotland said that the HSA itself was now profitable since government had begun purchasing a lot of outputs, i.e. services that otherwise could not be paid for by the patients, such as care for the elderly or paediatrics. “The HSA is in the black but at the expense of government,” he confirmed.

Dr Steve Tomlinson, founder of Cayman’s private hospital, the Chrissie Tomlinson Memorial Hospital, told CNS that public expectations of healthcare were extremely high.

“The first place they want to go to is the US – they expect this at the very least if the care is not available here. And it is government that ends up paying for it,” he said.

Dr Tomlinson went on to discuss the individuals who were entitled to free healthcare apart from indigents, including seaman and veterans, and stated that these individuals and their spouses were not means tested and entitled to receive free healthcare regardless of their income. “Some of these people are very rich,” he confirmed.   

The doctor vowed he would be speaking more on the drivers of escalating healthcare costs in Cayman at the conference, entitled Healthcare 20/20 2011 and taking place from 17 – 19 November at The Ritz-Carlton.

Scotland went on to say that any losses incurred by the HSA were not due to any poor business practices on the part of the authority, but due to uncollectable bills.

Chamber of Commerce CEO Wil Pineau echoed his support for the HSA, saying he felt that the authority had become business-friendly under its CEO Lizzette Yearwood and Medical Director Dr Greg Hoeksema, reaching out to the public and providing education about healthcare. 

Scotland said the culture of Caymanians only seeking to go to hospital when it was in an ambulance also had to change because waiting until a serious medical situation took place was far costlier than taking preventative measures. Dr Tomlinson agreed and said that although there was not a huge volume of individuals who wait until their condition becomes criticalbefore they seek healthcare, those that did usually ended up being sent abroad, vastly increasing the cost of their healthcare.

“Ninety per cent of them end up dying anyway, even once all that money has been spent,” he confirmed.

Ahearn said government was attempting to deal with these issues by a concerted public awareness campaign on preventative measures as well as amending the health insurance regulations.

“The current basic level of mandatory health insurance doesn’t have a robust enough package of benefits so people often exhaust their benefits then fall into the underinsured category where they won’t be able to meet the costs,” she said, explaining that an enhanced, and therefore more expensive, package was needed.

Scotland acknowledged that the current economic climate was a difficult one but said that with this public awareness campaign, businesses (which are required to pay 50 per cent of their employees’ insurance premiums) which will have higher insurance costs imposed upon them should realise that small increases in costs now should equal to savings in the future, as workers will need less time off due to ill health, especially if they take advantage of wellness packages built into the new insurance packages.

Ahearn added that employers needed to think seriously about the high cost of healthcare, especially the astronomical cost of sending an employee abroad by air ambulance, for which they would have the responsibility. “While there are going to be some higher costs, it’s something we can’t afford not to do,” she said.

The Healthcare 20/20 2011 conference, under the title ‘Healthcare Economics: the search for quality & affordability’ will feature international and local speakers, including Health Minister Mark Scotland and HSA CEO Lizzette Yearwood, as well as  Dr Jennifer Attride-Stirling, the CEO of the Bermuda Health Council, the Hon Elinor Caplan, CEO for Canada Strategies and Renee-Marie Stephano, the president of America’s Medical Tourism Association.

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  1. Anonymous says:

    I wonder if this estimate of the cost of free helthcare includes any element of the free healthcare received by government workers and if so, what the percentage is?

  2. Anonymous says:

    Yes! Cayman absolutely needs a "culture shift". What were we thinking by allowing everyone to get treated when ill or injured regardless of their financial situation? From now on, let's do it the right way and let poor Caymanians and expats die out in the streets.

    Fortunately Cayman is a Christian country so the poor people who die will go to heaven.

    Keep up the great work Minister Scotland. No more freeloading children, elderly and poor people getting their broken bones reset! No more free antibiotics for the dying! Enough is enough.

    After all, what would Jesus do? You don't think he would heal everyone, including the poor, do you? Of course not! Only the insured and financially able, need apply.

    • Anonymous says:

      Too funny.  If you think expats are getting any of that free medical care, guess again.

      • Anonymous says:

        Any civil servant gets free medical that would include the expats that are civil servants so try again.

        • Anonymous says:

          "Free" is maybe not the right word, although it is semantics, healthcare comes as part of the salary package, ie healthcare premium is paid for as part of benefits package for civil servants. Free healthcare would be where someone gives nothing back, (and before all the civil service bashers start on their "civil servants do nothing for their pay blah blah…" stop generalising and denegrating and insulting the majority of civil servants who do .)

      • Anonymous says:

        Err, actually, some are, I'm an expat who knows an expat who is!  I'm saying no more though.

      • Anonymous says:

        Actually they do. The minister himself gave me an example.

  3. Anonymous says:

    sound like a great idea mr S. When are YOU going to start paying?

  4. Anonymous says:

    FOI request CNS can you do an FOI request to see if tax on insurance policies is being collected and applied correctly? (see post below re Health Care Regs)

    CNS: Anyone can do an FOI request and you can do so by email anonymously. Here's the link to the Freedom of Information Unit's website which tells you what you have to do. Let us know when you get a response.

  5. Yo Mamma says:

    Yes! Cayman absolutely needs a "culture shift". What were we thinking by allowing everyone to get treated when ill or injured regardless of their financial situation? From now on, let's do it the right way and let poor Caymanians and expats die out in the streets.


    Fortunately Cayman is a Christian country so the poor people who die will go to heaven.


    Keep up the great work Minister Scotland. No more freeloading children, elderly and poor people getting their broken bones reset! No more free antibiotics for the dying! Enough is enough.


    After all, what would Jesus do? You don't think he would heal everyone, including the poor, do you? Of course not! Only the insured and financially able, need apply.


    • Joe Mammas says:

      Right.  Taking responsibility for your self is not what Jesus has promised Caymanian Christians.  So the free healthcare and Nation building is Gods work.


      So to the people that end up paying for all that be comforted that God will have your back next time around.

  6. Anonymous says:

    It has also been said that anything free is no D___ good!!!  Why not get free groceries and free gasoline and oh yes, free rent if health care is going to be free?   Get real people.

    It is called living on a budget!!!   Get your children educated, go to church, eat right and start looking into the cost of things.   Pay for what you get and be thankful to have the doctors that you have.   We pay teachers, plumbers, electricians, etc.   Why should doctors not be paid too.   Free health care is NOT a right!

    GROW UP!!!

    SIGNED, very thoroughly read and up on the different health options!!!!

  7. Anonymous says:

    How about free healthcare must continue!  Many of us work all our lives without a claim and then suddenly at 60 or 65 we are not insurable (and are most likely to need it)  I would happily pay a health tax to support our senior citizens

  8. Anonymous says:

    Instead of Government turning to profit off of patient's pain and illnesses as it appears the Chief Officer and Health Minister want to do by espousing the American health 'scare' model, perhaps they can look into ways to defray the rising costs of medical expenses brought on primarily by lifestyle choices.


    Beginning this 2011-2012 school year, if you smoke and want to work for (or keep your job at) the Palm Beach County School District (the largest county employer with about 21,000 employees), you will have to pay $50 per month extra for health insurance, or $600 extra per year to smoke, because studies have shown that medical costs such as hospital stays are higher for people who use tobacco than those who do not, so the surcharge is directed toward those employees who use tobacco as an incentive to quit.  The School District has a written policy giving hiring preference to nonsmokers, and is also offering a wellness rewards program in which employees were asked to get a series of "biometric screening" tests such as cholesterol, body mass, blood work done and complete an online health assessment by 1st August.  Employees who did not complete the wellness rewards program also will pay about $600 more per year for insurance than employees who did complete it.


    In 2010, New York smokers started paying thehighest cigarette taxes in the U.S. after an increase of 58 percent pushed some prices to almost $11 a pack, but nationwide, cigarette tax increases annually spurred more than 140,000 adults to quit smoking and raised more than $561 million in annual revenue, according to the Campaign for Tobacco-Free Kids.


    In 2009, with advice from Government's legal department and handed a new budget that was slashed causing her to drastically cut expenses across the board, the Chief Tax Collector in Palm Beach County instituted a policy that she would no longer hire any new employees who had regularly used tobacco in the previous 12 months, citing the higher health insurance costs of smokers.


    So, where poor personal lifestyle choices and our indulgences have us end up with lung ailments, high cholesterol, obesity, and the list goes on, which in the end costs more in medical care,  only when it hits us in the pocket will most of us dig deep within ourselves and change our behavior and lifestyle choices. 

  9. Lotto Woman says:

    One very easy solution is a Cayman LOTTERY. Everyone in Cayman supports it, they are buying Florida Lotto or already playing numbers. The Churches, schools, sports and social clubs have their "fundraisers" which are simply lotteries (buy a ticket for a chance to win something). First question out of church on Sunday is "what number played?" 


    I ask the UDP and PPM to come together and support a LOTTERY now, get it going and you can then pay these poor people's health bills. 80% of the people support it.

  10. Anonymous says:

    Doctors and Hospitals for profit, now how is that for prosperity and progress? thanks to tax paying citizens and countries like the UK, Germany and France now that I am about to enter my golden years and will need more medical attention than I did 30 years ago I am able to sell what I have here in Cayman and reinvest it in a country where I will have to pay taxes but atleast I know that I won't have to die or end up with substandard health care just because I did not have to pay direct taxes.  Again it proves that two things are for sure taxes and death, seems as if there's no getting away from either, suffice it to say they both catch up with you in the long run. 

  11. Anonymous says:

    I believe Mr Scotland said when he first took over the portfolio that we needed to do away with "preexisting  conditions" which gives the insurance companys the right to not insure people that have a history of certain illness or just age.

    Funny how that has not come up again.

    Now he wants to make sure everyone pays for medical care.  But he is backing down on one of the things that makes it unavailable to attain for a lot of people.

    Proper medical care is a right in almost all major county's in the world with the exception of the US.  Those with socialized medicine in most cases have a healthier populationby all measurements.

    It should not be: if you have money you get care and if you don't your suffer.

    Insurance company's are not in business to look out for our health!  They are in business to make a profit for their stock holder.  (Kind of reminds you of our politicians doesn't it?)

    Step up to the plate Mark.  Put a bill on the table that does away with the exclusion of preexisting conditions or be prepared to have government pay the medical cost of those shut out of the system because of a lack of caring on the part of elected officials who opt to back the insurance company's.

    Mark, what say you???


    • Anonymous says:

      Swindles of 'patient dumping' by insurance companies who try to get away from their obligations of treating ill patients will kill more people when a bill makes it law to exclude pre-exiting conditions.  Go to Blockbuster, or the library for free, and check out the DVD "Sicko" by Michael Moore, a documentary on the American healthcare system, which compares their system to countries like England, Canada, Cuba and France.  Then tell me you don't cry or throw up by the end, being sick of how heartless these insurance companies and pharmaceutical companies are, just so they can make a profit chasing the almighty dollar like medical tourism supporters in the Cayman Islands want to do.

  12. Bueller says:

    Is this a quote from Tomlinson, CNS?


    >“Ninety per cent of them end up dying anyway, even once all that money has been spent,” he confirmed.


    Pretty shocking from a Doctor, if it is

    • Anonymous says:

      I agree.  CNS, is this quote really from the Health Minister Mark Scotland, who is the Member responsible for health care in the Cayman Islands…"Health Minister Mark Scotland said that government policy had been to blame, which allowed everyone healthcare, regardless of whether they could pay or not, and regardless of whether that healthcare required expensive overseas medical care."


      If so, he does not appear to be the best qualified candidate to be the final answer for Cayman's Health Ministry, because any policy directives implemented will most likely reflect his position, which will ultimately compromise the care that people receive at a time in their lives that they are in no condition to battle for access to proper medical care.


      Let's get real:  the fact is that as a British Overseas Territory, the Cayman Islands CANNOT contravene the United Kingdom's legal framework while remaining dependent.  Just like the Cayman Islands spent $300,000 to design and construct gallows back in the 80's and were ORDERED to tear it down because of England's stand on the death penalty, it is hard to believe that CNS would quote the Minister as saying that government policy which allows everyone healthcare is to blame, because a knowledgeable person such as himself should know there is very little (no, let me break this down…NOTHING) that can be done to ABOLISH BRITISH GOVERNMENT POLICY OR BRITISH PEOPLE'S MENTALITY OF SUCH A BASIC HUMAN RIGHT AS FREE HEALTH CARE. 


      You want to see a RIOT in the United Kingdom?  Let the Minister responsible for Health over there in England say the same thing, and try to change government policy and see how quickly he'd be sacked and how aggressively people would react!  Looking at forum panel for the annual conference, it appears he is in bed with the Americans, and therefore, belongs on their team working for them since this is a position they embrace also, instead of being in charge of my medical policy decisions.

    • Anonymous says:

      Wow!  My sister had the option to pull the plug on her newborn son years ago, and all these years later spending the amount of money she has, it is unbelievable that someone who took the Hippocratic Oath that doctors take of "first do no harm" could say such a statement.  Yes, we all will die at some point, but I don't know any friend of mine that covets money with that much greed that would gripe about spending money to save a human life, even if everything that was explored failed. 

    • Anonymous says:

      What he should also say is that 90% of patients also are left here far too late before our hospital and system sends them overseas.  A doctor in Miami once told me that by the time they get the Cayman patient it is often too late for them to do anything and that the Cayman Islands keep patients here too long before sending them—I guess trying to save money.

      • Anonymous says:

        "A Doctor in Miami"??? Oh there is a real impartial opinion devoid of financial motivation for you! Yup, straight from de mout' of de Oracle at Delphi!!!! Sheeesssshhh!!!!

  13. Anonymous says:

    Good speech Ms Ahearne! Does anyone believe Mark actually thought about this and wrote it? Please! It's an issue that has been going around government for years but noone wants to take it on, of course.

  14. Anonymous says:

    Yes the chickens are coming home to roost, by this I mean, how in the world do you expect to have 1st word conditions without any form of direct taxation while doubling the population. This kind of thinking is only a farce and cannot happen.  Things were much easier to manage when the population was smaller and the demands for services were less, no but we want to have our cake and eat it too, can't and won't happen in the real world. 

    If the population continues to increase at its present rate there will be no other option than direct taxation, like it or not that is just the facts.  Well, I just hope that the government, business community and chamber of commerce will be able to come together and find the right solution to thisproblem before it becomes worst.  Should we allow people to die if they do not have the money for health care?

    The UK and the rest of Europe expecially France does not seem like such a bad option now atleast if you pay taxes you will have free health care. 

    • Lazarus says:

      You and the other buffoons who continue to propose direct taxation think it will be like turning a switch, and Voila !  Direct taxation for all.

      The country can't manage to enforce laws & rules in respect of pension deductions and health insurance premiums, so what makes you think direct taxation will work ?

      Just say direct taxation comes in.  Who is to enforce its application across all employees and all employers ?  Once I have my X% deducted from my salary, what guarantee do I have that my employer will account for it correctly and pass it over to the authorities ?  And who will take action if that money isn't paid over ?

      Then there's the concern about how the money will be used.  I hardly think it fair for employees to contribute a tax, and yet the politicians and big-wig consultants for the govt continue to fly away on expenses-paid jollies with no obvious result or benefit, except for their own wallets.

      Oh and don't forget that a direct taxation scheme will involve many administrators and bean-counters to collect, account for and report all of the tax collections, so there will be a surge in civil servant employment, driving up the cost of government.  Will the cost of tax collection outweigh the tax actually collected ?

      And of course people can't afford a tax right now anyway.

      Then there's the debate about who is to pay tax.  Do we tax foreigners even though they have no say in the direction of the government or the country – "No taxation without representation" ?

      Too many issues.  Direct taxation is just a non-starter.

      • Anonymous says:

        Lazarus you are so right, taxes could and will never work in Cayman.  I for one will not blame the government when they do not dole out free medical because no one should be entitled to free medical, we all make good money and have jobs and health insurance so I fully agree with the minister of health about people having to pay for their hospital bills and you hit the nail right on the head when you say "No taxation without representation" again nothing for nothing. 

    • Anonymous says:

      You are absolutely correct. The sooner we all understand that our future obligation to have healthcare available to our elders the better. We are fooling ourselves to believe we have a magical model in cayman to not contribute to a healthcare fund today and have healthcare available when we retire. It has not been a major issue because of our continued high growth experienced in the past in our economy which will eventually levelize.

  15. Anonymous says:

    Yes-but also do the 'Means Test' to prevent children of millionaire parents from receiving scholarships!

    Yes they may be bright – but if a bright poor kid needs help give it to him instead (even if its to a trade school).  There are many such cases of lost / undeveloped potential here.

    BTY – how many kids of government MLAs send  their kids to public schools – and what does that say?!!

  16. Anonymous says:

    Welfare state

  17. Anonymous says:

    Workers/slaves who make the minimum wage of 5 dollars should be able to pay for healthcare…not.

  18. Anonymous says:

    Mr. Mark Scottland are you going to give us all a promotion at work or raise our pay?  We the poor people who have kids and high costly  CUC bills don't have the kind of money you MLAs have.  No Hospital should ever turn anyone away because of not willing to pay!   Majority of us do not have insurance simply because we can't afford it.  Why dont the Cayman Island Goverment try to work out ways like the U.S.A for etc..(medicare) taxpayers money go on these important things….even though Cayman is a tax free Country things can change so how about y'all start taxing  the expats that have businesses here in Cayman and make that money go towards free heatlhcare for the Caymanian People.  We can call it Caycare!

    • Anonymous says:

      I agree with the first paragraph but not the last – The expats would get up and leave, so try it.  They already pay for your standard of living and have just about had enough,  they don't need any more taxes on their shoulders, thank you very much.  It is people like you who give your fellow caymanians a bad name.

    • Anonymous says:

      Because all of the Expats with compaines here would probably leave if you started taxing them.  Then we wouldn't get the health care.


      I don't see why for example government empolyees get free healthcare.  Everyone else has to pay in the private sector why not those payed by the givernment too?


      In the UK government employees pay the same tax as everyone else to get their "free health care"

  19. Anonymous says:

    Indigent Tax…….  

    There is a "tax"  on all private health insurance premiums to pay for indigent persons, I wonder if this is being collected and used for the purpose? (see below)


    Also seriously time to start charging for prescriptions, (and maybe even hospital appointments??) if a nominal fee was charged then perhaps people would not go running to the hospital to get ibuprofen and cough mixture for free. Set the price of a prescription higher than generic pain meds available at pharmacies and supermarkets. This would have 2 effects…first bring in some revenue, and secondly save the country a ton of money because fewer people would go to the hospital for consultations when they simply have a common cold…… Special rates for the elderly and chonic ill could be set to prevent hardship….(rate could be zero)


    Health Insurance Regulations 2005

    Healthcare for Indigent persons


    5. (1) The Commission on behalf of the Government shall, in order to cover medical costs for indigent persons, collect from-
    (a) each approved provider, five dollars per month of each premium charged by the approved provider under each standard health insurance contract effected by such provider in respect of an insured person with no dependants; and
    (b) each approved provider, ten dollars per month of each premium charged by the approved provider under each standard health insurance contract effected by such provider in respect of an insured person with dependants.
    (2) Where the Commission considers it necessary and in the public interest, it may, after giving three months’ notice in writing to the approved insurers of its intention so todo, vary the amount to be paid under subregulation (1), and such variation shall be set out in a notice published in the Gazette.
    (3) Payments collected under subregulation (1) shall be paid to the Commission for payment into the segregated insurance fund established under the Health Insurance Commission Law, 2003.
  20. Anonymous says:

    I could only wish my healthcare plan in the U.S. covered Tummy Tucks, Breast Lift, Gastric Bypass…..and all of the follow up visits to another country!

  21. slowpoke says:

    In addition to funding prevention, we have to move away from all these "for profit" insurance companies, seeking to cherry pick their clients from a small pool.

    We need a single, not for profit, insurance plan that covers all primary care.  It is the only way to ensure that all are covered AND that costs can be controlled.

    Please, please, please do not continue to follow the US model.  Other than for the wealthy, it is the most expensive and inefficient , of any of the models used by developed countries.

  22. Anonymous says:

    Civil Servants Health Insurance premiuns keeps HSA in the black. 

    Have a look at the financial statements of CINICO. If you examine last years records you will see that CINICO made a profits from all the health insurance premiuns paid to them from cival servants. From these premiums CINICO was able to cover the cost of care to indigients, seamen, and verterans and civil servants, AND made a profit. Majority of this money went to the HSA.

    The down side of this is that cival servants have to use the facilities and services of the HSA. Civil servants have to pay 100% for ALL medical treatment not offered by the HSA.

    People are demanding that civil servanst pay the 20% co-pay like private sector which seems like a good idea – it should decrease the cost of health care. BUT civil servants will demand that they have access to health care from both private and public providers which may result in 50% of HSA revenue going somewhere else – increasing the cost of health care for the goverment in the long run.

    What the government needs to do is re-exam in the health insurance law and make the private insurance companies pay a percentage of the profits into a fund for those individals in need of assistance. Private health insurance coverage is obviously making a profit.

    And HSA needs to have the ability to charge private health insurance the true cost of providing health care instead of using outdated prices. Also goverment needs to give the HSA the ability to increase prices without them haveing to go the Legislative Assembly every time HSA needs to increase prices.


  23. Anonymous says:

    Part of the problem is that a lot of the health care providers are not operating in a way that allows someone who holds a full time job to get any care within a reasonable time frame and in some sort of effecient manner. It blows my mind that a GP (for example) can close their office at 5 p.m.which is the time when most people get off work. If you go during the lunch hour, you likely sit and wait at least for an hourbefore you actually get to see the doctor and god forbid if you then have to go for further tests etc. It is just not feasible. There needs to be a way where people actually can get to see a doctor without causing issues at their work place or having to take half a day vacation! I know it turns off a lot of people from seeking care at the onset of a problem and they wait until things get a lot worse. Also, in many cases the cost is just outrageous and patients are expected to pay upfront and then claim back from the insurance companies. I can't tell you how many times I have been at the doctor and had somebody look at me for 10 minutes, I was shuffed out the door with a bad of meds and got a bill for some outrageous amount, without any conclusion to what my ailment actually was. This needs to change – people need to be encouraged to seek medical care not be turned off from doing so.

  24. Anonymous says:

    Free healthcare is a form of preventative measure that the government can allow to ensure that the population stays healthier. just tax the hell out of something else like the causes of most health issues like tobacco, alcohol and politician's promises.

    • Anonymous says:

      Why should milk and water cost more than beer and liquor for the same quantity?? Double the duties on alcohol and Cayman will be SOOO much healthier!!

  25. apprentice says:

    I tend to not fully agree with Mark on this one. I don't believe in direct taxation in an unworthy cause like to fund war or fill politicians pockets. But I do believe in direct taxation for healthcare, free education (up to first 4 years in college), rehabilitation, and poor people relief. If everybody is taxed on this island for these four things, I believe that would solve most of our the problems in Cayman. It would help to alleviate the temptation of crime as well. However, just let me say this:  I am not advocating the UK impose income or any other direct  tax on us or on financial industry. I am only suggesting these four things only – HERP.

  26. Anonymous says:

    well,  well,  well, nothing new here. guess who started this, i'm entitled to attitude.

    inforce the pension, medical, immigration, traffic, social servicese's, company license and all other laws and the country will be better off. it will also reduce crime.

    this politicking (hand outs) for support must stop now.

    everyone know what's wrong. stop wining and do right now, whats needs to and must be done.

    the country is more important than winning the next election.

  27. Anonymous says:

    I believe the health insurance companies are getting ready to shift group rate plans to single out people who are getting free insurance or who could have pre existing . They also will only give you the basic plan where it will only cover $100.00 for outside treatment while paying under $200.00 a month. What a rip off 2400.00 per year for $100.00.  But of course they are complaining. 

    CINICO the company that Gov't help create made a profit . While paying all the seamen and veterans and drug addicts and poor people during a recession . So why are they complaining now? Greed.

  28. Anonymous says:

    This free health care he is speaking of means that they will be moving Civil Servants away from having free health care.  They should pay for the health services just like everyone else.  How about moving them all off of free health care and having them pay health insurance and then paying the 20% like everyone else.  Also have these civil servants go with a private insurance company.  Does the public realise that the free healthcare extends to not only the Civil Servant but their spouse and dependants?

    That lump sum of individuals off the public health care system would ease the problem.  Leaving the elderly, seaman, veterans, pensioners  and indigents. That is a significantly smaller number of individuals.

    Maybe with all these individuals off of the free health care, the money could be better spent on improving the services and number of high caliber docters?

  29. Anonymous says:

    I ask Mr scotland have u and your office actually analysed monies spent by directors across differnt govt depts, authorites and ministries……there is alot of money to find there.

    I work for a  dept with two  directors who spend govt monies like the won it from a state lottery….perhaps other readers can relate to this or not.

    They have no concrete plan of execution as they constantly fail in respect to deadlines, always having to re do work even if other team members have pointed out flaws in their "guessing game"(costing the department thousands in office supplies alone) they have hired buddies in senior positions who jus cruise along their days working with inferior methodologies and who lack the experience to make a positive and efficient step forward for the team(so u can add their salaries to the pile with wasted monies).

    Now we consider the serious cash spent on traveling around the world available to a selected few  for training and development, some of you might say well training is necessary(i agree)however after these expensive training trips not once  have they ever transpired into changes for the department(good or bad) jus a little time out of the office …lets call them mini vacations….more wasted money on the pile!

    Whats the funniest thing is that i have not even mentoined some of the more abusive ways monies are being spent….

    take a closer look mr scotland if your interested in the truth!

    Yeah and as for  health care…Tomlinsons opinion on this topic means nothing to me or should to anyone else….point is if civil servants have to start paying they will choose his hospital(i do) so i wonder who he is  really looking out for…..

    How about some proof that HSA losses were not because of poor business practices…???? Strung together words should not cut it anymore Cayman!






  30. Anonymous says:

    Why not let government workers pay for a portion of their healthcare?

    • Anonymous says:

      Won't be a problem for Government Workers.  They won't complain- just as long as they have a choice as to where they can go to receive their health care.  You can't force people to pay directly and then tell them they have only one go to Government's dentist, GP, or optician.  

      That's communism buddy.

  31. Anonymous says:

    I agree with Mark, only UDP members and christians should be alowed to have healthcare.

    The poor, sick from hard labour, should not be a burden to the wealthy.

    Many people HAVE no insurrance, because they are refused by insurrance companies. Then only cinico is an option, that does not cover all treatments.

    Many employers don't pay health insurrance (and pension).

    "A nation's greatness is measured by how it treats its weakest members."

    I am again disgusted.

  32. Anonymous says:

    Free Health care has to stop, says Minister = some or many people will die as some people simply can not aford insurance/health care many of them may be umemployed other may work as domestic helpers. More over some employer are illegally breaking the law by not offering medical and insurance for their employees  and what is the government doing about it – SIMPLY PUT NOTHING! What is the Minister Mark Scottland doing to control the rising cost of health insurance/health care?? Every year the premiums and cost for  are rising people simply can not afford to pay for a premier health plan and have to choice but to get the standard plan. The standard health care plan should have more benifets – Only one doctor visit per year?

    What the govenment/minister needs to do is to make civil servant contribute to their health insurance.For hundreds of civil servant and their families to have free health care is foolishnes. Civil servants should be required to pay 50% of their medical insurance just and every citizen who works in the private sector. I would like to know what much the HSA/government is paying for their civil servants and their families per annum? I'm pretty sure its in the millions – THIS IS THE REAL issue which needs to be addressed and they are the one wirth free health care!

    • Anonymous says:

      anon 0757 I as a civil servant have no issues with paying, but you cannothave your cake and eat it too. The civil servants will simply say if you want us to pay then we must have an option to go elsewhere but the government hospital. You dont even realize it but that insurrance is a disadvantage of sorts.

  33. Adam Smith says:

    Free health care properly managed is a far more efficient way of providing health services than an insurance based model.

    • R.U. Kiddin says:

      Maybe so, but I've never seen free healthcare properly managed…..  Have you?

  34. Anonymous says:

    cayman need means testing for all types of social welfare assitance…..

    anyone who recieves government support should be means tested…… some times the poor are not so poor….

  35. Anonymous says:

    Sorry Mark, while I do believe that those who can afford it, should certainly pay their fair share and that civil servants should also be required to pay 50% of their premiums, I also believe no one should be turned away from a clinic, doctor's office or hospital because of lack of money or health insurance.   Health care is the basic right of all human beings, no one should suffer ill health because they can' t afford health care.   While you are at it, how about Govt. stop giving away millions of taxpayers money freely to churches?  How about Govt. stop paving people's private parking lots in the Brac and elsewhere freely?  How about Govt stopping the excessive travel for Govt. ministers who go on expensive jaunts globally in the guise of seeking investors and have nothing to show for it?  How about Govt. ministers stop doubledipping and taking both salaries and pensions at the same time?  How about Govt. ministers taking the promised paycut that they should have taken when the civil servants pay was cut? This is called leading by example.  How about Govt. ministers stop going on retreats to sister islands, and just simply meet at their new Govt. building which cost so much money to build (surely they have meeting facilities there), and brainstorm there the whole day about their performance and come up with fresh ideas to lead the country out of this mess?  How much did that retreat to the Brac cost the taxpayers who paid th airfare, the hotel stay, the meals, drinks, transportation, etc.?  How about Govt. simply stopping the wastage of public funds?  How about Govt. stop inviting bids for projects, letting potential developers spend millions of dollars and then firing thm, thereby inviting costly lawsuits which end up costing the country more?    Do you see my point.  Some of those savings could go towards taking care of the health of those who are most vulnerable, i.e. the indigent, veterans, elderly people, etc. Govt. finds money to do the things it considers important, but not what is truly important.  You might just find that once you stop the wastage, you will then have enough money left to take care of the more important needs of society.

  36. enviromentalist says:

    There is an underlying problem, and it involves all of the govt/civil servants. All govt staff are entilted to free healthcare for themselves and their familys. This is a HUGE cost to the country. If the govt would provide "the minium required coverage" as is necessary for any private buisness, to their staff, then costs would be signifigantly lower. People dont seem to get as sick when their coverage has been exhausted, or use their medicial benifits for every sniffle or cough. Just a thought.


  37. Anonymous says:

    Scotland … If you are going to say the bills are uncollectable you should at least admit that often this is a result of a refusal by Governmant to robustly pursue claims through the courts, not just a failure, but direct instructions not to enforce the maintenance law, and a total failure to enforce the health insurance law.

  38. Anonymous says:

    When we opened the flood gates, we opened a can of worms.  People who have illnesses need help but when they are contributing to their illnesses by smoking, the line should be drawn there and then.  Most of these folks are not paying proper attention to their health by eating healthy, thereby reducing governments liability.   Healthy people results in a healthy nation.

    • truth says:

      People who do not take responsibility for themselves are a liablility to their country period.

      A country of people who cannot take responsibility for themselves is doomed to financial failure.  O look!  Its happening here.  And no one will take responsibility to stop it. 

  39. Anonymous says:

    Wait a minute! Dis is my island. You can't do that!

    • Work at hospital says:

      This is too true.  The amount of people that THINK the hospital is FREE is just ^@#$ crazy.

      Grow up, go to a doctor for your sniffles, andpay your bills.  The free ride is OVER!

      Just ask any doctor who has worked and served this community here for the past twenty years, it is NOT the poor who do not pay their bills, it is the civil servants and the wealthy who think becasue of their birth-right they do not have to pay.  That is wrong!!!

      If you are reading this, ask yourself…"Do I owe any medical bills?"  if so, then do what is right and PAY UP.  


  40. Anonymous says:

    What is wrong with the system is that government allows double standards. Many people cant afford healthcare so they don’t have regular care thinking that they have no way to pay it back and then when there is a huge emergency, government ends up covering the costs anyway.It has been proven in countries where free healthcare is available to all citizens that the people of that country are much healthier, there by reducing the incidences of emergency medical care caused by neglect of health. Personally, I believe in free healthcare for all citizensacross the board with an encouragement for people to live healthy lifestyles and for them to take advantage of free healthcare for preventative care.The US model of healthcare doesn’t work and encourages people to neglect their health when it doesn’t fit in to their financial budget.I read an article just a few days ago where a young man who had a toothache caused by an abscess had to choose between antibiotics or pain medication. The young man chose to buy the pain meds since that was all he could afford. That choice, made because of limited finances, cost the young man his life when the infection travelled to his brain. That was totally preventable, but because of the insurance and healthcare industry, the young man lost his life. Free preventative healthcare with a focus on healthy living is the most sensible approach because it will actually lower the government’s overall costs and keep people healthy.

    • Anonymous says:

      You should only have what you can afford.  OItherwise "others" pay for it. Is this fair?  Wait wait.  this is Cayman its been fair here forever.  But its not fair anywhere else and shouldn't be here.  Responsibility is something that Cayman hasn't learned and isn't taught.


      • Brotherhood says:

        Such a shame you believe the world is a level economic playing field! Not everyone will be needy of welfare because they are lazy and refuse to work. There are those who are victims of circumstance and their dilemma should not deny them proper healthcare–we are our brother's keeper and everyone is entitled to live and receive proper healthcare despite their limited means! No wonder there are those who turn to crime, because of people like you who are caught up with self – me, myself and I! Not everyone is poor because they are lazy.

    • Anonymous says:

       So in your story this young man (who could afford food, shelter,etc.) could not afford to go to the dentist or doctor and died becuase of it? Really?  Because of this you would expect him to be intitled for healthcare that is to be payed by someone else?

      I live in the US and Pay well for my great healthcare and it works for me. But I don't want to pay for anyone elses health care and I don't expect anyone else to pay for mine.  Its called responsibility.  And it works great IF you are a responsible person.

    • B.B.L. Brown says:

      Free healthcare sounds good, but NOTHING is free!  You said it all when you said the U.S. model of healthcare doesn't work. 

      • Anonymous says:

        Of course I didn't mean completely FREE, that's impossible. The money has to come from somewhere (as it already does). And since we can find money to give to churches and "nation build" etc… wouldn't a more economical, intelligent and forward-thinking way to distribute those monies (that come from all of our pockets) be better spent by making preventative healthcare available to all citizens free (at the level of healthcare facilities)?