CS will want more benefits if charged for health cover

| 21/11/2011

(CNS): Government is currently reviewing the need for civil servants to start paying towards their own healthcare cover but they will want to see proof of extra benefits if they are forced to contribute, Dr Paulino Rodrigues, of the Cayman Islands Civil Servants Association, has said. The senior civil servant said that government workers don’t perceive healthcare as “free” but as a benefit of around $1,000 per family per month, in lieu of other perks common in the private sector such as share options or pay rises. “We would have to see deep discussion and proven benefits if we were required to pay an extra $500 a month, for example,” he said at last week’s national health conference.

Speaking on a panel looking at the patients’ role in reducing healthcare costs at the government sponsored Healthcare 20/20 conference atThe Ritz-Carlton, Rodrigues told the audience that if local civil servants are to contribute to their healthcare, as private sector employees in the islands was required to do, they need to see something for it.

Healthcare covering civil servants, veterans and seafarers and indigents cost the government $93.4 million in the 2009-2010 financial year, or just less than one fifth of the total budget, a figure which both the premier and the health minister have stated is unsustainable.

Jennifer Ahearn, the health ministry’s chief officer, said they were currently reviewing expenditure in all areas, andlooking at whether civil servants should pay something towards their healthcare and their overall benefits package in general was definitely “on the table”.

The preliminary findings of a civil service survey revealed that most civil servants are relatively happy with their present healthcare coverage from the government’s health insurance provider, CINICO. But they are not satisfied with waiting times and have issues with the quality of care and lack of specialist service.

Rodrigues presented these initial findings to the audience, saying that he represented the 4,000 civil servants and their dependents, which totaled between 12,000 and 15,000 individuals, or about 20 per cent of the population. The survey of 30 questions was sent to all civil servants and they had so far received responses from about 20 per cent of them, which he said was “pretty good”.

Talking about the liability of civil servants when it came to healthcare costs, Rodrigues said that most civil servants were healthy and that most healthcare costs came from the very young and the elderly. “The vast majority of civil servants don’t use the healthcare system that often, only about 4 per cent,” he said.

He did concede, however, that about a quarter of civil servants or their dependents had pre-existing conditions which required long term healthcare provisions. Rodrigues added that the civil service was open and willing to look at where costs were coming from. “We will work with the Ministry of Health, CINICO and the Health Services Authority, whoever can help to reduce costs,” he said. 

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  1. Anonymous says:

    I wish as the speaker representing the civil servants says, the average person in the private sector earns $3000.

    May I suggest, the civil servants who complain can move into the private sector as they consider it very rosy.

  2. Anonymous says:

    I agree with Dr. Rodrigues, FAIR is FAIR!  People would want the same thing done to them in the private sector.

  3. Anonymous says:

    Most civil servants make less than 3k a month. In general there isn't anything left at the end of the month.

    If they were to lose 500 to a 1000 a month, there will be a lot of foreclosures.

    Healthcare should be available to everybody, not just to the people that can afford it (the american way).


  4. Anonymous says:

    As a country I believe we are focusing on the wrong end when we are amending health care benefits and privileges to a point where a lot of people can no longer afford it – in the long run, this will work against us. Other countries have recognized that prevention goes a long way and encouraging people from making use of regular check-ups etc is much more beneficial in the long run, rather than discouraging people from going to see a doctor. 

    Proper health care in this country is out of reach for a lot of people and it shouldn't be! I would welcome if someone would put the same effort in to researching why health care here is so expensive and these insurance companies get away with "literally" murder.

    If it is strongly felt that CS need to pay a portion of their health insurance, I sincerley hope that some rational is applied where perhaps people below a certain annual income are exempt from having to contribute, or where smokers have to pay more than others etc. Don't paint everyone with the same brush.

    I would have much rather seen if government would make an effort to reduce spending in other areas. Take away cell phones, government vehicles for personal use, travel privileges etc. There are a lot of ways spending can be reduced.

    Health care is not where you want to start saving.

  5. Anonymous says:

    civil service is an anchor around caymans neck…… unless a government has the guts to tackle the massive cost of civil service…… this place is doomed…..

    • ThisIsOnlyGood says:

      There is a good deal of fat that the government can cut from the Civil Service. But to appreciate how hard some people work for the comparatively low wages they receive is sad. You would have to work in government to understand that.


      Yes, there are slackers. They need to go. Yes, there is frivolous travel perks and wastefulness from the the higher-up civil servants. I have seen it and it needs to be curbed.

      But, if Civil Servants start paying for health care, can they please then have a choice as to NOT have to use HSA? It is not worth paying for, to be honest.

      P.S. what government really needs to get rid of in the Civil Service is the MUZZLE they have preventing them from expressing views, giving ideas, and all of that. It is only holding back the country because those who are outside of the Civil Service only get half the picture.

  6. Anonymous says:

    CNS – Look forward to your other articles on this three-day talking-shop. Did anyone have any ideas about reducing health care costs?


    CNS: More to come. Remember to check CNS Business.


    Doctor reveals key to affordable quality healthcare


    Local workforce must be priority for medical tourism

  7. Slowpoke says:

    It is really frightening that when these issues come up, there is a race to get to the lowest common denominator.  "If I don't get it, if I have to have a co-pay, if I have a deductible…" then "they" should too…

    Stand on your head, the real issue is that you too should not have these deductions and should  be demanding comprehensive primary care coverage.  We are copying the US system, and if you read or heard about the cost/benefit/results analysis comparing that to the rest of the world (with universal coverage) presented at the health care conference, you would understand that we are headed in the wrong direction.

    • Anonymous says:

      That breeds a welfare state and other countries are having issues with it.  Why should Cayman do that to further add to the debt.  Cayman has no exports remember.  Please explain how it would be funded? Taxes?  Have you forgotten that all those countries that you compare Cayman to pay taxes.  If you would prefer that then let us go that route otherwise it should stay as is and pay for usage. 

      • Slowpoke says:

        There are unfortunately, many misconceptions with your opinion.  1.  We already have taxes.  2. A universal plan is consistently cheaper because the risk is divided among the whole population, the insurer has more bargaining power, and there is not a for profit motive.  3.  Health outcomes, measured by such factors as infant mortality, longevity, etc. are cosnsitently worse in US style pay-as-you-go coverage.  4.  And much more…


        In summary, it would actually be more cost effective to move to universal primary care and give Cayman a competitive advantage business wise as well as increasing healthy outcomes.

  8. Anonymous says:

    Yes the private sector gets a lot of perks and pay rises! But still the Civil Service pay is a lot better, job security is much better, the civil service health benefits are a hell of a lot better than those in the private sector! Seems like we have a very ungrateful bunch of civil servants!

    • Anonymous says:

      How are the health benefits better, when the only place Cinico can be used is at the GT Hospital?Please explain yourself.


  9. Anonymous says:

    If the non functional financial record keeping entitiy of the CS is any indication of value for money spent before they get any more money for anything else there should be an accountability study done to see if paying all of these clowns all that money over all those years has actually had any value for the NON bush tribes of the island.  It would appear not.  If they would all stay home for a week would there be any difference in service?  And I mean service to anyone not already being subsidized from the publics purse.  CS will want more benifits?  The rest of Cayman would appreciate some benifits from spending all that money on them and their families first.

    • CaymanHeretic says:

      um I think teachers would be missed and refuse collectors to name but two 'civil servants'

  10. Anonymous says:

    I think I must have misunderstood Mr Rodrigues, how can only 4% of civil servants be using medical services with a 25% figure of pre-existing conditions, is that pre-existing conditions that require no medical attention?

    Or the $90+ million cost per year for, lets say, 12,000 people, that's $7,500 per year per person and if you use the 4% usage number that means that there are, only 480 people using the services at a cost of $187,000 each per year!

    I think there are some holes in the statements made.

    There are always going to be social differences in remuneration, all that anyone really wants is an affordable, sustainable and equitable solution, the goldilocks scenario.  Also a degree of social mobility where good work results in promotion, bad work demotion (don't take those words literally, consider promotion as better pay etc.).

    • Rick Berns says:

      There is a hole somewhere, but the figures are quite fine. CINICO coverage total includes many groups who are not Civil Servants, many of whom never worked for government. Mayby your retired or too old relative that you refuse to accept responsibility for is one of them?


      Most Civil Servants would agree to pay something for mobility and access to better primary care. The service we receive is not free. We work for it. It is a part of our agreed benefits. What the 'fees' will represent is a significant reduction in our benefits for nothing in return. Another huge tax on us.


      And this Roderiques person who claims to be speaking for us is obviously in bed with the persons who want to tax us to death. $500 per month co-pay? I would rather leave the service and certainly would prefer to purchase my own private and not have to attend the George Town Hospital and face the awful conditions there.

  11. Anonymous says:

    Seaman and their spouses pay a premium.  They have to pay it annually.  So Civil Servants stop complaining.  At least these elderly retired people contribute even a small sum.  What do you healthy able bodied people do but complain?

  12. Anonymous says:

    unbelievable……civil servants have zero concept of what is like to work (and stay in work) in the real world aka the private sector

  13. Off to find a job in government for freebies says:

    "The senior civil servant said that government workers don’t perceive healthcare as “free” but as a benefit of around $1,000 per family per month, in lieu of other perks common in the private sector such as share options or pay rises"

    Well I work in the private sector.  I get no pay rises as business is slow.  We don't get shares and I have to pay my $1000 out of my pocket.  Why doesn't the CS get in line with that.  Remember people private sector employees only get perks if things go well – if things go bad your out on your ass.  At the moment the world does not spend money.  The private sector is slow, as its slow I don't get benefits.


    • Anonymous says:

      $1000 a month, what kind of gold plated medical plan are the civil servants on?


    • Me too! says:

      Your name says it all… 

      me too… wishing I could get a job there too!

    • Anonymous says:

      It is amazing how many different points of view we have with this topic.

      Generally salaries in Government are lower than the private sector. Yes there are exceptions but it is a general rule. Some of you are assuming that all CS are unqualified which is is far from the truth. When you ask someone from the private sector who the CS members are they think of high paying positions and yes we have high paying positions without qualifications that are an embarrasment to the country but do you think of the Fire Service, how about garbage collectors, postal service etc.

      Generally there is a freeze on salary rises outside of promotions. There obviously was exceptions here notably in the police force.

      If they force the CS to pay for their insurrance they will demand the option to get insurrance coverage other than CINICO. This means CINICO will suffer and the HSA will suffer big time. You are busy hitting on the CS about free insurrance but at the same time you have to realize that CINICO means we HAVE TO GO TO THE GOVERNMENT HOSPITAL.

      So the deal is simple make us pay for our insurrance but

      1. Iwant to right to get a different insurrance.

      2. Pay me according to my qualifications what I would be worth in the Private Sector.


    • Anonymous says:

      You deliberately miss the point. Civil Servants get no bonuses when things are swell. When things went down they cut their pay. Now you want to take away their contracted rights? You really must be a Republican.

      • Dred says:

        Wait a second let's restate the facts here.

        We get bonuses YES but that is based on performance. If I do not perform guess what happens to my bonus? Babye bonus. If CS does not perform it's status quo. Want a case in point? Submission of unaudited financials to be reviewed by AG. 7 years. 7 years and you have never met the deadline. Let me be clear. I WOULD HAVE BEEN FIRED 7 TIMES. How many people got fired in CIG?

        Things in the private sector for the most part is cut throat, do or die. Please keep this in mind when trying to compare the two. When we get everything done when it is suppose to be done we don't get a congrats by press release, we don't get a pay bump, or a high rating. That my friend is called DOING YOUR JOB WHAT YOU ARE BEING PAID TO DO.

        So back to bonuses. Most have scales of 1 to 5 with 3 being average. Most employees who do their jobs and meet their deadlines CONSISTENTLY will get a 3. If we parted the Red Sea and Turned Water into Wine we get a 2. If we solved world hunger, fixed Global Warming and discovered a nearby planet with unlimited resources that has alien lifeform and is habitable by humans we get a 1 otherwise if we mess up once it's a 4, twice and we are probably a 5 and on the way out the door. This is private sector for you.

        As I mentioned before the last time I got a rause was 2008 which is nearly 4 years ago now.

        All I recall ever being done to you is they took back the 3.2% they were giving you. You should be thankful you got to see a 3.2% to begin with.

        Let's look a stereotypical CS employee in middle management say making CI$4,000/mnth. He/she is getting:

        Health Care say at $800/mnth FREE x 12 – CI$9,600.00 per annum

        Pensions $4,000 x 6% x 12 = CI$2,880.00 per annum

        Basically you are getting a bonus of CI$12,480 per annum for breathing. It's not attached to a performance standard. PS that's already CI$8,000 more than I make per annum based on my performance.

        Also you probably got 2 or 3 raises since I got my last one.

        I really do not see any arguement here.

        • Anonymous says:

          in other words you have a poorly paid job and want to drag everyone down to your level to make you feel better.

  14. Anonymous says:

    I am a Civil Servant and I have NO intention of paying anything towards my government health care for either myself or my family. That is part of my remuneration package and one of the main reasons that I went back to work for the government from the private sector. I could have been making much more in wages had I been working in the private sector. Most large private sector firms pay 100% health insurance premium for their employees anyhow with the employee contributing for their dependants.

    What the government wants to do with regards to NEW civil servants is another thing but to change the remuneration package of existing civil servants, some who are nearing retirement is WRONG and is a breach of contract. By all means say that going forward from such and such a date all new civil servants will have to contribute to their healthcare, This will be acceptable because that will be the remuneration package and contract agreement with them but to change existing contracts cannot and should not be permitted.

    To expect the seamen or their spouses to pay is also WRONG. These men gave service to their country and most of them are at an age where they are unable to work and need this free benefit. Soon there will be no seamen or dependents anyhow and this benefit will phase itself out.

    Talk of civil servants contributing to their health care has been around since the early 1980's and no polititian has had the "balls" to deal with it. If it had been dealt with then that all new civil servants were to pay they would not be in this predicament now – so why should LOYAL existing, long serving civil servants be penalised.

    • Anonymous says:

      Like people in the private sector you should pay your premium, 20%, deductible and everything else related.  If you don’t want to pay anything then maybe you should not be allowed health care as that is taking advantage of others that do pay. 


      Poor thing, the way of the world is that changes can be made to remuneration packages at anytime, especially when there is no money to foot the bill.  You are thinking of only yourself and not of the greater good of the country.  You want to retire and retire to what? A wasteland.  The global economy is in a hopeless state.  It means that everyone has to cut back.  You should pay for what you use.  You chose to work at the Civil Service, that is the way your cookie crumbles.  I used to work in the Civil Service and now I work in the private sector.  My insurance is actually worse than what CINICO provided, but that was my choice.  I cannot dictate to my employer to change insurance providers.  If I feel so passionately about it, I would change my job.  Maybe it is time for you to think about you changing your job.  Or are you one of those civil servants that could not get a job in the private sector because of your inept abilities, skills, education and experience.  While that was quite condescending, the entire Civil Service is not like that, however there is a stereotype and the stereotyped individual tends to be the complainer.   

      • Anonymous says:

        So in other words you rolled the dive and they came up badly, now you want everyone else to suffer just so you'll feel better. You are not a nice person. – Also, you may note that the CIG is not actually as broke as your employer, based on travel and other obvious expenses over the last year.

        • Anonymous says:

          Au Contraire, financially it works better.  Now I work for an employer where I am compensated for performance and if perchance I do not perform, I like others will be let go.  Working at the Civil Service was not like that whether I performed or not I was guaranteed my salary.  There was no incentive to perform. 


          I am a young healthy individual and my health insurance provider is not a concern at the moment.  Financially I am better off and it is a better move for me as I am ambitious and if I stayed at the Civil Service I would not make as much money or be as far ahead in my career. 


          My employer is not broke.  It is the choice of my employer to go with a certain insurance package and within that package I have chosen the basic. 


          You should also worry about the extensive travel expenses that the government officials are making because I as a Caymanian am very concerned.  Maybe I’ll make an FOI to illustrate….oh wait CIG doesn’t have appropriate financials….

    • Anonymous says:

      Nothing stays the same, last year my employer which used to pay both their half and my half of the medical insurance, changed back to half and half, my spouses employer went to 75/25. Your contract is up for renewal annualy and implicit in that is renegotiation for both raises and expenses. In hard times it might even be a renegotiation reducing pay.  To say it is wrong ignores the financial realities we live in.

    • Anonymous says:

      Yes, most private companies pay 100% health insurance for the employee, and the employee pays for his/her dependants. Pay raises? Not for 3 years now in this slow economy.  You're dreaming, bobo!

      I pay almost US$1,000 a month for my dependants.  And on top of that $12,000 a year, we each still have a $750 deductible then $600 co-insurance. So unless it's something catastrophic, we pay out of pocket EVERY SINGLE TIME we see a doctor, even though I pay $12,000 PER YEAR for health insurance.

      Do you have a deductible? Do you have to pay co-insurance after your deductible?  Don't you get free prescription drugs as well?

      You have it very very very easy, and your dependants' free health care is sinking our Government. Stop complaining.

    • J.B. says:

      So does that mean you will quit working for the CS and get a job were they pay you what your worth?

    • Anonymous says:

      Sounds good to me. Start somewhere. So… Reduce the benefit on,

      1/ New Employees

      2/ Employees with less than 5 years of service

      3/ Employees under 35 years old

      4/ Employees with no dependents

      Then maybe in 40 or 50 years we will have this situation under control.

      Lets not forget about the pensions as well. Before anyone starts tooting about independence from the UK, realize they are on the hook for guaranteeing the CS pension plan. I am sure they would love to have that liability off the books.


    • Anonymous says:

      Can you actually name ANY private sector employer who pays 100% of health care? You have no idea what you are talking about. My husband pays about $6000 per year for 3 of us in healthcare costs. Why should civil servants pay no premium, no coinsurance, no deductible, no out of pocket for UNLIMITED health care for their whole family. I agree with you on one thing tho', a lot of people like you go to work for the civil service so that you don't have to pay for health care and the rest of us have to pay the bill!!!

    • Anonymous says:

      so why should LOYAL existing, long serving civil servants be penalised.

      Because they promised something they cannot deliver.  In that you are not very different from the rest of the island.  Get used to it.

  15. Anonymous says:

    There are two points here that the Government never ever talks about. 1) The reason the health insurance premiums are so high for Civil Servants has to do with all the FREE healthcare that is provided to those who can't afford it.

    When CINICO was created, it was created with the intention of providing health insurance for those who were not 'cherry picked' by the private sector. When that happened CINICO realized that they were losing money hand over fist. So, someone then came up with the bright idea and said 'hey, let's take on the Civil Servants healthcare' (remember, the CS were getting their insurance from the private sector). By taking on the CS healthcare, CINICO was able to pass on the losses it was facing from insuring all the other people; by passing on the highest premiums to the Civil Service.

    That is why it cost so much for the Government to keep the Civil Servants with healthcare coverage. Not because the Civil Servants demanded a change.

    I, as a Civil Servant, would love to switch insurance providers and go to a different company (paying for myself)  BUT I AM NOT ALLOWED.

    The law was never changed to stop the private companies from refusing people with pre-existing conditions, so CINICO picks them up and spends a hell of a lot of money on them, and the Civil Servants absorb those cost for them.

    That's why this is such a touchy issue. If the Civil Service leaves CINICO for another healthcare provider, where would CINICO (or should I say who?) break it off in to subsidize the losses?

    So yes, if I have to start paying (as I want to do) I must decide where I can go to seek healthcare. That's the other issue, they are afraid that the Civil Service will seek healthcare outside of the HSA. Because as we know, the HSA bills CINICO and gets paid a handsome fee for treating Civil Servants


    • Anonymous says:

      But none of this money comes out of your salary….So as a civil servant it is free for you!

  16. Polly Tricks says:

    "4,000 civil servants and their dependents, which totaled between 12,000 and 15,000 individuals" or probably close to 40-50% of the voting electorate.  Cayman has become a socialised state with handouts coming from too many government jobs with excessive benefits.  This political reality is why Mac has lacked any spine in dealing with the civil service.  Rather than waiving the MOU of the week, Mac should be cuting civil service costs by 33% while keeping pension obligations up to date.

  17. Anonymous says:

    Not that I want the Civil Service to ask for more but completely free healthcare costs the country way more than $1000 per employee (including family coverage) per month. Civil servants pay no premium, no deductible, no coinsurance, no condition is excluded and nothing is sent back for them to pay with the lovely "exceeded coverage" comment that the rest of us get. For example, we (CIG) pay a massive premium (I believe over $1,000,000) for catastrophic coverage for civil servants or newborns etc… in the US. This insurance is for individual events exceeding a certain amount and is renegotiated every few years. Therefore, more huge claims, more premium for all of us to pay in future.

    • Anonymous says:

      Sounds like the problem is that everyone else has bad health insurance. Instead of tearing down the ones who are decently covered you might want to ask yourself/employer/MLA why your health is treated so shodily. – Or are you happy being a replacable cog in the wheel?

  18. R.U. Kidden says:

    93.4 million???   How much is that per "civil servant"?  That's a lot of money!  And the doctors and other healthcare services are getting the money, not the civil service people.  They get the poor service mentioned in the article.  I wonder what CINICO's take is….. ?

  19. Lazarus says:

    Not sure where the good doctor has been.  Maybe under a rock with the Geico people.  Does he think that the private sector is awash with pay rises and stock options ?  Come on, get real.  I'm in a good job myself thankfully but have had no payrise for 4 years as the business isn't making enough in these tough times.  Stock option – well if there were any, surely its only the top mgmt who will get this, not the rank & file employees.

    As for not using health care, its not just the employee that you have to look at but all of the employee's dependants.  You only have to visit A&E at GTH to see all the CS depenants lining up for free medical care.  Any suggestion that CS are not using that benefit is baloney.

    Its no good comparing CS with USA executives.  All of the private sector in Cayman has had pay or hiring freezes, and is suffering.  Why can't CS share some of that suffering with the rest of the country ?

    What salary does the doctor get and what payrises has he had each year ?

  20. Anonymous says:

    Cinico are being ripped off by the exhorbtant   fees and excessive treatments that are carried out by private doctors overhere and in the States.  They should get more specialist doctors at the hospital. Also should investigate sending patients to Cuba, which will be much cheaper than Miami

  21. Anonymous says:

    WTF am I reading here?  No, seriously, WTF?  

    Do you have any idea how many people in the private sector get the kinda perks suggested here, or even perks at all, let alone a pay rise?  

    The only thing the private sector have that I'd like to see in the CS is the ability to fire and lay off people like they do in the real world, sort out this pathetic expensive liability around each and everyones neck draining the public purse and sending Cayman into a dire future.


  22. Anonymous says:

    The premiums paid by Civil Servants subsidises healthcare for indigents, seaman, veterans and pensioners. The premiums would be half Civil Servant premiums just covered Civil Servants. So it ias not $1000 benefit per month per family.

    • Anonymous says:

      19:23. Civil servants do NOT pay any premium. Government pays it on their behalf. They lose NOTHING from their payslip. Got it???

  23. Dred says:

    Share Options are not given to everyone across the board so that is not a fair comparison. Also my boss must have missed the memo because the last raise I got was 2008.

    The CS get many more additional benefits than the private sector does and could probably even get more if their leaders actually did work instead of collecting paychecks. There is no reason under God's green earth CS employees should not receive:

    1) Property and Vehicle Insurance Discounts

    2) Gym Membership discounts

    3) Similar Discounts as offered by the COC Cards

    Let's look at some facts. CS controls some 4,000 employees and their families. This could easily amount to 10,000 people. I would say that matches any organisation capability on Island.

    The problem is their leaders sit on their hands and bark instead of making their feet hit the pavement and finds deals for their people which would make being a CS that much more inviting.

    Trust me when I say the above is the tip of the iceberg.

    • Anonymous says:

      Really? I'd love to hear your explanation of how discounts on gym memberships offered by most gyms to any group of people should for some reason be denied them. – Talk about meanspirited.

      • Anonymous says:

        I don't think you go the point of the post which was to say that CS get loads of perks in excess of what is available to the general public

        • Anonymus says:

          No, the point was that the perks aren't really perks of the job. Just sour grapes.