Overseas health care accounts for the most significant area of increase to health costs on the Island and needs to be streamlined.According to the National Health Plan 2011, released yesterday, money spent on overseas care has risen by 106 percent in the past seven years, and is not sustainable.Overseas care is contributing to the soaring cost of health care, which was $8,661 per capita, approximately 9.2 percent of the Island’s wealth, in 2008/2009.This level of expenditure is not affordable for a significant amount of people.And for nearly 11 percent of local households, which fall below the low-income threshold of $36,605, these costs can be a substantial financial challenge, the plan stated.Jennifer Attride-Stirling, CEO of Bermuda Health Council, said by ensuring stakeholders made smarter use of overseas facilities it would help stabilise these costs.She said people would not be prevented from getting the care they needed, but it was necessary to seek best value for money.“There is no medical need in some circumstances for a party to be in a very high cost facility, but in some cases it is necessary because that facility may be the only one that has that level of service needed.”“We will have to be very measured to match the facility with the clinical need in order to get value for money.“There will be a difference in terms of what the minimum package will cover and mandated coverage, but if people want further coverage individuals may buy from a major medical policy.”According to Dr Attride-Stirling, the choice of coverage will still be there.The National Health Plan, unveiled yesterday by Health Minister Zane DeSilva, aims to ensure that quality health care is affordable and accessible to all residents.First announced in the Government’s Throne Speech in November 2009, it will usher in profound reforms to Bermuda’s health system within the next five or six years.Eleven goals are set out in the plan, including providing basic coverage for all Bermuda residents and ensuring health coverage contributions are based on ability to pay.Other goals like introducing an integrated health IT system and health promotion schemes will also be implemented.The plan stated that: “Bermuda is like other small-island nations, and unlike other high-income countries in its need to access overseas hospitals for specialist care not available locally.“The Bermuda Hospitals Board provides the major part of acute care needed by residents, but a community hospital in any jurisdiction is not capable of developing the volumes or economies of scale necessary to provide complex, tertiary treatment.”Due to the unsustainable cost of overseas care, resources must be redirected to streamline this care.This means only medically necessary cases where high quality, cost effective treatment is not available on the Island will be covered.In addition, patients will also be directed to facilities with proven clinical quality that are cost effective.“Providers, payers and patients will have a role in curtailing the use of overseas facilties to contain the increase in healthcare costs, while assuring quality care for the population,” the plan stated.It is expected to take two years to implement this streamlining.l Useful websites: www.gov.bm; www.bhec.bm