A forum on healthcare as a human right was offered glimpses of the coming universal healthcare system as well as the island’s barriers impeding access to medical care.

A single-payer model is “going to be the direction of travel” for universal healthcare, health minister Kim Wilson told the gathering at Bermuda College, organised by the community group Bermuda Is Love.

“Who will run this? We are not anticipating it will be the Government,” she said.

Ms Wilson was joined last week by Myrian Dill, a nurse practitioner with the Bermuda Hospitals Board; Preston Swan, the BHB’s acting chief operations officer; and Peter Lozier, global head of health at Argus Insurance.

As the panel took questions from a moderator as well as the audience, all were in agreement that the island had work to do on equalising access to healthcare services.

Asked about the main impediments to healthcare access, Ms Dill singled out the linking of health insurance to employment. Ms Wilson noted the influence of social determinants and Mr Swan, who has a long background at the Mid-Atlantic Wellness Institute, highlighted the stigma associated with mental health.

Mr Lozier flagged up the island’s reimbursement model for medical care as “one of the barriers”.

“Our fee-for-service model is a challenge,” he said.

“Providers are remunerated for how much they deliver, not the quality.”

He said universal healthcare would be achieved in Bermuda “when everybody has the same access”.

Mr Lozier also pointed to care management aimed at helping patients with chronic health conditions, which he said was offered by Argus.

“I can empirically tell you that every patient that goes through care management will have a win at the end.”

He said costs went down “significantly”. “Somebody that graduates through care management will cost their insurance company at least $1,600 less per year,” he added.

However, he said, care management still lacked an insurance code to cover billing and payments.

Mr Swan told the forum that MWI had been moving increasingly towards putting its services out in the community. “The healthcare costs of taking care of someone in a hospital are astronomical compared with community services,” he said.

He added that MWI “should be able to close one of our wards in a few months”.

Ms Wilson emphasised that the island’s present health outcomes, despite high levels of spending, were “dire”, and often driven by lifestyle choices.

She said the core benefits package for universal healthcare, expected to come into effect in July 2025, would include more preventive care.

However, she urged the public to take “personal responsibility” when it came to their health choices.

She added: “Maybe we’re not getting the message out, of diet, exercise, sleep, taking care of your mental health.”

Ms Wilson pointed out that a Snickers bar was more expensive than an apple.

“We are increasing our healthcare costs simply because not enough of us are taking responsibility.”