April 21, 2011Dear Sir,I find it ironic that ‘sustainability’ is being used as an argument for the proposed National Health Plan. According to the Oxford dictionary ‘sustainable’ is defined as, “able to be maintained at a certain rate or level”, but the proposed National Health Plan will not meet that definition for several reasons.First, we have an issue with Government’s inability to control costs. Under the current private plans, those cost controls are embedded in the process due to competition; if a private health insurer charges too much they become unsustainable as clients will simply move to a more affordable competitor. When Government is unable to control the costs they will have to increase the rates, defying the definition of sustainable above.Next we have the impact of this plan on employment in Bermuda. The cost of the plan will be covered through increased income (sorry payroll) tax and this drives up the costs of employing people in Bermuda. As we learned from the payroll tax debacle of 2010, these increased costs are unsustainable and therefore employment levels will drop (more). With decreasing employment levels the payroll tax base will decrease which will also impact the sustainability of the plan. This issue is compounded by the fact a greater percentage of our population is retiring, i.e. not paying income (sorry payroll) tax. Therefore the burden on the working/taxed population increases and this makes the cost burden of this plan unsustainable.This is not about providing equitable healthcare. This is about Government running unsustainable healthcare programs such as Future Care and HIP. They are hoping that by increasing the premium base through a nationalised system they can gloss over the glaring cost and efficiency issues that are being witnessed every day in their current healthcare programs and many other departments within Government.KENT SMITHSt George’s