Patients 1st is a weekly column where the Bermuda Medical Doctors Association answers your questions about the proposed Bermuda Health Plan 2020 and how it may impact you and your family

This weekend marked the end of the public consultation period for the proposed Bermuda Health Plan 2020.

Today we wanted to ask YOU questions: How do you feel about that? Do you feel like you understand how the changes impact you? Do you understand the difference between a unified health finance model and a universal health plan?

It is not too late to still ask questions. The public consultation may have closed, but you can still contact your Member of Parliament or the health ministry directly.

Let’s talk health financing. The unified system is what the medical community, Patients1st and the BermudaFirst working groups have asked for more consultation about. Why is this? Because a unified/single-payer system puts the payment collection into the Government’s hands — which can be a good or bad decision.

Why might you be concerned? Because Kim Wilson, the health minister, and the Bermuda Health Council continually refer to the Report on Health Financing Structure Options for Bermuda, a 103-page document from 2012 that formed the basis of their decision to “choose unified”.

On page 37 of this document, labelled Section F — Sources of Funding, the funding options are analysed to support a unified/single-payer system as follows:

1, Premiums: “The premium rate could vary by income band by family size or by status (retired, unemployed, indigent).”

2, A payroll levy: “The payroll levy could be a single uniform rate, a rate that varies with income, or a dollar amount that varied across income bands.”

3, Collect funding through the Contributory Pension Fund: “To fund healthcare benefits, a levy could be added to the CPF contribution. In addition, during retirement a deduction could be taken from the CPF pension.”

4, Land Tax: “The levy could either be a flat rate or vary with the assessed value of the land and property.” We urge you to pause and carefully re-read item Number 3. When you are 65, an option of financing is to deduct funds from your pension.

Also not to be ignored is that in Thursday’s edition of The Royal Gazette it was announced to include ex-pat workers into the pension fund.

On the surface it was portrayed as “the right thing to do”. In reality, it means that a bigger unified pool of funding will be available to support the proposed healthcare reform.

Reading a 103-page document can be tedious. Going to public forums can be tedious. Signing a petition can be tedious.

Contacting your Member of Parliament to specifically ask how this healthcare scheme can be funded is not tedious — it is simply your only option if your voice has not yet been heard.

On Thursday, a petition of 7,000 residents asking to:

• 1, Rethink the unified approach

• 2, Extend the public consultation period, was denied by the health minister

How does that make the people of Bermuda feel?

• The Bermuda Medical Doctors Association is a local body of physicians that represent the concerns of community physicians working directly for the welfare of the doctor/patient relationship. Over the past five years the BMDA has grown to more than 75 physicians, which represents the majority of community doctors on the island