The Bermuda Health Council recently published a public consultation paper with proposals to "enhance the regulatory framework for health insurers".

The paper has received a good level of interest, and we are looking forward to receiving more written feedback.

Why should I care? Because it will affect you directly – whether you have insurance or not.

The proposals have one key aim: to make affordable health insurance more readily available. From there it gets a little technical, but the most important points are to:

1. Make the "minimum package" better than it is currently. Right now it only covers hospital fees; professional fees in and out of hospital are not covered. This can leave individuals struck by serious illness or injury, and the professionals who care for them, at risk of big financial losses.

2. Ensure the "minimum package" has a price that is affordable. This is already in place in Bermuda. We achieve it because that package (called the Standard Hospital Benefit) is "community rated". This means that the premium is based on the average cost of providing care to the whole insured population.

It is very different from setting premiums based on the level of risk an individual presents to the insurer, where older, sicker people have to pay more. Bermuda instituted the "community rating" method decades ago. The result is that the risk is spread, with a small negative impact on the many who are healthy, and a large positive impact on the few who will fall ill. It results in equity. We propose to continue doing this. Health insurance above and beyond that minimum package would still be available, and priced, as always.

3. Ensure everyone can buy the "minimum package" from any insurer for the same cost. With a package that is properly priced through community rating, and other safeguards for the whole system, discrimination based on age, sex or pre-existing conditions would be done away with.

4. Ensure everyone has the "minimum package". There are many countries where 100 percent of the population has coverage, which manage to spend less on health care. We know Bermuda can achieve this too. Any proportion of the population without insurance is a risk for the rest of us, because one way or another, we're going to pay for it anyway. Either financially or through social problems. So ensuring everyone who can, contributes, so everyone who needs care, gets it, is a good way of preventing big financial losses for everyone.

5. Ensure the process of paying for health care is faster and more efficient. The better we organise paying for health care, the more everyone will save.

The three terms used by the paper are: protect the public, promote equity and promote cost-efficiency. To achieve that, some important changes are needed in the way we do things. The paper details some of them and with public feedback we can make sure it's done right.

Where is the consultation paper?

It's on our web site at www.bhec.bm. Look under "Reports and Publications". Or call for a copy on 292-6420.

Who should give feedback?

Health insurers, employers, health care providers, and the public are invited to provide feedback on the proposed reforms.

How do I give feedback?

Write or e-mail Mr. Dane K Commissiong, Director of Health System Regulation by 30th August 2010, at dkcommissiong@bhec.bm or Bermuda Health Council, PO Box HM 3381, Hamilton HM PX, Bermuda.

* Dr. Jennifer Attride-Stirling is the Chief Executive Officer of the Bermuda Health Council and has been a health care advocate for over a decade. She has worked at the UK health care regulator and the London School of Economics; and has published papers on health regulation, health promotion, mental health and research methodology. Her work in Bermuda led to the introduction of various national initiatives by the Department of Health.