insurers are concerned with some of the conventions local physicians have adopted.

Hitting back at allegations that the local health insurance companies are often unfair and change policies "at their whim'', Gerald Simons, CEO and president of Argus Insurance, said local physicians also need to be policed.

Speaking in the absence of Judy Panchaud-White, the head of the Health Insurers Association of Bermuda (HIAB), Mr. Simons conceded many of the concerns voiced recently by Dr. Burton Butterfield, are being addressed by various committees and task forces.

In an interview with The Royal Gazette earlier this month, Dr. Butterfield a member of the Government task force on health care, claimed that the industry needed to be regulated. He also revealed his task force would be discussing the possibility of a special commission to carry out the function.

"Argus have called for a body to oversee the health care industry for a number of years,'' Mr. Simons said in response.

"While doctors are concerned about insurance companies, insurers are concerned about how doctors practise,'' he added. "When we make payments we need to ensure that they are medically necessary.'' Admitting that local insurers do change their policies, Mr. Simons held that the changes have always resulted in better health care.

"From time to time the health insurers have changed their plans, usually in April,'' he said.

"But the result has been that over the years health insurance has improved in the Island. Health insurance today is greatly improved over what it was 20 years ago,'' he added.

And he was optimistic that progress in the field would continue. He pointed out that the HIAB actively participates with the Ministries of Health and Finance, the Government, the Bermuda Medical Association and the Bermuda Medical Society on the matter.

"I'm sure goodwill can overcome these problems,'' he said.

But Mr. Simons took issue with Dr. Butterfield's suggestion that local health insurance companies are largely to blame for the financial woes of the King Edward VII Memorial Hospital.

"Health insurers strongly deny they play a major role in the poor finances of the hospital,'' he said. "Payment from insurance companies represent the most reliable sources of funding to the hospital.'' And he also noted that insurers do not determine how long people stay in the hospital and what treatment they receive.

" The per diem (flat daily) rate is not set by insurers,'' he said. "It is determined by the legislature and insurers must pay that amount in full.'' Countering allegations that local insurance companies are driven by greed in setting their premiums, Mr. Simons claimed that advances in technology and growth in the elderly population are the main factors determining the rates of premiums.

"In Bermuda people are voracious in their demand for health care,'' he said, "but the overwhelming majority of premiums are used to pay claims.

"And I can tell you that any insurer who tried to add on too much would be quickly undercut by other providers. Competition keeps a check on Bermuda's health insurance premiums.'' Hitting back: Gerald Simons HEALTH HTH