If people took better care of themselves, eating healthier and exercising they would not face ever-spiralling healthcare insurance premiums currently rising at between eight and ten percent each year.

That message became a central theme at a public forum hosted by the Bermuda Health Council entitled ?The Dollars and Cents of Healthcare? at Bermuda College last night.

And medical coverage given by Government?s own healthcare insurance plan (HIP) and how it measures up to private sector coverage was also a point of discussion for around 50 attendees at the meeting.

On the four-strong panel Senate President Alf Oughton spoke of the escalating costs of healthcare insurance premiums which he said for the past five or six years have been running in the eight to ten percent region compared to the annual retail price index rise of around three percent. Advances in technology and medical breakthroughs accounted for increases in medical bills, he said. Coupled with that is the higher expectations of Bermudians with regard to healthcare. Then there is the higher number of seniors within the population as more people live longer presenting a greater demand for healthcare assistance through their insurance.

Giving a public sector perspective, assistant director of Health Department of Social Insurance Colin Anderson asked the audience to remember that nothing in life is free and you essentially receive the level of healthcare proportional to the level of insurance paid.

The HIP scheme accounts for around 4,000 people on the Island, roughly ten percent of total healthcare insurance, and mostly covers ?standard hospital benefits? without the add-on benefits given by many private insurers.

Explaining the dynamics that determine the level of premiums Mr. Anderson said, as a simplified example, if an insurer got a $1 premium but had to pay $1.10 for a client?s standard hospital care that insurer would soon be unable to sustain repeated losses as other clients seek treatment. That basic cause-effect forces insurers to increase premiums.

Cindy Campbell, executive vice president of the Argus insurance group, extolled the benefits people could gain if they led healthier lifestyles and made better choices.

?We know we should eat well, exercise, not smoke or drink too much. Healthcare costs are driven by our behaviour. If people were made aware their healthcare insurance costs could be cut by 70 percent by changing their lifestyle they would sit up and notice,? she said.

Using US statistics Mrs. Campbell said 70 percent of strokes, 71 percent of cancers, 82 percent of heart disease and 91 percent of Type-2 diabetes are preventable, adding: ?As a society we have to start living healthier lives. We pay for everyone else?s bad habits.?

Representing the Bermuda Employers Council, William Desilva said employers are concerned as they have normally pay half the premiums for their staff, but he also said a trend that started around two years where some healthcare practitioners adopted a system where the client had to pay ?up front? for treatment and then claim back through their insurance has created a challenge for people not earning the best wages and with cash flow problems exacerbated by the pay-first medical system.

Understanding why healthcare insurance premium increases was outstripping both inflation and pay rises was one of the aims of the public forum, which was attended by a number of past and present politicians including Deputy Premier Paula Cox, Sen. Davida Morris and former Health Minister Quinton Edness, along with healthcare providers and public.

Bermuda Health Council chairman Dr. Michael Bradshaw acted as moderator and invited audience questions. One person asked about the effect of dismantling the ?indigent clinic? at the hospital, which has been used by those without healthcare insurance.

Sen. Oughton suggested those people who use the facility could be given HIP certificates to seek the healthcare they need, and he said the HIP premiums for the former clinic users could be paid from allocations out of the $6.1 million currently spent subsidising the soon-to-be abolished clinic.

However, former Minister Mr. Edness, sitting in the audience, spotted a flaw in that idea as HIP does not cover all doctors? costs. He said the clinic had been created specifically to assist those unable to get treatment from doctors, but a mere HIP certificate would leave those people facing the same difficulties as before.

Moderator Dr. Bradshaw wondered if Bermuda?s taxpayers would agree to higher taxes in order to cover the premiums to allow former indigent clinic users access full healthcare.

Other members of the public put forward ideas such as introducing a medical aid system similar to Legal Aid for those who can not afford the healthcare they need, another man said a celebrity TV chef in the UK called Jamie Oliver had successfully campaigned to promote healthy eating in schools. He told the meeting: ?If you can catch a habit early and prevent it you will have an impact on how much we pay in healthcare insurance premiums.?

Dr. Bradshaw said ideas, opinions and questions from the evening would be considered by the Bermuda Health Council as it looks to the future healthcare needs for the Island and particularly the issue of increasing healthcare insurance costs.