Healthcare costs will be the next government’s number-one challenge, according to economist Peter Everson.

He warned that because of the island’s ageing population, costs will continue to rise if there is no policy intervention.

“Demographic challenge makes healthcare costs the number one challenge for the Government on July 19, 2017,” Mr Everson, who is also chairman of the Bermuda Hospitals Board, told The Royal Gazette.

“Without policy intervention, healthcare costs will rise quickly because of the imbalance between younger healthy Bermudians and the elderly, who have increasing healthcare challenges.”

According to Mr Everson, care solutions for the elderly have been neglected for more than a generation. Although “great work has been done in the last 12 months mapping out the current needs”, the former president of the Bermuda Chamber of Commerce added that “the political will to implement lasting and funded solutions is required within the coming 12 months”.

“In the meantime, stopgaps and workarounds must be funded,” said Mr Everson, who was speaking ahead of the General Election, which has seen the One Bermuda Alliance pledge to push ahead with programmes that have resulted in the “first declines in Standard Health Premium charges in more than two decades”.

The Progressive Labour Party, meanwhile, said it would manage “unsustainable” healthcare costs by implementing a national health plan, allowing small businesses to join others to obtain group insurance, increasing competition in the local insurance market and using technology to make healthcare delivery more efficient.

But according to Mr Everson, the Standard Premium Rate — the actual cost of the minimum health benefits package that must be included in every health insurance policy sold in Bermuda — will only “come down when appropriate controls are placed on the private sector providers”.

He said: “Bermuda should be able to achieve a 10 per cent reduction in premium rates within 18 months. The goal would then be to achieve a further 10 per cent reduction in the following three years,” he added.

“This is a tough target to achieve but it is what Bermuda and all Bermudians need.”

But Mr Everson said the Bermuda Health Council also needs “to be empowered to regulate the private sector”.

The Bermuda Health Council Amendment Act 2016 “was a casualty of the early election”, he said, “and thus remains the first order of business for the new House and Senate”.

The legislation, which was drawn up to monitor health providers and the importation of “high-risk” medical technology, was withdrawn last year after doctors claimed it targeted private physicians.

Long-term care is another key issue, Mr Everson said, adding that “collectively, the total number of beds is less than Bermuda requires today and less than it will need in the future.”

Noting the increased demand at King Edward VII Memorial Hospital, he added that solutions that “provide all of the facilities that the community needs in the appropriate settings and at a cost which is affordable” are needed.

The lack of adequate infrastructure to support various types of care in the community was also highlighted by John Wight, speaking in his capacity as CEO of BF&M.

“We have been aware of our troubling population trajectory for many years and the continuation of social admissions at the KEMH yet have not planned and provided sufficiently for the required infrastructure within the community to support various types of medical and psychological care outside of the hospital,” he said.

Mr Wight listed several of the “many achievements in the past five years in the medical and health sector”, including the licensure and registration of physicians, passing privacy legislation, the Premier’s Youth Fitness Programme, and the addition of oral chemotherapy within the Standard Health Benefits.

But he added that he would have liked to have seen the Standard Health Benefit package modified and more transparency around Mutual Reinsurance Fund taxation and its uses and goals.

Mr Wight said they would like to see the SHB modernised to create “a more holistic package of benefits” that also addresses inappropriate use of the emergency department.

“We are also supportive of private provider fee regulation, the creation of a national drug formulary, and the implementation of a universal electronic health record,” he added, while also recommending an assessment of government health clinics to optimise access, accountability and quality.

For Age Concern’s executive director Claudette Fleming, more emphasis is needed on disease prevention early in life and more resources for public health initiatives for young children.

“I would also like to see more public health initiatives that help seniors and their families manage wellness; more creative and portable ways of making use of community nursing, supporting those with chronic illness in particular to make informed decisions about maintaining their health as best they can and/or to improve wherever possible.”

And more taxpayer dollars should be considered to support those needing financial support for healthcare costs, especially prescription drugs and long-term care, she said.

But Dr Fleming added that the Bermuda Health Strategy Action Plan, the Long-Term Care Plan, the further development of the Well Bermuda Plan “and some work around an eventual national ageing plan” stood out as achievements, along with the introduction of the home care benefit to FutureCare, which was “as ground-breaking as the introduction of FutureCare itself”.

“This initiative represents an important paradigm shift towards community-based care and provides the critical financing piece to make it happen.”

Reducing the cost of healthcare costs is also a priority for the Bermuda Healthcare Advocacy Group, who called for Government to continue reducing the SHB further “which will help reduce the skyrocketing costs”. Reducing high insurance premiums is another critical issue, a spokeswoman said.

The Royal Gazette also approached the Bermuda Medical Doctors Association for comment on Friday, but was told that it would not be possible to receive a response that did the request justice in less than 36 hours. The Bermuda Health Council declined to comment.

As part of its platform, the OBA has also pledged to continue the Enhanced Care Pilot Programme and evaluate its success. And the PLP has said it would conduct a comprehensive review of mental health services and “make progressive reforms to adequately address mental health challenges”, as well as creating a continuum of services “that will increase access to services and improve long-term outcomes for people suffering with addiction”. It would also increase community health education, require restaurants to publish nutritional information, implement a sugar tax and install fitness equipment in public parks to promote healthy living.

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