(CNS): The NCFC is aiming to make the government-owned insurance company, CINICO, the single provider of health insurance for all residents of the Cayman Islands. While this is likely to take time and will be subject to wide consultation, Premier André Ebanks has confirmed that this is now a government policy goal.
He told members of the press on Thursday that Finance Minister Rolston Anglin, who has responsibility for CINICO, is putting together a working group to see how feasible it will be. But Ebanks said he believed there would be many benefits for all Caymanians, for the public purse, and the healthcare system as a whole, as well as helping with cost-of-living difficulties.
When CINICO was launched in 2004, spearheaded by then-health minister Gilbert McLean, the stated intention was for it to eventually become a national insurance company, available to all.
However, during the rollout of phase one to public servants, the UDP government allowed statutory authorities and government companies to use private insurance companies instead, leaving CINICO to cover civil servants, pensioners, seafarers, veterans, and their families.
Successive governments since then have failed to widen the prospective client base for its health insurance, despite some signalling their intent to do so. This has led to a situation where private sector companies offer coverage primarily to healthy people of working age, offering extortionate, often unaffordable, rates and inadequate cover for pensioners and those with chronic conditions.
Meanwhile, the private sector’s collective annual profits are almost in line with the tab that the government picks up to cover the under- and uninsured. This indicates that even the most basic single-payer system would reduce the overall cost to the public purse.
Ebanks said if everyone was paying into the one pool, there would be multiple benefits, such as giving CINICO the ability to negotiate better prices with healthcare providers and create a SHIC (Standard Health Insurance Contract) plan that has better coverage but is still affordable.
It will also reduce the growing cost of healthcare for the indigent and elderly, which the government pays for, and ease the cost of living for those currently paying eye-watering monthly premiums for their families.
The premier said that Cayman has reached the point where it is necessary to think about the long-term future and have all insurance money pooled with CINICO in “one large pot”.
He also noted that CINICO could then “negotiate the cost of health packages for the whole country, as it will be in a more muscular position to make better deals for everyone and strengthen the SHIC plan.” SHIC is the basic minimum level of health insurance everyone living in Cayman is required to have by law.
Ebanks said everyone knows that the current SHIC plan doesn’t go very far and is in desperate need of reform. “We are the second largest captive insurance provider in the world. And what this is is essentially a large captive insurance pool of money for the Cayman Islands and its people.”
He said that with such a large pool, the government could begin to consider free healthcare for children under a certain age and for the oldest members of the community. However, he said the policy was in its early stages.
“We don’t have all the answers,” he said, but confirmed that a single-payer system using CINICO is the goal, and research was about to get underway in earnest. He said the working group wouldn’t just be a talking shop but would make recommendations for transitioning the system and “turning the model on its head”.
The NCFC is expecting pushback. However, Ebanks said the government will consult extensively, and people will be able to choose where they get care, so it will be important for CINICO to work with all healthcare providers that meet the required standards.
Ebanks said he believes that the single pool model “will have enormous benefits for Cayman”.