Commentary: Turks and Caicos health: A cost crisis or epidemic?
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| Published on Saturday, July 12, 2008 |
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By David Tapfer
During the recent budget hearings in the Turks and Caicos Islands, Minister of Finance Floyd Hall reported that 32 million dollars had been spent in fiscal year 2007/2008 for overseas health care for TCI natives and belongers.
This was up from seven to ten million dollars spent in recent years. For budget year 2008/2009 Minister Hall budgeted only 20 million. Therefore we assume he believes that last year’s costs were above normal.
Recently he reported in an article published in the TCI Weekly News that 1,100 people had been sent to the States for medical procedures not available in the TCI. Most serious overseas medical procedures are performed in the USA in the Miami-Dade County area. Nassau is an alternate source, which the TCI uses for more routine procedures.
We would like to examine this figure of 1,100 patients sent overseas. This is an extremely high figure.
The population of this country who might qualify for overseas care is only 11,000. Many of these are Canadian and American expatriate belongers who qualify for their own foreign national or private health care plans, therefore they do not need or qualify for TCI coverage. This then reduces the 11,000 total of men, woman and children to something less than 11,000. However for the sake of examination, let’s work with the 11,000 and the 1,100 figures. If these figures are accurate something more than one out of every ten Turks and Caicos Islanders has been so seriously ill they had to be transported to the USA (or Nassau) for surgery or in-depth treatment not available locally.
Here in Middle Caicos, with a permanent population of 150 to 200 people, many of whom are advanced in age, only two were sent to the USA in the last budget year for procedures. This is less than one percent of our population, not ten percent. Now we admit that this is not a fair statistical analysis. However, we ask the citizens of this country if you can report that ten percent of everyone you know went overseas last year for serious treatments not available locally. If you friends and relatives number 100, that would be 10 people seriously ill.
If over ten percent of our overall native population is so seriously ill we have to send them out, we are already in the middle of a health care crisis. The population overall in Provo is 25,000 including non-belongers, which at this rate would indicate that 2,500 of these are seriously ill. This is a lot of serious sickness in our tiny country. Remember this is only serious illness requiring procedures that are not available here in the TCI. It does not include illness that can be treated within our in-house system.
In any event, these figures must be brought into question.
We also submit for the citizens’ examination the change in health care administration. Minister Floyd Hall has switched from Canadian Heath Care Network to a Cayman Islands-based firm, Southern Health Care Network. We are wondering why the change, and was it well advised, in that the costs have tripled under this new health care administration. The change preceded the escalating cost.
We cannot help but wonder from a common sense standpoint what knowledge or leverage a Cayman Islands company has with health care providers in the USA. Would it not be better to select a US administrator that has an ongoing record of service and knowledge of the best providers in the South Florida area?
The newly-released FAC report contains submitted information that Minister Floyd Hall has separate business dealings with the principal of Southern Health Care Network. The upcoming Enquiry must investigate this. It has been reported that Hall has commented on the BBC, lobbying for avoidance of the enquiry. He should drop that and let these charges be cleared up, unless he has something to hide.
Part of the cost of overseas health care is the cost of transporting patients to and from the USA. We have received recent reports that the arrangements for this transportation are made through a travel agency owned by the wife of Minister Galmo Williams. Sources have indicated that the government is charged $1,000 for each patient flying coach to Miami by this agency. As all islanders know, the cost of a plane ticket is normally less than $400, including the government departure tax, which should not be assessed when the government is buying the ticket. This provides a profit to Minister Williams' wife of well over one half to three-quarters of a million dollars last year if 1,100 patients went out. The Enquiry needs to check into this. If this was done properly, a voucher system for the airline could be established, eliminating any need for a travel agency.
We encourage our Finance Minister, auditors and now the Enquiry to look into this health care business. Thirty-two million dollars is a lot of the people’s money. We also ask them to have the receipts for treating these 1,100 people audited by a reliable health care administrator in the USA to see if we were charged fairly.
The Minister of Health Lillian Boyce has an agenda to promote healthy living, for which she should be applauded. If we are able to prevent drug and alcohol abuse, obesity and all the lifestyle choices that conflict with good health our people will be better off.
The larger immediate problem now is the epidemic affecting more than ten percent of our native population We respectfully ask Minister of Health Lillian Boyce to have a medical team check into the reasons why over ten percent of our native population are seriously ill. Someone needs to obtain the list of the 1,100 people who were treated and the treatments received and see if there was a health care pattern that needs to be addressed. Over ten percent needing upscale overseas health care is indeed indicative of an epidemic. The people need to know: Are these figures factual and, if so, what is going on health-wise? If they are not factual, where did they come from, what are the actual figures and who inflated the figures and for what purpose?
Health care is a high priority item. Without health our people will not have quality of life and it is proper for it to demand a large part of our budget. If we find out that all these charges are proper, then let’s accept the fact that the health of 1,100 of our citizens is worth spending only 15 percent of our recurring revenue.
If we have a health epidemic, let’s find out what it is. | | | | Reads : 418 | | | |
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