Every so often I come across something so profoundly ridiculous and fundamentally flawed that I feel it is my duty to share it with my readers.
This time, surprisingly, it doesn’t come from the likes of Carol Hay but from another cerebral dwarf: Gordon Barlow.
While Barfblow is tickling himself pink with his mediocre attempt at disguising clever discourse and veiled satire with cynical wisdom, what he fails to do is offer anything more than more whinging. What Gordon fails to provide us with is any sort of solution – proving yet again that someone with an editorial position completely devoid of merit is nothing more than a two-bit hack shouting at the wind.
But he does work with Dismal… monkey see monkey do.
Apart from the fact that Gordo’s commenterrible suggests a number of options that would in fact infringe on numerous human rights, her arguments are weak and they really take no position and offer no new thoughts or perspectives on an old problem; which is for the most part the exact opposite of what this blog has done.
So for Gordie’s sake let’s re-set the argument of what is wrong with the health care scheme in Cayman.
The government isn’t aware that they are slowly moving back toward an entitlement system of health care and they are trying to involve capital markets (insurance companies) in their failing endeavour and the insurance companies aren’t allowed to compete so it doesn’t work and the patients suffer as a result.
Further – the HSA is unaccountable and the entire system stinks.
Fact: without the insurance companies health care would be unaffordable to 95% of the Caymanian population. Fact: the insurance companies and the government know this. Fact: The HSA is underfunded, over-burdened, staffed with under-motivated fools at all levels of the system including the board, and is wholly incapable of self-sustaining activity that would afford them even the slightest chance of maintaining financial viability and social credibility. Fact: the government knows this and ignores it.
Gordster, you and everyone else must grasp the notion that the most fundamental concept that is being overlooked here is that the wrong people are in the wrong positions and therefore are categorically incapable of doing the right job. THAT is what is killing the health care scheme/scam here.
Irresponsible (or in this case non-existent) government oversight is pervasive throughout the system which leads to a tacit acceptance of fiscal mismanagement by all parties to the system – including the end-user/patient. In this instance, health insurance companies aren’t willing participants but rather victim’s to the government’s idiocy.
Health care is not unaffordable because health insurance companies are in the mix and it’s not unaffordable because of migrant workers, rogue employers or ladies having babies on airplanes.
Health insurance is unaffordable because the low quality of care in Cayman leads to forced over-utilization by the demographic who can least afford it; there is poor care on the primary, secondary and tertiary levels; there is no accountability for providers to produce results and; there is an over-emphasis on the financial aspect of health care as opposed to the concept of treating the patient first and billing second.
I said it before and I’ll say it again: results-based provision of care will result in a higher level of care for the patient, a higher level of trust in the provider, a lower occurrence of missed diagnoses or over-utlization and; ultimately a reduction in the hard-dollar costs to providers and insurance companies that drive up the cost of health insurance at double and triple the rate of inflation.
Regardless, all parties to the health care system can survive and thrive if they all agreed that a healthy population was better for the bottom line than simply trying to develop the perfect plan of benefits or make some fiscally mis-managed quack shack profitable.
We don’t need higher benefits – we need results.
How do we do that? (Okay Gordon, pay attention. When you ask a question – answer it.)
We do it by holding doctors accountable for their performance and for their results.
Presently the notion of requiring doctors and health care professionals to behave responsibly and to commit to results-based delivery of care is nonexistent – even at the government hospital.
Here’s the irony in that.
The government has in place for all civil servants a performance-based system of accountability. Put simply: you don’t perform up to standards, you don’t get money.
The HSA must be held to this practice and must be staffed with individuals who will abide the concept of doing a GREAT job ALL of the time, not simply doing a “good job most of the time” as Gordie suggests.
Much like an airline pilot. He or she has to be perfect everyday or hundreds of people die. Doctor’s should approach every patient in the same manner and the government should demand no less from its employees at the hospital.
Therein lies the paradox with the HSA because, you see, the government is expertly experienced in pretending to oversee an industry about which they know nothing, blaming insurance companies for rising costs, blaming employers for not effecting insurance cover for their employees, and then not holding doctors responsible for quality of care… all the while pointing the finger at everyone but themselves when quality of patient care goes down and costs go up.
So basically, the government is letting us get on a plane with a drunk pilot.
I mean honestly Gordo – if you were in need of medical attention and you went to the HSA and a doctor told you to get on a plane and go somewhere else, what would you do? What could you do? Not much.
People whom we trust to – at the very least – keep us alive are turning patients away.
Why? Who knows? Maybe it’s because they don’t have the skills. Maybe it’s because they don’t have the tools.
You give us very lame arguments/ solutions in your crappentary which show you have no grasp of the situation.
Your commenterrible asks, “Can anybody think of a fourth option?”
No – I can think of an ONLY option and I’ll wrap it up here: 1) Have a hospital management company take over the HSA; 2) Allow domestic insurers to add products to their baskets without government approval which will allow them to compete; 3) Allow ex-pats to satisfy Cayman’s compulsory insurance law by having and maintaining health insurance at least equal to the government’s minimum levels (although such a crappy product probably does not exist) from a foreign jurisdiction.
Your idea of reduced import duties as a result of higher benefits levels doesn’t make any sense whatsoever. The dollars, whether spent by insurance companies in the form of reimbursements or by patients in the form of premiums and cost-shares or the government in subsidy or annual budget items have to come from somewhere so the net result of cash flow within the system is arbitrary.
Higher benefits are more expensive to the employer and the employee and you suggest that employers should bear the cost. That will in turn either force the employer to raise prices or force the employer to close his doors.
Higher benefit levels can lead to over-utilization, over-billing or “churning” by providers, higher reimbursements and lower margins for insurers which leads to premium hikes, etc…
Miss Airplane Baby didn’t need a higher level of benefits – she needed a higher level of professionalism from her doctor at the HSA.
Furthermore, reducing costs does not reduce the need for the government to generate revenue to continue to subsidize the HSA or any department for that matter – I don’t follow your logic, but leave import duty out of this equation because it is a variable with no value.
At the end of the day Gordon’s commenterrible is dangerous. Dangerous because he comes off as a credible source on the topic but at the end of the day he couldn’t make a credible argument on this topic if he read someone’s blog, stole a concept and printed it as his own.