John: Healthcare is readily available and accessible. If I need to go to see the doctor or make an appointment to go see my dentist, it’s not a six month wait.

Beth: I was hit by a car seven years ago. It’s left me with spinal damage and a lot of long-term issues. So, there’s a lot of medical professionals involved in that. And one of the positives is that they all communicate really well with each other. So, if I’ve been to see a pain management specialist, then he’s also speaking to my orthopedic consultant.

Peter: Freedom of choice. There’s a good selection of GPS, dentists, chiropractors.

Ian: For overseas referrals, there’s no copay and 100% reimbursement. I think that’s really good, really beneficial.

Kitty: There are highly qualified professionals on island, and some who are visiting professionals and some pretty great facilities, considering our size. I also think of the access to dialysis, diabetes care and even radiation therapy.

Maryln: I have been traveling overseas on vacation, multiple times and I’ve had some sort of injury and had to go to the emergency room or a doctor, and then I’ve come home and put in my claim, and I’ve been reimbursed very quickly. So I think that’s great.

Peter: The distribution of services available. Sometimes there’s an abundance of a particular specialty, and then other times there isn’t. Like with an ENT, there was a long time when there was no ENT on the island, so even a minor issue required an overseas trip.

Kitty: The lack of continuity and preventive care and the disparities in access to care based on ability to pay or insurance status. I went to a knee specialist recently, and my copay was $250 to $260, I think. But, if you can’t afford it, you just don’t go to get your knee looked at. 

Anne: The cost and the disparity in some of the doctors charges. You can have a doctor that has a copay of $50 and then another doctor has a copay of $10 and you just you don’t know why.

John: It almost seems as though, doctors, dentists and the likes of them, have almost free reign on whatever it is they  feel like charging. I believe that the health council should regulate those charges

Anne: The cost of prescriptions can also vary between different pharmacies.

Gayl: The disparity is absolutely ridiculous.

Gayl: It means deciding whether I’m going to go or not, or when I’m going to go.

Peter: I have no idea. If I pay $50 for a doctor’s visit, how much is the doctor charging my insurance? I don’t know if it’s value for money, because I don’t know what the real cost is behind the services.

Maryln: I was on HIP a few years ago, and I broke my leg, and actually HIP covered it. It would have cost $37,000 had I had no coverage whatsoever. I think that’s value in that sense, but the price is just astronomical. It really is. 

Kitty: I don’t think I get value for cost. I don’t think that there is nearly enough value in outcomes as we’re paying for it. I expect more overall comprehensive coverage. Sometimes the quality of individual care is good, but the overall system just feels inefficient. 

Anne: I don’t know if we have any way of knowing, because we have nothing to compare it to.

Gayl: I always ask what the copay will be, and then I make my appointment around when I will have the money to pay it.

Maryln: If I need to go, I can afford to do that but what about so many Bermudians who can’t? I know of a number of seniors who are struggling, and I know a couple of seniors who are forced to work when they shouldn’t be working in order to afford not only health care, but some of their other basic needs.

Anne: No, I don’t really understand what coverage we have. 

John: Even having a good health care package doesn’t entirely tell you what you can and can’t do and what’s covered. Or, you know, why do I have to pay such a large copay?

Edward V: I have everything that’s available for myself and my son. I get it all. But for some reason, just like John alluded to, if you have dental, for example, you would expect that braces would be included in that. But they think that at after a certain age, you shouldn’t be able to get them…but I’m paying for dental. So why are braces not covered?

Kitty: I do understand my coverage, but sometimes there’s terminology that you might not understand, like, what is home health care? If it’s not a caregiver, you can’t bring a caregiver in, but you might be able to bring a certain other profession, and your doctor might be able to see you on home visits, or you can get a registered nurse, but you can’t get a PA or somebody else. So it’s not home health care. It’s a home visit for certain people, certain professions.

Peter: I’m 69 now, when I was in my early 60s, I was contemplating retiring at 65 and then my wife and I would go traveling. I got to 65 and we looked for our budget and our income, and we thought, well, can’t quite afford to retire yet, and I’m still having that conversation with myself. And the fear of retirement is affording medical coverage.

Ian: I myself, as well as my coworkers, we talk about that all the time, retirement and early retirement. The only reason why we hesitate is because of health care. It depends on how healthy I am when I want to retire, but it sounds like it’s a big consideration, and that retirement planning is your health care needs.

Gayl: I would definitely like to retire at 65. I’m 59 now, but just recently I made the decision that I would have to work until I’m 68 in order to save that extra money, because, again, health care is a major concern, and it shouldn’t be.

Anne: I do think about the people I work with that are 65 plus, and the reason they still work is because of health insurance. They can’t afford to pay the full deductions themselves, so they still come into work and cannot enjoy their retirement because they can’t afford to live if they pay for their insurance.

Maryln: I’m worried about the future because I see so many seniors and they’re struggling.

Edward V: If this initiative [Universal Health Care] goes through, I’m very hopeful and optimistic about what this may very well mean. If I’m paying $1,500 a month for myself and my son for health insurance, and I can pay something less, but get comparative care, I’d be happy with that.

Maryln: I like the idea of lumping GEHI, Future Care and HIP together to increase the pool. That could help reduce some of the costs. I hope that happens.

Ian: What’s the total cost going to be? Because, Minister Wilson spoke about baseline coverage, what does that include? And how much is that going to cost me per month, and then if I need supplemental coverage on top of that, what’s the total cost going to be for my particular situation?

Peter: I was surprised that the minister said that it will just be basic coverage. Universal Health Care will provide a baseline of care, while employers, individuals and insurers can negotiate additional supplemental coverage that tailored to their needs.

John: If that’s the base now, if you want all those other things that you had and had in your private plan, oh, that’s another $1,000 so you might end up paying more. 

John: They need to say, “this is what’s covered” and “this is what’s not covered.” And can people actually have the option of no? If it’s a reasonable amount and it covers everyone, that will be a good thing but I feel it will miss out on a lot of things, and we will actually be left paying more for health care.

Ian: My main question is, what is covered? Is the information readily available? 

Peter: My concern is that it’s going to increase the cost of the supplemental coverage. I would rather the government regulate the existing system with private insurance. And instead of treating each company as a separate group, they should require the insurers to pool their entire book of health coverage, so that instead of me being in a small group of five people, I would be in a group of 46,000 people. At the moment, the current system is very unfair to small companies, right, but I think the government system is going to make things worse and more expensive. 

Anne: So one of my concerns is, how? Our government isn’t doing a great job at running other things, for example, education. How can we trust that they are going to be able to run this properly?

John: Insurance companies are a business. They’re  in business to make money. They’re in business to make money for their shareholders, which, you know,  when you operate on that principle, we’re unfortunately, going to be the last ones in the chain to get the better end of the deal.

Peter: I was shocked by those statistics, especially 50% of the residents having at least one chronic condition.

Edward V: We have a sugar tax but for some reason, that doesn’t deter a disproportionate amount of individuals from consuming sugary drinks. They pay the extra money to buy the snickers bar. They spend the extra money to buy the soda instead of drinking water. So I mean, some of the stuff is self inflicted. I’m not going to be calJohns about it, but there are choices that individuals can make in order to assure that they’re not in the danger zone when it comes to their health. 

Edward V: I wasn’t offended. I agree with it. Okay, I work out, I walk, I run, I cycle. So I mean, that’s just me personally. You have to find the time for the things that will benefit you.

Anne: I’m kind of going to disagree here. I remember there was a person on the radio talking about Bermudian culture and how our family history impacts what we eat and how people get together. The example she gave was whenever we have a family function, there’s always foods like peas and rice, mac and cheese, just heavier, starchier foods. And that is what people have grown up on, because that is part of the culture of Bermuda. And this person wasn’t saying it in a bad way. She’s just saying this has been a reason why we have such high incidences, because it’s ingrained in Bermudians as they grow up. So I wasn’t really surprised. I was actually kind of surprised that only 12% of residents are uninsured, just because insurance is expensive, and considering we have almost a quarter of our population in retirement age.

Kitty: I understand the argument about personal choice. I think though that that view actually oversimplifies a much more complex issue. And the fact is that access to healthy options isn’t just about cost or about personal choice, some of it is about age and education and even marketing. I have a neighbor who works four jobs, three of them in a day, and she may not have the time to cook fresh meals or grocery shop or cycle or walk or run and all of those things. And I think of the fact that sometimes she knocks off work at 11:00 p.m. when everything’s closed, except for the gas station or Ice Queen. So what exactly does she do, other than not eat?