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Insight: How Do You Pay For Your Healthcare?

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Dr. Desiree Cox, MD, PhD

By Dr Desiree Cox, MD, PhD

Meet Maureen. Maureen is a single mother. She teaches at a public school in Nassau but her true calling is church mission work. Like 70 percent of Bahamians Maureen has doesn’t have health insurance. She was sharing about her situation at Church outreach seminar in Atlanta, Georgia.

When she was finished, one of her American Missionary friends told she used to have the same problem until she joined a Christian Medishare - a US-based healthcare insurance that operates like a credit union. Christian missionaries pool their funds and pay for each other’s health expenses. It got Maureen to thinking: What if there was something like this medishare in The Bahamas or the Caribbean she could join? As it stands, if something happened to her or her teenage son, God forbid, she might have to organise a hurch cook-out to pay for her medical bills.

Paying for healthcare is complex for patients, providers and employers all over the world. For employers, health coverage is a major expense, often the second highest corporate expense after payroll. The key questions for employers are: What is the return on investment for the dollars spent? Are we keeping people healthy, so they are productive, innovative and thriving?

For many years, employers have been frustrated with rising healthcare expenses, declining population health, and wide variation in quality and outcomes. Employers need new solutions.

Providers and patients are frustrated too. They are challenged by the inconvenience, administrative barriers and convoluted practices driven by what their doctors, physiotherapists and other healthcare providers must do to get paid. Take John, for example. John is a senior executive at shipping company headquartered in New York. He’s married with two kids, his health is good and he makes $115k a year, before taxes. John’s company pays for his health insurance. His wife and kids are covered under his insurance policy but the high insurance deductible John ends up paying out of pocket for minor family healthcare issues like the flu – up to $1,500 a month during winter.

In the US, entrepreneurs, who are not insurance companies, are becoming health payers, creating medishare and other programmes that offer affordable healthcare packages for people who either don’t fit into the usual boxes, or for niche employee groups such as teachers, firefighters, nurses, construction-workers, small and medium business owners who need health coverage but can’t afford the traditional insurance plans. One such US-based programme even pays for stem cell and regenerative therapies as part of a preventive healthcare programme. What’s stopping these solutions taking hold in The Bahamas and the Caribbean?

The high cost of coverage, or of many common procedures for the uncovered has forced a growing number of people to get creative and others around the region are exploring the quality and cost of healthcare treatment abroad, a practice known as medical tourism.

Other healthcare trends fuelling the global medical tourism phenomenon include: increasing healthcare services demands driven on by demographic changes especially population ageing and older people’s requirements for more medical services, rising incidence of chronic conditions, waiting times and increasing cost of health services in patients’ home country coupled with the availability of cheaper alternatives in many developing countries. Surgeo - the ‘Airbnb’ of operating theatres - is one example of a successful medical healthcare business based on the region.

The global medical tourism market is estimated at worth $19.7bn in 2016, and climbing, with market growth estimated to reach $46.6bn by 2021. So why isn’t medical tourism big business in the Caribbean?

Tourism is the main industry of coastal US, The Bahamas, the Caribbean, and coastal South and Central America; why not leverage tourism assets, build medical infrastructure and invest in medical tourism in the region. Sounds simple. And, like most simple answers to complex problems, they’re usually wrong. There might well be new jobs to be had through medical tourism, but the untapped economic opportunities for this region are in translational medicine and research.

What opportunities? Translational medicine? More on this next week.

Speakers at the 2018 HEALinc Future Summit addressing complex issues of paying for health include Bernie Knobbe (VP benefits, AECOM), Alan Spiro (Blue Intelligence), David Contorno (founder of Lake Norman Benefits), Bill Fields, (chairman, Fields Texas Limited LLC, President and CEO of Wal-Mart Stores Division and executive vice president of Wal-Mart Stores, Inc), Morgan Pile (FutureHealth Alliance), Cathy Cather (Parallel Profile), Dr Steve Gerst (co-founder and principal of Asclepius Life Sciences Fund, LLC) and more. We’ll be discussing new economic opportunities and jobs opening up in the region entrepreneurs, healthcare cost management strategies for employers and ways employees can avoid depending on cook-outs to pay for healthcare. Don’t miss out. Register for the summit online at www.healincfuturehealthsummit.com. For more information, contact the Summit organising team: USA/Canada (877) 426-5361; Bahamas (855) 826-1165; Worldwide (716) 442-3798.

• Dr Desirée Cox, MD, PhD (www.desireecox.com) is the founder and CEO of the 2018 Inaugural HEALinc Future Health Innovation Summit (www.healincfuturehealthsummit.com). She is the first Bahamian Rhodes Scholar and first female British Caribbean Rhodes Scholar, a medical doctor, creative artist and published author. She has earned degrees from McGill, Oxford and Cambridge Universities. Her career achievements include honors by Oxford University and the British Medical Journal. In 2013, a 70 cent stamp bearing her photograph was issued by The Bahamas Government.

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