Post on 15-Aug-2020
Dr J Attride-StirlingChief Executive Officer2nd February 2010
BHeC ROTARY PRESENTATION
Overview
Who we are
What we do
Why we do it
BHeC: Who we are
Quasi-Autonomous Non-Governmental Organisation (QUANGO)
Established by Bermuda Health Council Act 2004. Operational since 2006.
Mission: to regulate, coordinate and enhance the delivery of health services
BHeC: Who we are (…cont’d)
Healthcare users
Annual MOH Grant $1.3 million
Structure: Council (Board) has 15
members Secretariat has 8
employed staff
Vision: Working together for a sustainable healthcare system
BHeC: What we do
Find out more at www.bhec.bm
BHeC’s Strategic Plan
Core operational activities
License health insurers
Review Standard Hospital Benefit (minimum insurance package) & Standard Premium (SHB price) annually
Review regulated provider fees
Enhance regulatory framework for healthcare
Enhance coordination of healthcare stakeholders
BHeC: Why we do it?
Why: Sustainability
Key assumptionsWHO health system modelBermuda’s health systemValue for money
Assumption 1: Health as a human right“Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services…” Universal Declaration of Human Rights, Article 25(1)
Illustration taken from “We Are All Born Free”, Amnesty International (2008) An illustrated children’s Universal Declaration of Human Rights.
Assumption 2: Healthcare is unlike consumer goods
Market forces don’t follow the same rules for healthcare
Healthcare interventions are provider-driven
Patients ability to shop-around is skewed
OECD Financing & Equity
Systems based on individual premia usually more responsive, but larger
burden on high-risk, high-use groups, usually the sick and the poor, leading to financial barriers to access
Systems based on ability to pay more equitable financial impact and
access to care, but less responsive to patient needs
Stewardship
Financing
Generating Resources
Delivering Services
Health Outcomes
Responsiveness
Fair financialcontribution
WHO Health System: Functions Goals
Source: WHO (2003)
Professionals per 10k:International comparisons (2007)
334515Singapore
656525UK
8129022Canada
988424USA
1377224Bermuda
Pharmacists (per 10,000)
Dentists (per 10,000)
Nurses (per 10,000)
Physicians (per 10,000)
Technology:International comparisons 2007
18.714.4Switzerland
12.76.7Canada
34.326USA
3131Bermuda
CAT Scans(per 1,000,000)
MRI units(per 1,000,000)
Health Indicators: Some international comparisons
14
8
7
11
0
Maternal Mortality (2007)
2.1 (2nd)
4.8(32nd)
5 (36th)
6.2 (46th)
1.3 (1st)
Child Mortality (2007)
80.6 ( th)
79.1 (30th)
80.7 ( 8th)
78.1 (35th)
78.3 (36th)
Life Expectancy
at birth (2007)
Singapore
UK
Canada
USA
Bermuda
Financing: Sources (2007)
100446,910Total
51.83.5
15.670.9
231,80315,65169,721
317,215
Private sector (est.)InsuranceNon-profitHousehold financingTotal
27.91.1
29.0
124,7424,993
129,735
Public sectorConsolidated fundOtherTotal
%BDA$ (000)
OECD average: 70% Public and 30% Private
Financing: Expenditure (2007)
100446,910Total
271096
52
119,68243,94640,06526,550
230,283
Private sector (est.)Local providersOverseasDrugs and others suppliesInsurance administrationTotal
74148
29,533187,134
216,667
Public sectorMinistry of HealthBermuda Hospitals BoardTotal
%BDA$ (000)
Financing: Share of GDP (2007)
7.6Health share of GDP (%)
6,982Per capita health expenditure (BDA$)
5,855,379GDP (BDA$000)
446,910 (est.)
Health expenditure (BDA$ 000)
2007
Per Capita Healthcare Expenditure and Health Share of GDP (2007)
Per Capita Health Expenditure and Share of GDP
0.0%
2.0%
4.0%
6.0%
8.0%
10.0%
12.0%
14.0%
16.0%
18.0%
USABerm
uda*
Norway
Switzerl
and
Luxe
mbourg
Canada
Netherlan
dsAus
triaFranc
eBelg
iumGerm
any
Denmark
Irelan
dSwed
en
Iceland
Austra
lia
United King
domFinl
and
Greece
Italy
Spain
Japa
n
New Zealan
dKore
a
Czech
Rep
ublic
Slovak R
epub
licHung
aryPola
ndPort
ugal
Mexico
Turkey
Perc
ent o
f GDP
-
1,000
2,000
3,000
4,000
5,000
6,000
7,000
8,000
Per
Capi
ta E
xpen
ditu
re
Per Capita Health Exp. Health Exp Share of GDP
Bermuda: Per capita health exp. = PPP US$6,982 (est.)
Health share of GDP = 7.6%
Life Expectancy and Per Capita Health Expenditure – OECD (2007)
Health Expenditure &
-
1,000
2,000
3,000
4,000
5,000
6,000
7,000
8,000
USABerm
uda*
Norway
Switzerl
and
Luxe
mbourg
Canad
aNeth
erlan
dsAus
triaFran
ceBelg
iumGerm
any
Denmark
Irelan
dSwed
en
Icelan
dAus
tralia
United
King
dom
Finlan
dGree
ce Italy
Spain
Japa
nNew
Zealan
dKore
a
Czech
Rep
ublic
Slovak
Rep
ublic
Hunga
ryPola
ndPort
ugal
Mexico
Turkey
Hea
lth E
xpen
ditu
re (P
PP)
66.0
68.0
70.0
72.0
74.0
76.0
78.0
80.0
82.0
84.0
Life
Exe
ctan
cy
Per Capita Health Expenditure (PPP in $US) 2007 Life Expectancy at Birth (years) 2007
Per Capita Health Expenditure in Bermuda Relative to Income (1993 - 2007)
4.8 3.35.06.7
7.27.6 2.84.67.3
10.013.9
19.9
0
5
10
15
20
25
VI V IV III II I
Inco me bracket ( V I = lo w; I = hig h)
%
1993
2007
Low Income
High Income
Healthcare expenditure and income
Take-home messages
Healthcare is a right, not a commodity
The way in which a health system is structured impacts on its cost
Bermuda can get more bang for every healthcare buck
Vision and collaboration are needed to get us there
Thank you!
Any questions?
Visit www.bhec.bm for more information