some European countries, comprehensive healthcare costs are covered
by social insurance eg France, Germany. In the UK,
Canada, Spain, like in Trinidad and Tobago, there is universal
healthcare. In the US there is no universal healthcare.
Universal healthcare is the term that expresses governments
involvement in health that seeks to ensure almost all citizens
have some access to free healthcare. This free healthcare is subsidised
by tax dollars or compulsory health insurance. In Canada, government
covers about 70 per cent of all healthcare costs.
In T&T, according to PAHO, the Government carries about 50
per cent of all expenditure on healthcare.
Bankruptcy linked to medical bills
The system in the US is based on private insurance, and, ironically,
US citizens spend the most money per capita than any other country
in the world. In fact they spend about US$6,000 per person, per
year. That is more than double the amount spent in Canada per
One study even put forward the idea that a large percentage of
personal bankruptcies in the US are related to medical bills.
Here at home, we have free hospitals and health offices,
paid for by tax dollars, and we have the National Insurance Scheme.
We also have private healthcare, some of which is employer sponsored.
Private health insurance and employer-sponsored heath insurance
are paid for by the individual and the employer together, and
the premiums are calculated based on risk, and not on income levels
More earned, more paid
National Insurance includes certain health benefits, and is paid
for via a compulsory deduction from wages and salary, based on
income levelsthe more you earn the more you pay. These deductions
from your pay have been dramatically increased effective January
2008. It will continue to increase until 2012.
For certain private health plans sponsored by employers the premiums
have almost doubled in the last three years. Rising premiums is
the result of raising claims experiences. Claims experience is
total cost of all claims submitted by the group of privately insured
While we may not have local up-to-date statistics on the cost
of healthcare to the individual, these increases in premium are
an indicator that the cost of healthcare has rapidly increased.
NIS contributions for people earning more than $5,459.99 per month
will now be $46.55 per week from their earnings. They used to
pay just about $34 per week before 2008.
People who earn more than $8,300 will now pay $67.03 per week.
They used to pay just about $34 before. They will pay between
$268 and $335 per month to NIS now.
The health-related benefits under NIS have increased by about
25 per cent overall.
Insurance that covers major medical conditions like heart attack
and stroke can also be bought by individuals to supplement the
cost of private healthcare. One major advantage for this kind
of protection is that your individual premium doesnt increase
with a higher claims experience.
But the longer you wait to buy this type of protection, the higher
the premiums will be.
Ironically, my experience is that only when people want to retire
do they seek this type of coverage. But by that age, the cost
is almost prohibitive. This is because the premiums are based
on risk assessment, and not income.
So, the premiums are really cheap, when you are young. Plus, the
benefit will be paid wherever you are in the world.