Andrew Vincent MBA DipM
Director, Integra Healthcare Ltd
In many respects I should be epitome of health. As Director of Integra Healthcare Ltd, a multispecialty clinical practice with approaching a dozen providers and a focus just as much on good health as ill health, and relationships through a field of excellent healthcare provision across Grand Cayman, I have enviable access to high quality healthcare. And yet, I will openly admit I am a way off being the model healthy human. And there lies the problem. I am also human.
Conceptually, we all understand it is better not to get sick than to get fixed for sickness, and yet we all lie along on a spectrum of behaviour from the fastidiously health conscious in every decision, all the way down to what appears more like wanton self-destruction with our health choices. Few people are at the extremes, but most would have to admit there is room for improvement.
The problem is not a standardised one and so we have to recognise the solution won’t be either.
I am a somewhat overly busy professional who, despite having access, insurance and a reasonable disposable income, frequently makes poor health choices in diet and places that busy work-life in the way of good health. I am not solely my own self-cause. As any fee-earning professional will attest to, and we have an army of these on our Island, an hour out in the day to attend a healthcare provider is not a matter of just co-pay, it is the loss of that hour. Healthcare providers tend to keep the same hours as most other employees, and although very few employers would frown upon clinic attendance for ill-health, we are inclined to view wellness care as more optional.
For some, it is the access and insurance that is the barrier. The allowance for wellness is the SHIC (Standard Health Insurance Contract), that many find themselves on out of sheer financial necessity, are woefully low, designed instead to ensure that emergencies and major illnesses receive a basic level of cover. There is, of course, an irony to a health insurance policy that increases the likelihood of being used because of the absence of cover for wellness, prevention and health.
What’s more, whether you are on a premier plan with a premium provider or the very basic plan, they are all increasing, typically at a rate in excess of background inflation. The insurer is faced with the ultimate catch 22 of cover – do they increase cover, pushing policies out of reach of more people or resulting in the choice of a lower policy, or do they continue to maintain or even clip benefits to remain affordable? Presently, with background inflation topping 10% in the Cayman Islands, those difficult health choices are already being made by many faced with food versus adequate shelter versus adequate health cover. And of course, food and shelter contribute to health. Everything is interlinked.
Ultimately, good health is good for all. It benefits insurers, who enjoy a lesser disease burden and thus can maintain lower insurance premiums. It benefits employers, through lower rates of sickness and absence. It benefits the Cayman Islands Government, who carry the healthcare costs for a significant proportion of the population, both now and in future liabilities. But most of all it benefits you. Better health for self is an investment in a longer, healthier and ultimately less costly life.
We can all take a walk, reduce a portion size, or survive without so much sugar. If we have the right cover, we can go for a wellness or executive medical and set a baseline. We can all do more, and I would suggest, in fact, that none of us can afford not to, both economically and in healthy longevity. As this column unfolds, we will explore what more optimal health for self looks like and some of the options available to us. What I can promise though, is that it will come with a good dose of realism and not a shred of judgment until the day I am the perfect example of better health for self. Given my current position on that spectrum, you are safe for a while.
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