It is a difficult dilemma to solve when you have $90M of bad debt and the vast majority of it is uncollectable.

This is the problem the Cayman Islands Health Authority has and realistically only $10M of it is collectable.

The Public Accounts Committee last Wednesday (7) was quizzing Health Services Authority (HSA) CEO Lizzette Yearwood and HSA Board Chairman Jonathan Tibbetts.

It was determined that the debt had risen to the $90M figure over the last ten years and it was time they said for a realistic analysis of what could be collected they told the Committee.

The HSA has had to treat patients who have no insurance or they are underinsured or they would die. There is no way the HSA could sue these persons who have no visible means to pay for the treatment they have received,

I fully can understand that and I have no quarrel with that analysis.

What has staggered me is there are insurance companies here who have not paid the HSA for treatment their customers have received.

Both Joan and I are under the government health plan CINICO and that is woefully inadequate for serious medical emergencies. And even when you are covered CINICO are reluctant to either sanction the treatment before the patient has it and refuses to pay or argues about it after the patient has received it.

We both know from experience.

When Yearwood told the Committee that there are insurance companies who have not paid up I have to wonder how much is owed by CINICO?

Even though the HSA have said they are going to be tough with the insurance companies I cannot see them actually suing the government for the debt they might owe.

Before my wife and I have had treatment that requires surgery we have had to pay the HSA the remaining money CINICO will not pay under the plan one is on. In our cases this amounted to 10%. And when I say we had to pay it – we had to pay it BEFORE any treatment took place.

In my case I was scheduled for a five day stay in hospital that was only in fact two days. Did I receive any credit on the $3,000 up front payment? No I did not.

I bet I am not the only one.

So it works both ways, too.

I wish the HSA the best of luck in their endeavours and although government has agreed to write off the vast amount of the debt I cannot see much improvement no matter what measures they say they are now taking to recover at least $10M of the debt currently owed.