When the previous strategy was set to expire in 2019, the Ministry of Health began work to create a new strategy for the next five years (2020-2025), which could serve as a frame for a redesign of the healthcare system. This work included a public survey, as well as surveys of, and interviews with, providers, insurers, professionals and patients. A series of workshops with key stakeholders assisted in identifying design principles for a refreshed Health Strategy. Unfortunately, due to the pandemic, this progress stalled. In early summer 2021, a new group of passionate and dedicated stakeholders from across Bermuda’s healthcare community, joined together to form a steering committee whose main purpose was to develop a roadmap for strengthening the island’s health system and achieving universal health coverage. In parallel with those efforts, the Ministry of Health, supported by professional advisory firm, KPMG, started once again to develop the next Health Strategy. The Bermuda Health Strategy 2022- 2027 incorporates feedback from both the pre-pandemic stakeholders as well as the UHC steering committee members. Thanks to both of these groups’ hard work and enthusiasm for serving our island, we now have a high level strategy that outlines the steps needed to improve the healthcare system in Bermuda.

Just like you would not build a house without a blueprint, the Ministry of Health would not want to make changes to our unique and complex healthcare system without a clear plan, in this case the Bermuda Health Strategy 2022-2027. The Ministry of Health is looking forward to guiding the necessary system changes and delivering the stronger, more sustainable healthcare system that Bermuda’s people need. We believe that a healthy nation benefits all citizens, as well as the wider economy. Through this strategy, we aim to provide Bermuda with a clear vision for health alongside our refreshed priorities for the local health system. This Strategy will help us as we navigate these system-wide improvements and changes over the next five years.

At the Ministry of Health, our vision is healthy people in healthy communities. In order to accomplish this, it is important that we look at our health system on a regular basis to determine what’s working well and not so well and plan a way forward to improve it. The Bermuda Health Strategy 2022-2027 does just that. It looks at some of the challenges our health system is currently facing and ways that we can change it for the better in years to come. While we are grateful to have a health system that is well- developed and well-supported by dedicated professionals, the fact remains that not all Bermuda’s people are currently able to afford essential medical care. We believe that change is necessary and the refreshed Bermuda Health Strategy 2022-2027 maps out how we can get closer to that goal.

The Bermuda Health Strategy is now available on our website HOME page. If you have any feedback or questions, please email moh@gov.bm.

The new Strategy is a continuation of the Ministry of Health’s previous work (outlined in the 2014-2019 Strategy). It takes into account many of the strengths and weaknesses of Bermuda’s healthcare system, some of which were uncovered throughout the Covid-19 pandemic, and is now organised around eight guiding principles. One of the highlights of this Strategy is its focus on the need for greater collaboration among stakeholders within the healthcare industry. We believe that together we can find solutions to some of the challenges the Island is facing. Additionally, the Strategy outlines our shift to a more people-centred approach to healthcare with the aim of delivering better care that meets the needs of individuals and families today - and into the future.

The Government’s vision is “healthy people in healthy communities”. Bermuda Health Strategy 2022-2027 outlines eight (8) core principles to follow to strengthen Bermuda’s healthcare system. These include: Promoting healthy living and preventative care; Focusing on people-centred care; Understanding our population’s health needs; Providing universal access to healthcare coverage; Strengthening our healthcare workforce; Harnessing healthcare technology; Partnership and collaborative working; and, Preventing wasteful care and promoting efficiency.

One of the goals outlined in the Bermuda Health Strategy 2022-2027 is to promote healthy living and preventative care. Research shows that high rates of preventable chronic illnesses (like diabetes and heart disease) place a huge burden on our healthcare system’s resources. These diseases are strongly related to lifestyle factors like poor diet, lack of exercise and smoking. By increasing public awareness of these issues, we aim to prevent and reduce the amount of people living with these diseases. We are also looking at how we can develop future policies that make it easier for people to make healthy lifestyle choices. If you have ideas or suggestions for ways to better promote healthy living and improving health outcomes, and are interested in being part of one of our working groups, email us at uhc@gov.bm. We did not produce an unhealthy population overnight, and it will take some years to see an improvement in our Island’s health outcomes.

Bermuda’s healthcare system is one of the most expensive in the world - and yet our people’s health is still struggling in many aspects. The latest statistics from before the pandemic show that 50% of adults in Bermuda have at least one chronic condition (e.g. diabetes, heart disease, or kidney disease), while 75% of the population is overweight or obese. Additionally, up to 35% of the population remains unable to access quality healthcare without financial hardship. This includes those that are uninsured - around 12% of Bermuda’s population; as well as those have defined unaffordable health insurance or are underinsured, which accounts for approximately 23% of the population. In order to address such issues, including the cost of healthcare on the Island which rose 69% between 2006 and 2017, we must commit to strengthening our healthcare system. The Bermuda Health Strategy 2022-2027 outlines eight core principles for improving healthcare on the Island. One of those is providing Universal Health Coverage, whereby all Bermuda’s people would have access to an essential healthcare package. Meanwhile, insurers would be needed to provide additional supplementary coverage to individuals and families.

Universal Health Coverage (UHC) is described by the World Health Organization as a basic human right. That means all people should have access to the essential health services they need, when and where they need them, without falling into financial hardship or distress. Bermuda’s version of UHC also seeks to provide all people with access to essential health services. We want to stress that there will still be a need for local insurers to provide supplementary coverage that goes beyond these essentials. UHC does not mean free access to every possible health service for every person at all times. Each country which has adopted UHC has taken a different path to achieving this goal. We must decide for ourselves - with the help of all stakeholder groups - what essential health services to cover based on the current and future needs of our people, as well as the resources available. Ultimately, Bermuda will adopt a system which suits our island nation and population best.

While there are a few different models which Bermuda can copy to achieve UHC, it is important to recognise our own starting point. Bermuda already has a well-developed health system supported by dedicated professionals. The challenge is affordable access and whether we are getting all possible value in our interactions with the system. So, simply picking a model and following it is not a practical option. We must undertake the work necessary to create a system which is uniquely suited to the island and its population. There are likely to be overlaps with other jurisdictions simply because this is not a new journey; it is just a new journey for us.

Just as it did for the rest of the world, the Covid-19 pandemic highlighted both the strengths and weaknesses of Bermuda’s healthcare system. With respect to our employment-based health insurance system, a number of employers found they were unable to maintain the legal obligation to provide health insurance for their employees as the world shut down. The Health Insurance Department is working with affected companies to assist them so that employees are not put at risk. As it relates to our targets for UHC (announced previously in 2018 and 2019), the pandemic most certainly impacted our ability to pursue these goals in the way and on the timeline we first expected. We were forced to slow down quite significantly. On the plus side, the pandemic allowed us to pause and reflect on our desired course of travel before, once again, moving forward. We now have a new, refreshed strategy (Bermuda Health Strategy 2022-2027), which was developed with the input of a diverse group of stakeholders in our community.

Yes. Bermuda’s current payment structure is complex and the Government intends to streamline by having a single or dominant payor for the essential benefits that will be provided under the Bermuda Health Plan. Decisions about how the system will work have not yet been made but one entity, which will not be a government department, will provide the essential health coverage for everyone. And the “extras” will be covered by the private insurers. It is a work stream for the future to determine the legal and operational structure of the entity which takes on the role of dominant payor for the people of Bermuda. The initial work to pool the government funds will likely be led and managed by the Government.

Bermuda has implemented various different public health plans over the years, including FutureCare and HIP. The Bermuda Health Plan will be a core plan, specific to local residents, which includes benefits to keep people healthy and provide access to essential health services and medicines. The essential health services that will be covered under the plan have yet to be determined. There is a substantial amount of investigation and research, survey work and stakeholder engagement that is needed first, including a comprehensive national health needs assessment to ensure a proper understanding Bermuda’s current population health needs and challenges.

Bermuda will need to consider, “What are the most essential healthcare benefits?” The recommendation from the UHC Steering Committee is to focus in on the highest priority care to start with, to pick which services are covered in a prioritised and phased way, starting with what everybody can agree are the highest priority elements to ensure that the greatest needs are met first. There is a local knowledge base of medical practitioners, insurers, patients, health service providers, and more, who will be asked to assess the evidence and data and to make recommendations. Collaboration will be critical, and Government’s role will be to bring together the necessary participants.

Information on the UHC Steering Committee, including its terms of reference, is now available online on this website's 'ABOUT' section. If you have additional questions about the Steering Committee, please email uhc@gov.bm.

To put it plainly, changes to Bermuda’s healthcare system will not happen overnight. Countries around the world have undergone a similar journey to provide universal health coverage (UHC) to their residents, and it has taken ten or more years to complete. At this stage, we are clear on the high level steps and the initial timelines we need to meet. However, a lot more groundwork needs to be done with the help of healthcare stakeholders before this plan becomes a reality. We hope to provide regular updates to the public as more progress is made with UHC. To be added to our mailing list, email uhc@gov.bm.

So far, the Ministry of Health HQ, the project sponsor, has held initial meetings with the private insurers, Bermuda Medical Doctors Association, representatives of the island’s health professionals regulatory authorities such as the Bermuda Medical Council, Bermuda Nursing and Midwifery Council, Bermuda Dental Board, Bermuda Psychologists Council, Council for Allied Health Professions, Optometrists and Opticians Council, and Pharmacy Council, Bermuda First, executive committees of the Bermuda Hospitals Board and Bermuda Health Council, also, Ministry of Health staff, representatives of the Chamber of Commerce, Bermuda Employers’ Council, Bermuda Hotel Association, Bermuda Business Development Agency, Bermuda Economic Development Corporation, Association of Bermuda Insurers and Reinsurers, Association of Bermuda International Companies, Bermuda International Long Term Insurers and Reinsurers, and the Bermuda Trade Union Congress. As stated by Minister Wilson, part of the work to achieve UHC involves setting up a governance structure for the transition period, with active working groups as part of that structure. We hope these stakeholders, and more, will participate in the working groups. The transition to UHC will be supported by a programme management office (PMO) to be staffed, initially, by public servants.

While we are clear on the high level steps and the timelines we need to meet in order to strengthen Bermuda’s health system and introduce UHC, a lot more groundwork needs to be done to iron out many of the details. With the help of diverse healthcare stakeholders, who will be engaging with us through various working groups, we are confident we’ll be able to answer questions about current health plans at a later stage. In the meantime, check this website for updates or email us at uhc@gov.bm to ask a question or get more information.

While Bermuda works its way towards providing a package of essential health coverage for all residents, the need for our insurers to provide supplemental health insurance will continue. It is too early to say what might need to be included in a supplemental health insurance package, however the public will continue to receive updates once details emerge over the coming months and years.

In Bermuda, private payors are the insurance companies and the public payor is the Government. Providers are the persons or organisations offering the services such as doctors, dentists, physiotherapists and associated professionals, as well as the hospital, non-profit charities, and diagnostic laboratories.

There are many components in the work stream that eventually determines the cost of health insurance premiums. We have not yet done the work to know the answer. What we do know is Bermuda currently spends around 11.55% of our GDP on health - the third-highest in the OECD. Additionally, up to 35% of the population remains unable to access quality healthcare without financial hardship. This includes those that are uninsured - around 12% of Bermuda’s population; as well as those have defined unaffordable health insurance or are underinsured, which accounts for approximately 23% of the population. The Ministry recognizes the need to ensure both value and cost effectiveness throughout the health system, and this is not just limited to our insurance premiums. One of the eight principles outlined in the Bermuda Health Strategy 2022-2027 is to prevent wasteful care and promote efficiency in the Island’s health system. The aim is to avoid wasteful healthcare spending, whether that be administrative, operational or clinical. While more work needs to be undertaken to better understand Bermuda’s current and future health costs, one of our first undertakings will be determining how to provide better value for residents, payors and providers.

At this stage, we are clear on the high level steps and the timelines we need to meet to achieve Universal Health Coverage in Bermuda. However, a lot more groundwork needs to be done with the help of diverse healthcare stakeholders before final decisions can be made. In order to determine what will happen to the current Government health plans, including FutureCare, the relevant working groups must engage in further discussions and assessments. We look forward to providing an update on this when that information becomes available. In the meantime, please periodically check this website for the latest updates and progress reports related to UHC and the Bermuda Health Strategy 2022-2027.

Yes, although the exact point at which it is included has yet to be determined.

One of the working groups identified as part of the governance structure is a ‘Health Advocacy Forum’. The Ministry plans to encourage patient representatives, non-profits and civil society groups to participate in health system reform through the Forum. In addition, there is a patient representative on the UHC Steering Committee.

The Ministry of Health is looking to engage widely and seek feedback from a broad cross-section of healthcare stakeholders, including the general public. If you haven’t yet been consulted or are interested in participating in our working groups to help determine best next steps for making UHC a reality in Bermuda, please contact us at uhc@gov.bm. You can also visit this website periodically for updates and more information.

This website will provide regular updates, as well as the latest news and information on UHC. If what you’re looking for is not on our website, please email your questions to uhc@gov.bm.