LETTER TO THE EDITOR
C.I.M.D.S. Council addresses fee splitting
Wednesday, June 8, 2005
Dear Sir,
This letter is in reference to the statement made by Mr. Steve Scott,
Chairman of the HSA and published in your newspaper on May 31, 2005. In the
article, a mention was made that an HSA spokesperson had said “ It is unfair
that private sector doctors use the facilities and equipment in George Town
Hospital without making any contribution whatsoever.” This misleading
statement suggests that the “spokesman” for the management is either ignorant
of acceptable hospital billing practices or is displaying incompetence in the
running of the hospital, or both.
The C.I.M.D.S. Council would like to address the facts.
Hospitals charge patients for using their facilities. This facility fee is
charged to cover the hospital’s costs. The patient, either directly, or
indirectly through a third party provider/insurance company, pays for the use
of the hospital’s facilities. All fees billed by the hospital are kept by the
hospital. A doctor’s fee would only be paid directly to the hospital if they
were a salaried doctor employed by the hospital. The suggestion by the HSA
spokesperson amounts to double billing of the patient for the service. This is
an unethical practice that is fraudulent and illegal in many countries.
It is indeed unfortunate that the HSA management seems to be unaware of
correct and acceptable billing practices in today’s environment of mandatory
health insurance and reimbursements from insurance companies. Correct and
acceptable billing is necessary in order to receive reimbursement for services
provided. Correct billing practices and accounts receivable management provide
the conduit for the revenue stream. If this stream is weak then changes based
on good practice, not on gouging doctors should be made.
In most jurisdictions, hospitals actively encourage doctors to bring their
patients as every patient generates income for that hospital. The greater the
usage, the more cost-effective services become, the larger the revenue. On the
other hand if you are losing money, you would lose less by discouraging
doctors to use the facility.
The hospital was paid for and still is being paid for by the residents of
the Cayman Islands through taxes paid to the Government. The hospital
continues to lose money despite the establishment of the HSA intended to make
the hospital an independent, self-sufficient organization. So far, it has not
succeeded and it is now no surprise. Since Government still supplements the
hospital and makes up its shortfall from its coffers, every citizen and
resident continues to pay for it. The public deserves more accountability and
value for money.
The C.I.M.D.S. knows that there are good doctors and nurses in the hospital
who are very dedicated and trying to do the best for their patients with
little support from the HSA management. We admire and salute those who are
still here and feel sorry for the many good ones who left out of frustration.
Whilst the C.I.M.D.S. does not pretend to know all the answers, its members
have been and still are extremely keen to work with the hospital to increase
its utilization and cost-effectiveness. Just as every citizen and resident, we
all have a stake in making the hospital a success.
The C.I.M.D.S. Council
Back...
| 
