'We need to design something that works for us': Jersey minister looks at funding options for health

  • ITV Channel reporter Alex Spiceley has been looking at the various options Jersey could take to fund its health services in the future

Jersey’s Health Minister believes the way the island's healthcare system is funded may have to change.

This could mean residents taking out private insurance or paying more charges as Deputy Tom Binet considers what needs to be done to meet rising demand amongst an ageing population, although he says any decision would first need public consultation.

Speaking exclusively to ITV News, he says: "We have to be careful not to be over radical but the current plan is to restructure the health service. Some work has already been done to look at other models.

"We need to design something that works for us. The first thing we need to do is to be efficient.

"Once you have got efficiency in the system you can then layer on different things to help the process."

The minister is looking at the prospect of having someone in charge of the health service in its entirety.

He also wants to address spending which hit £303 million in 2023 and is expected to reach £329 million this year just to keep the current services running.

That figure is more than a quarter of the entire States' budget.

Deputy Binet adds: "Health is spending more money than we thought and we are probably going to require £24 million more this year than budgeted, and the same next year.

"We are never going to save money to the extent we can come back from that.

"Some of that budget does include work on bringing wait times down. The short term is to make sure we have the funding we need for 2025."

The minister says that the Government has looked at other healthcare funding models - a few global examples are listed below:

The Beveridge Model (National Health Service)

Funded by taxes, there are no out-of-pocket fees for patients or any cost-sharing. Everyone who is a tax-paying citizen is guaranteed the same access to care and nobody will ever receive a medical bill.

One criticism of the Beveridge Model is its potential risk of people overusing services.

Without restrictions, free access potentially allows patients to demand healthcare that is unnecessary or wasteful. The result would be rising costs and higher taxes.

The NHS is used by the United Kingdom, Spain, New Zealand, Cuba, Hong Kong and the Veterans Health Administration in the United States of America.

The Bismarck Model (Public Health Insurance)

Employers and workers are responsible for paying for their health insurance system through payroll deductions that create 'sickness funds'.

They cover every employed person, regardless of pre-existing conditions, and are not profit-based.

Providers and hospitals are generally private, although insurers are public.

In some countries such as France, there is a single insurer.

Care is subsidised for those who are unemployed and receive pensions.

The primary criticism of the Bismarck Model is how to provide care for those who are unable to work or can't afford contributions, including ageing populations and the imbalance between retirees and employees.

The National Health Insurance Model

This option blends different aspects of both the Beveridge Model and the Bismarck Model together.

First, like the Beveridge model, the Government acts as the single-payer for medical procedures. However, like the Bismarck model, providers are private.

The National Health Insurance Model is driven by private providers but the payments come from a government-run insurance program that every citizen pays into.

Essentially, it is universal insurance that does not make a profit or deny claims.

Since there is no need for marketing, no financial motive to deny claims, and no concern for profit, it is cheaper and simpler to navigate.

This balance between private and public gives hospitals and providers more freedom without the frustrating complexity of insurance plans and policies.

The primary criticism of the National Health Insurance Model is the potential for long waiting lists and delays in treatment, which are considered a serious health policy issue.

This system is used in Canada and Taiwan and is similar to Medicare in America.

The Out-of-Pocket Model

Patients must pay for the procedures and services they need and rely on savings or private health insurance.

This is used by rural areas in India, China, Africa, South America, and uninsured or underinsured populations in America.

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