Bermuda’s Aging Health System, Dr. Ricky Brathwaite, Senior Health Economist

RickyBrathwaite_PresentationPresented at the 2016 Summer Leadership Conference: Bermuda’s Aging Health System, Dr. Ricky Brathwaite, Senior Health Economist

Who are we? The Health Council
Quasi-Autonomous Non-Governmental Organisation (QUANGO)
 Established by Bermuda Health Council Act 2004. Operational since
 Structure:
 Council (Board) has 15 members
 Secretariat has 8 employed staff
 Mission:
To regulate, coordinate and enhance the delivery of health
 Vision:
To achieve a quality, equitable and sustainable health system

What do we know?
 Healthcare in Bermuda is not affordable for all
 Relative low income threshold for 2013 was $51,012
 Our chronic disease burden is significant and our aged population is growing
 13% Diabetes compared to 8.3% globally
 Trends demonstrate growth in healthcare costs and expenditures over time
 Subsidies have more than doubled since 2005
 The international standard of health financing has encouraged greater
collaboration within new financing models
 The current Standard Health Benefit package has the potential to limit choice
and competition
 Our population is aging, with an average age now of 51 years old

You can view the full presentation here.

What the US and Bermuda Have in Common: “Perspectives” from Dr. Claudette Fleming, Executive Director of Age Concern Bermuda

ClaudetteFlemingPresThe challenges associated with aging demographics go well beyond the usual and customary calls for more professional, trained personnel, age appropriate accommodations, or medical and rehabilitation services. While all of these are needed, according to Claudette Fleming, DDippl, the Executive Director of Age Concern Bermuda, the history of how we got where we are, or as Dr. Fleming put it, “perspectives” informs what’s possible for the immediate and long-term future. Speaking at the Summer Leadership Conference 2016, hosted at the Fairmont in Southampton, Dr. Fleming described how the Bermudian and US age care systems are headed toward a period of “integration,” after periods of “institutionalization” and “medicalization.”

This is certainly true in both Bermuda and the United States. With very similar demographics, including progressively aging populations, and growing dependency ratios, post-acute care services are drawing significant new attention. Government bodies in the US such as the Centers for Medicare and Medicaid Services (CMS), as well as private intermediaries are looking for efficiencies and economies in the post-acute, or long-term care systems. Dr. Fleming described the current situation in Bermuda for lodging, rehabilitative, and respite services as, “a crisis situation,” and suggested that only political will would resolve the current difficulties. While the supply and demand situation in the US probably isn’t at a crisis, there certainly are imbalances which government and private market forces are attempting to rebalance. Claudette described the government penchant for commissioning study after study, while the underlying issues go unaddressed. In the US, we call this “kicking the can down the road”.

Another painful fact which Bermuda shares with the US is the extraordinarily high cost of healthcare. While it is common to refer to the United States as the most expensive health care system in the world, in fact, Bermuda ranks 3rd among developed economies. Amazing, considering the small size of the country.

The cost of health insurance is another painful similarity. The Bermuda market is of course much smaller than the US, with a population of only 64,000 versus 384,000, the actuarial characteristics of the risk pool mean that health insurance is staggeringly expensive for the average Bermudian family, often costing $10-$15,000 per year. There is no “safety net” insurance available for the island’s poor, such as the Medicaid program in the US. Moreover, with an age-targeted infrastructure that has been developed like topsy, many Bermudian hospital beds are taken by aged consumers who, while not in need of acute-care hospital services, have no other place to go where their chronic care needs can be met.

There certainly are lessons to be drawn from developed countries around the world, including the US and Bermuda, about how to address the expensive and culturally critical care needs of each populations. Dr. Fleming’s “perspectives” are an excellent place to start.

You can see Dr. Fleming’s full presentation here:

The 2016 Summer Leadership Conference Focused on Long-Term Care Leadership Being Held at the Fairmont Southampton, July 25 – July 29

SLC_Broch2Southampton, Bermuda – July 25, 2016 – The Summer Leadership Conference (SLC), an annual event coordinated by the NYC-ACHCA and NYSHFA/NYSCAL, is now underway at the Fairmont Southampton through July 29. The event brings together leaders in the long-term care field, including CEOs, facility owners, ACHCA and NYSHFA members and nonmembers, and healthcare company providers, who want to increase levels of productivity and cooperation in their organizations or communities. The SLC has been held in Bermuda since 2002.

The Summer Leadership Conference is a unique opportunity to “get away from it all, to get into it” for long-term care leaders. The conference is regularly attended by executives who relish the opportunity to discuss real-world issues with fellow leaders in an intimate, collegial setting. Loyal participants have been attending for many years, citing the quality of the program, the ability to interact one-on-one with other executives, while earning 15 CEUs.

The theme of this year’s Summer Leadership Conference is 5 Steps to Building & Leading a More Results-Driven Team and is being facilitated by Dr. Bryan K. Williams, D.M. Dr. Williams is a service consultant, trainer, and author. He has facilitated workshops and delivered keynotes worldwide for various companies in diverse industries. The SLC program is presented in a series of highly interactive sessions and focused on class models for leadership, sound principles of management, and the behavioral science of motivation. You can view the full program here.

After participating in this program, participants will:

  • Know what it takes to be a leader whom others want to follow
  • Be better at communicating each member of their teams’ roles
  • Empower their team members to connect to a greater purpose

This year, the SLC is pleased to add a new, international perspective to the Conference. Two Bermudian healthcare leaders – Dr. Claudette Fleming and Dr. Ricky Brathwaite – will deliver presentations about the challenges of serving a growing aged population in Bermuda.

Dr. Claudette Fleming is the Executive Director of Age Concern Bermuda, the most important advocacy group for issues of persons of age in Bermuda. She brings a wealth of experience and will discuss the demand, access, and challenges associated with the aging population in Bermuda.

Dr. Ricky Brathwaite is an internationally recognized healthcare economist. A native Bermudian, he splits his time among his home country and clients all over the world, while managing to spend significant time in Washington DC. A global thinker, he will share his perspectives on comparative health care systems, specifically as these relate to care and services for persons of age.

“The best thing about the Summer Leadership Conference, after all these years, is being there with our friends and colleagues. We’ve grown close over the years – much of this commenced and centered around the SLC. At the professional development level, there’s a level of honesty and openness. This is a great place to see first-hand different styles of leadership and learn from each other. Each year when I leave, I can’t wait to get back!” says Larry Slatky, SLC Organizer and Conference attendee since 1982.

The Summer Leadership Conference is an ideal way for long-term care leaders to refocus, recharge, and plan for today, tomorrow, and the year ahead. You can learn more about the Conference here:

About ACHCA, New York Chapter

The New York Chapter of the ACHCA (NYC-ACHCA) is a State affiliate, of the ACHCA that was founded in 1962, the American College of Health Care Administrators is the only professional association devoted solely to meeting the professional needs of today’s long term care administrators and executives. Focusing on advancing leadership excellence, NYC-ACHCA provides professional education and certification to administrators from across the spectrum of long term care.

For more information, visit


The New York State Health Facilities Association & New York State Center for Assisted Living is a member-driven association of providers of long term care services, caring for individuals of all ages in proprietary, not-for-profit, and government-sponsored skilled nursing, post-acute, rehab, adult care and assisted living communities across the state of New York.

For more information, visit