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Bermuda's Senior Citizens compared to other countries

Far lower social security and benefits than USA, Canada, UK and Europe

By Keith Archibald Forbes (see About Us) exclusively for Bermuda Online

To refer to this web file, please use "bermuda-online.org/seniorcitizens1.htm" as your Subject.

Preamble

As communicated in March 2005 to Age Concern (Bermuda), the Bermuda Healthcare Consortium and summarized by the author at a National Assembly meeting of Age Concern Scotland (of which the author is a National Assembly member) in Edinburgh, Scotland on March 16, 2005.

How pensions, benefits and services compare with those overseas

Social Security Payouts by age 65

• all converted to US$ 

• $= lowest payouts

• $$$$$ = highest payouts
• See Social Security Monthly averages below

Per Capita Income

Countries with highest per capita income in the world are, in order of wealth, Bermuda, Liechtenstein, Luxembourg, Switzerland and Monaco (not USA as commonly assumed, it merely has the world's biggest economy). The first five countries, despite their small size geographically, are all major international business centres and tax havens. This yields the greater part of their revenue, far more than tourism. In  Liechtenstein, Luxembourg, Switzerland and Monaco, they make a point of ensuring their elderly citizens get a significant share of their international business and tax haven revenues to correspond with their social welfare needs.

Home care provisions

• At Government expense, paid out of taxes.
• Least generous - none
• Most generous - $$$$$
• In Australia, Denmark, Liechtenstein, Luxembourg and Monaco, more than 20% of those 65 or over receive home help, from medical care to tidying up. In Norway, 17% do; in the Netherlands, 14% do; in UK (via carers) and Switzerland, 12% do; in USA, less than 10%.

Employees/employers government-required private pension coverage

$ shown do not represent amounts but effectiveness.  Required by law in most European countries and protected by legislation, some 0- like the Netherlands - for over 30 years. In USA, only about 50% have such coverage.  In UK, Bermuda, USA, if companies go bankrupt or wind up, there are no laws protecting these pensions.

Sheltered Housing and Care Homes

USA is the most generous overall, although it varies and is administered and often owned directly or indirectly, by each State. In USA, pensioners who qualify get and can keep all their Social Security and pay as rent only what they can afford. The sheltered housing apartments this author and his wife saw at Hope Homes in Attleboro, MA, as typical, are in various sizes for widows or widowers or married couples, but all have at least one double bedroom; bathroom with shower/bath and toilet; separate living room, kitchenette with dining area; and storage space, with a central lounge and other facilities, usually with a car park for vehicles owned by persons living there. By contrast, the sizes of the premises in all other countries shown are smaller. Citizens of most of them keep their social security or pay a moderate amount as rent. In the UK, premises are small and pensioners have to surrender all their social security, except for about £18 a month. In Bermuda, the least generous, rents are far higher than social security and premises are only for those who can afford them from their own resources or those of their families.

Universal Health Care included in taxes

Universal prescriptions included in taxes

In UK, free Prescriptions automatically without limit to all over 60s and qualified others  doctor-confirmed qualifying condition such as diabetes, heart problems, asthma, thyroid. In USA, mostly under Medicare. Nearest Bermuda has is $1,000 Annual Prescription Drug Benefit to all seniors - over the age of 65, not 60 - providing they have local Government-provided Hospital Insurance Plan (HIP) insurance, costing each of them $133.20 a month.

Overall evaluation

• The UK has the world's 4th largest economy but does not score well compared to other countries with smaller economies. 
• Bermuda, the world's most affluent country per capita, appears to be the least-generous country by far.
• Health & Disability Resource Centre. Shows benefits and more in USA, Canada and beyond.

Social Security monthly averages compared to UK and USA

All converted to Bermuda/US $. In the case of the UK, figures shown are weekly converted to monthly and also converted to US $ at the exchange rate of £1=US$1.90. Source - the author. 

• Why is it that only in  Bermuda , not in the UK or in any other country overseas, persons aged between 65-74 years require a medical and competency certificate every third year and those 75 years or older require an annual medical and competency certificate. This should be stopped immediately as chronic age discrimination. As Government has passed a bill to raise the mandatory retirement age for civil servants and also made provision for them to be re-employed by Government without losing their pension benefits, the same should surely apply to vehicle licensing benefits, to eliminate for the reasonably healthy over 65s and over 75s the highly discriminatory vehicle licensing restrictions that now apply to them only.  
• Why is it that despite the fact that the World Bank has rated Bermuda as the world's most affluent country by far since 2005 in gross national income and per capita income, they treat their seniors with far less respect than the far less affluent  UK , countries of Europe, Australia , etc? I refer to two particular areas, Social Security and medical prescriptions. In the United Kingdom and elsewhere in Europe, anyone over the age of 60, not 65, qualifies for entirely free prescriptions and without any need for senior citizens to enroll in any government plan such as the Bermuda Government's Hospital Insurance Plan (HIP), to qualify.
• Even when they have HIP, it only allows for four visits a year, and only up to $1200 a year in prescriptions, unlike in the UK where the National Health Service offers seniors free and unlimited visits to their doctors . Most of the senior citizens can use this up in one month. Plus, there is no dental care offered on HIP, unlike in the UK where senior citizens who qualify for the National Health Service (NHS) Tax Exemption Certificate can also receive fee unlimited dental and many other supplemental health services.   
• It must be said that by comparison, wealthy Bermuda is mean and uncaring to its seniors.
• Re the Bermuda Government's Special Person's ID for both seniors and the disabled, to enable them to travel free on buses and ferries, there is an added humane factor now in effect in the UK and Europe, that Bermuda should copy. It is that persons under the age of 60, when travelling as a registered companion of an over 60 or disabled or an over 60 and disabled person, can also ride free. In many cases here in the UK, the elderly are so feeble or with greatly restricted mobility or effectively disabled that the only way they can go out at all on most buses, ferries and trains is with the active help and kindness of an able travel companion. They can register for a special ID card for both themselves and an under 60 companion. 

None of the points above have been made public in Bermuda, they ought to be. Age Concern Bermuda and the Bermuda Council on Aging should follow the example of  Age Concern England, Age Concern Scotland, Age Concern Wales and Northern Ireland and the UK equivalents of the Bermuda Council on Aging who were the leading spokespeople here in the UK to get them legislated. 

Both Age Concern in Bermuda and the Bermuda Council on Ageing were written to about these points.  It is worth noting that both organizations show in their mission statements that they are in active partnership with Government.

Eligibility of Pensioners

Overview in Bermuda

The World Bank says only Luxembourg, Liechtenstein and Switzerland exceed Bermuda in Gross National Income. Their seniors live in reasonable comfort and dignity, with concern, compassion and adequate funding. How do seniors and disabled in Bermuda compare in social security pensions, benefits and services with seniors in countries lower than Luxembourg, Liechtenstein, Switzerland and Bermuda in Gross National Income, such as in the USA, Canada, United Kingdom and rest of Europe?

Certainly, in transportation - by bus and ferry - Bermuda offers totally free public transportation to seniors and disabled who can produce a Special Persons Card. Plus, if you are severely disabled, with such an acute balance problem you cannot use a bus - you might qualify for free annual car licensing. But in all other important respects, we rate very poorly compared to Luxembourg, Liechtenstein, Switzerland and USA, Canada, United Kingdom, rest of EEC, Australia, New Zealand, etc.

In Bermuda, the maximum Social Security benefit for those who qualify is presently USA/BDA $900 a month. Some receive less than $400 a month. Only about 20% of all local pensioners qualify for this maximum amount. Locally, benefits average $650 per month per qualifying retiree. This is very low compared to UK, USA and elsewhere. They include many seniors who do not own their own homes, have to rent, are no longer employed, depend 100% on their Social Security as their only monthly income and as a result cannot afford even the very basic Government HIP insurance. With Bermuda having perhaps the lowest percentage overall - ignoring the relative differences in race - of home ownership in both the Western and other Hemispheres, how do they live! Not in any comfort or dignity! There is no way any of those in this category can afford the $600-$900 it will cost to have any kind of median health insurance with a local licensed health insurer.

It seems they don't qualify for Financial Assistance from the Government. It appears the latter is only for the truly destitute. The USA, Canada, UK and Europe are significantly more generous in this respect. Some financial assistance, via the Ministry of Health and Social Services, is given to Bermudians only who are pensioners who don't own and have to pay to rent a home and don't have a job or any private investment income and have virtually no savings. (In Bermuda, the average household income for working people was estimated to be $80,500 in 2008, with the average salary per person island-wide earning BDA/USAS$59,596.

Compare this situation in Bermuda with the USA, where Social Security averages $1085 for persons who are still living but have not worked - mostly because they have been housewives since the late 1940s - for the past 50 years. For those with a more modern and sustained employment history, it can quite easily be US$1,644 a month, or $1,931 a month at age 67 or $2,697 a month if a pensioner is healthy enough or willing to wait until age 70 before drawing benefits. (See the website for USA's Social Security Administration). Plus, in the USA, according to the AARP Bulletin December 2002 pages 21/22, only about half of all older Americans have any income tax liability. Many who do are in the low or lowest tax brackets. Some pay no income taxes at all. In Bermuda, apart from Land Tax if they own property and are exempted from it in whole or in part, all senior citizens pay the same amount of taxes as anyone else.

Only relatively few seniors - non-Bermudians and Bermudians - are truly sufficiently affluent enough to afford the Bermuda lifestyle, high cost of living and, by international standards, hugely inflated cost of government and civil service.

Most people in Bermuda don't own their own homes, are no longer working and, after age 65, no longer have any decent health major medical insurance. In Bermuda, the overall cost of living is 280% more than in the UK and Canada and 380% more than in the USA. As some examples, gasoline is the highest in the world - higher even than in the UK. It is more than three times the cost of the USA and 275% higher than in Toronto (last week, the price there was Ca$.0.68 per liter). Cars are more than twice the cost of USA and Canada and approaching double what they are in the UK. Electricity per kilowatt hour (KwH) and fuel surcharge is 250% more than the $0.11 average in the UK (7p), USA and Canada. Most groceries and consumer shopping are twice or more the price in the USA. Housing is several hundred percent more than the USA, Canada, UK and elsewhere. 

When residents go to the USA for treatment not available in Bermuda - such as for strokes or heart bypasses - they must have the money or medical insurance means. The average for a triple heart bypass or 10-day stay in Boston or Baltimore seems to be $100,000. A few lucky ones, if under 65, have major medical insurance. But the rest do not. Such coverage ends at 65 for most. Government-provided HIP is woefully inadequate and even that is too expensive for many over 65. Nor does it cover any prescriptions. If you don't have the money, you can try to borrow from the LCCA. Or you cannot afford to go, period. Locals who go overseas for treatment are never forgiven by any of the governments and hospitals from where Bermuda gets the huge majority of our visitors.

Is it assumed that there is no reason for this because Bermuda is one of the most affluent countries in the world and therefore all Bermudians must be affluent or have full major medical insurance irrespective of age? Or have a government with a true social conscience for the needs of seniors?

If they are indeed the assumptions, then they are wrong. There is no legislation that either provides decent, affordable, comprehensive, public sector health insurance - or a requirement or tax incentive - for private health insurers to extend major medical to beyond 65. Some seniors can't afford high-priced health insurance. Withdrawal of health care insurance generally - and major medical insurance in particular after the age of 65, if people have it at all in the USA - is an ever-increasing problem. But at least in the USA there are alternatives, such as Medicare and Medicaid, to those who qualify by residence, age or disability or income. The closest Bermuda gets to them are with the basic public ward hospitalization only and HIP/FutureCare insurance, both by the Government, with the HIP at a huge cost compared to the cost to enrolled taxpayers in the USA of Medicare and Medicaid, yet with few of their benefits and services.

Even when local licensed insurers don't offer at all any type of Long Term Health Care Insurance, locally-based but overseas-owned insurers offering them are either prohibited or discouraged from offering them in Bermuda or face formidable barriers. The irony is that some international Bermuda-based insurance companies do offer Long Term Health Care insurance to some or all their own employees. And in other countries where they do business but do not have their head office or jurisdictional incorporation, are routinely offering regular healthcare, major medical and Long Term Healthcare insurance in its several ways.

A typical example is AIG. It is allowed - even encouraged in Europe - to be one of the biggest health care insurers, even when and where local taxes include free hospitalization and surgery on a "needed" basis, such as in the United Kingdom, Ireland, Canada, etc. Only Bermuda seems to restrict AIG and other international insurance companies from offering a wide range of health insurance options, but we are dubbed one of the Insurance Capitals of the World - and "the" Special Risks Capital. What is made clear is that insurers and their various types of insurance concerned are generally not allowed to be offered in Bermuda to any residents of Bermuda. But there is a little-known provision under Bermuda law - currently not yet invoked by any non-Bermudian employer - that allows a foreign but Bermuda-based insurer to offer certain classes of insurance in certain circumstances.....