GREAT BAY--The Soualiga Employers Association (SEA) is calling for urgent government action to address the deteriorating financial outlook of health and social insurance funds administered by Social & Health Insurances (SZV), warning that combined reserves are projected to decline by more than Cg 100 million over the next several years.
As reported by The Peoples' Tribune, projections contained in Government’s 2027 budget indicate that the combined reserves of the ZV, OV, FZOG, AVBZ and OZR funds could fall from approximately Cg 279.8 million in 2025 to Cg 178.3 million by 2029. Annual deficits are also projected to worsen, increasing from approximately Cg 19 million in 2025 to Cg 28.8 million by 2029. (see article here:https://www.thepeoplestribunesxm.com/articles/budget-projects-health-and-social-fund-reserves-could-fall-by-more-than-cg-100-million-by-2029)
SEA said the figures require urgent and deliberate policy attention, stressing that the issue should not be viewed only in terms of how much money remains in the reserves at any particular moment.
According to the association, continued structural deficits indicate that the underlying financing and expenditure framework requires meaningful intervention if St. Maarten is to preserve the long-term sustainability of its social insurance system.
SEA acknowledged Government’s plans to introduce National Health Insurance (NHI) as part of its strategy to address healthcare financing. The association said, however, that NHI alone cannot guarantee the long-term sustainability of the healthcare system and must be supported by additional structural and policy measures.
The association said the urgency is heightened by St. Maarten’s increasingly aging population and believes complementary measures should be developed and implemented alongside NHI in a timely manner.
SEA said the objective must be a healthcare and social insurance system that remains financially sustainable, provides appropriate protection to the population and does not create an increasing and potentially unsustainable burden on employers, employees or public finances.
Rather than prescribing one solution, SEA is urging Government to develop a comprehensive package of reforms addressing the structural challenges facing the health and social insurance system.
Among the areas identified are the acceleration of healthcare financing and structural reforms, timely development and implementation of the NHI framework and accompanying measures, and a review of contribution and financing structures across the various health and social insurance funds to ensure revenues remain aligned with their obligations.
SEA also pointed to economic growth as part of the wider solution, noting that measures aimed at stimulating the economy can contribute to income growth and support a vibrant working population.
Greater attention should also be placed on containing healthcare costs, according to the association, particularly in areas such as procurement, pharmaceutical expenditure, specialist care, referrals and other significant cost drivers.
SEA said strengthening preventive and primary healthcare should form part of the reform agenda, with the objective of reducing avoidable illness and limiting the need for more costly medical interventions.
The association also called for stronger actuarial forecasting, financial monitoring and accountability, supported by regular reporting on the long-term financial position of the various funds.
St. Maarten’s changing demographics should receive particular attention, SEA said, including the impact of an aging population and the relationship between the number of people contributing to the system and those receiving benefits.
Measures to improve compliance, reduce leakage and ensure that all parties properly meet their obligations should also be pursued.
SEA is encouraging Government to establish a structured and inclusive dialogue with employers, employees, healthcare providers and other relevant stakeholders as reforms are developed.
Such engagement, according to the association, can help ensure proposed measures are practical, balanced and sustainable while building greater understanding and support for changes that may ultimately be required.
SEA called on Government to treat the projected financial trajectory as a matter requiring immediate policy attention and to establish a clear, time-bound reform agenda.
The association said it stands ready to participate constructively in the national dialogue and contribute the perspective of employers to efforts aimed at securing the long-term sustainability of healthcare and social protection in St. Maarten.
