Health supplements for patient choice

Supplementing the NHS could hail a more effective recovery for employees, companies and even UK healthcare says Charlie MacEwan, corporate communications director at WPA

Charlie MacEwan

Given the economy and the challenges that companies face, employers are acutely aware of their costs. Employees seem less connected. Employers think that medical insurance is expensive. Some question its value while others annually gauge the success of their broker by how much they can cut the premium.

The fundamental problem is that, while companies understand their healthcare costs, employees think that the perk of medical insurance is free and there is little incentive for them to act as customers when they are a patient. Why try to understand the costs and benefits when you are in the hands of a capable consultant?

To change this, perceptions need to evolve. Some employers engage in strategies that stop premium inflation becoming a self-fulfilling prophecy.

If price is the problem, the advice should be to put a strategy in place to remove the issue and make the benefit sustainable into the longer term. A deductible, where employees become partners to the scheme and contribute to costs is effective and becoming well used.

Perhaps change the benefit structure so that different levels of employees are entitled to different benefits such as a cash plan for the 20-somethings and a more comprehensive policy for the directors.

Variety and value create engagement. I have yet to see a plan that pays for hospital treatments on a Thursday or Friday so that employees can convalesce over the weekend – a bit radical but it at least reduces the costs associated with a key person being absent due to illness.

Isn’t it ironic how some people think that medical insurance is an alternative to the NHS. This view tends to be combined with a ‘full refund, private at all costs’ demand which naturally adds to the costs, claims and premiums; often excessive and sometimes unnecessary.

There are significant savings to be made by defining private healthcare as supplementing the NHS. The best place for emergency care is the NHS so it could be seen as profligate to have private intensive care (except for postelective surgery) as an insured benefit.

NHS cancer care is excellent in some parts of the UK which is why customers are now given the option to rely on the NHS for cancer care. Along a similar vein, some effective cancer drugs remain unavailable in the NHS which is why some insurers will now only pay for advanced therapeutic drugs that are not ‘readily available’ on the NHS.

The fundamental problem is that employees think that the perk of medical insurance is free and there is little incentive for them to act as customers when they are a patient

Supplementing things is all about paying for the things that you need to pay for. Personally, I would never pay for something if it was free somewhere else. Private healthcare has always supplemented the work of the NHS reducing the queues, giving NHS patients more attention and cleaning hospitals.

In financial terms this support adds up to £2 billion per year. Supplementing is becoming more refined in the cash plan sector which is evolving into an NHS top-up market, possibly because 97 per cent of Britons do not know what a cash plan is, and policies are developing to include relevant benefits such as NHS car-parking, second opinions, GP fees, cancer drugs, emergency abroad cover and cosmetic surgery. NHS top-up policies are finally doing what they say on the packet.

Last year, I became a case study after an emergency admission with pancreatitis. I stayed at Dorset County for six days because ‘it was the best place for me’ – it cost me nothing although some may say I have been paying for it for all of my working career. I needed my gall bladder removed and I had a choice; wait 94 days, according to Dr Foster, to have it removed in the same hospital or 4 days and go to the BMI hospital next door. It cost WPA £5,202 – I know because, through Shared Responsibility, I paid my share.

Supplementing the NHS, which is common in the rest of Europe – 93 per cent of people in Holland have top-up schemes – means that the insured patient has a choice. By exercising that choice, downward pressure on claims costs will prevail.

With the private sector more involved in the NHS than some would care to admit, supplementing the NHS is symptomatic of that partnership and has enormous potential to make healthcare spending more efficient. Being a patient may be a virtue but it is not a reason to pay twice.