Cancer Lottery

National Health Primary Care Trusts (PCT) are responsible for healthcare in their area. They individually control funding and this is the reason why NHS healthcare across the UK is very uneven. This is a contributory factor to why some people like to take out health insurance: they have a high standard of care no matter where they live.

PCTs are responsible for spending around 80% of the national health service budget. They work within the overiding rules of the Department of Health and there are 152 care trusts in England.

Cancer sufferers seem to be particularly vulnerable to the 'postcode lottery' as the situation has been coined in the media. According to the National Colorectal Cancer Audit 60% of patients have a major resection (where parts of the bowel are removed) but there are variations across the country from 20% to 80%.

Survival rates vary too. In Kensington and Chelsea patients have a 43.7% survival rate for lung cancer and only a 15.4% rate in Herefordshire. Breast cancer patient one year survival rates are 89.3% in Tower Hamlets and a 99% in Torbay.

In the private health arena there is a more standardised level of care. Bupa the private health insurance provider, for example, include Avastin in their range of allowed drugs but some NHS trusts do not. Avastin is a chemotherapy treatment used for metastatic or secondary cancer and it costs around £60,000 a year per patient. The drug does not cure cancer but it prolongs life.

If you are considering private medical insurance you may be deterred when you hear that the NHS is improving. This is true, there have been improvements in the NHS over the last five years. However the improvements are not standardised across the country. It still depends on where you live and which hospital you go to.

Health insurance for cancer is available from many private medical insurance providers although there is currently a great deal of debate in the industry about the high costs of cancer treatment and what the industry plans to do about cover for this illness in the long term.

Insurance Fraud

Insurance fraud is not only a nuisance for the health insurance companies involved but also for consumers. The costs of fraud has to be paid for and its the average person who takes the brunt of it.

According to report from the National Fraud Authority (NFA) published last week insurance fraud costs the UK more than £30 billion a year with the insurance industry taking a £2bn loss.

Nick Starling, director of the Association of British Insurers, who regulate the health insurance industry said:

'Fraud costs every family in the UK. In these tough economic times, the last thing people need is to be paying for fraudulent activity. Dishonest insurance claims alone cost around £2 billion year, which adds on average an extra £44 a year to every household’s general insurance budget. The insurance industry’s zero tolerance policy towards fraud means we are making it harder than ever for cheats to succeed, and detecting more of the fraud that is committed.

'Today’s report shows that such a policy is needed by all agencies involved in tackling fraud, to protect potential victims better and reduce the financial cost to honest UK households.'

The UK Insurance Fraud Bureau (IFB) was set up in 2006 in order to combat UK fraud. John Beadle an NFB board member said:

'Insurance fraud is not a victimless crime and, in the case of ‘crash for cash’ scams, innocent lives can be put risk. The insurance industry is no longer an easy target and takes this criminal activity very seriously. Through working closely with law enforcement agencies, the IFB has been instrumental in over 300 arrests and this drive will continue.

Anyone with Fraud information can call confidentially and for free:

Cheatline on 0800 328 2550

You can also report online at: www.insurancefraudbueau.org/report.

Health Insurance for Cancer Glossary

Health insurance policies can be complicated and they vary a great deal from one to the other. When it comes to health insurance for cancer there are even more complications. Different policies offer varying degrees of cover. Becoming savy with the terminology of medical insurance policies will help you to choose the best cover for you.

The Association of British Insurers (ABI) which regulates the health insurance industry has a set of common definitions which I have replicated here. This is a good starting point but of course is not exhaustive. Each company will have refined definitions of their own.

Acute condition
'A disease, illness or injury that is likely to respond quickly to treatment which aims to return you to the state of health you were in immediately before suffering the disease, illness or injury, or which leads to your full recovery.'

Cancer
'A malignant tumour, tissues or cells, characterised by the uncontrolled growth and spread of malignant cells and invasion of tissue.'

Chronic condition
‘A disease, illness, or injury that has one or more of the following characteristics:

• it needs ongoing or long-term monitoring through consultations, examinations, check-ups, and/or tests
• it needs ongoing or long-term control or relief of symptoms
• it requires your rehabilitation or for you to be specially trained to cope with it
• it continues indefinitely
• it has no known cure
• it comes back or is likely to come back.’

Day patient
'A patient who is admitted to a hospital or day patient unit because they need a period of medically supervised recovery but does not occupy a bed overnight.'

Diagnostic tests
'Investigations, such as x-rays or blood tests, to find or to help to
find the cause of your symptoms.'

Inpatient
'A patient who is admitted to hospital and who occupies a bed overnight or longer, for medical reasons.'

Outpatient
'A patient who attends a hospital, consulting room, or outpatient clinic and is not admitted as a day patient or an inpatient.'

Pre-existing condition
'Any disease, illness or injury for which:

• you have received medication, advice or treatment; or
• you have experienced symptoms;

Whether the condition has been diagnosed or not in the XX* years before the start of your cover.'

(*this time scale varied between insurers)

Take Vitamin D says Bupa

According to Bupa, the health insurance company, people should be taking vitamin D supplements during the winter to reduce their chances of getting certain cancers.

According to Bupa research taking supplements of Vitamin D can reduce your risk of cancer by up to 25%. The recommended dosage is at least 1,500 - 2000 international units (IU) a day, which equates to 3-4 high strength capsules (12.5 micrograms/capsule).

Vitamin D can be obtained naturally from sunlight and foods but according to Bupa the British sun during winter is insufficient to provide us with what we need. Taking good doses of the vitamin is thought to reduce the onset of bowel, breast, colon and prostrate cancers.

Bupa’s assistant medical director, Dr Virginia Warren said:

'Natural ways to get enough vitamin D aren’t realistic because our skin cannot make vitamin D from winter sunlight in the UK as it is too weak. In the summer, people are rightly concerned about risks of skin cancer. And nobody wants to eat four tins of mackerel every day to get their vitamin D from oily fish.

'People have to act now to take preventative measures against cancer for their future long-term health. The old-fashioned view was to take a low daily dose of vitamin D for healthy bones. Cancer is today’s biggest killer and we need to protect our bodies from it as much as we can. Taking vitamin D supplements are an effective, inexpensive and easy way of doing that.'

Medical insurance for cancer in the UK is a subject of much debate at the moment. Bupa provides specific cancer cover in their Bupa Select Heart and Cancer policy but there is a great impetus at the moment on the prevention of the disease.

All the major private health insurance companies have been focusing on health prevention over the last few years. Obesity, lack of exercise, smoking and drinking as well as a poor diet are all linked with increased risk of cancer.

10 Disadvantages of Medical Insurance

1. Chronic conditions are not covered
Health insurance is designed to cover you for an acute illness and restore you to the health you enjoyed prior to the illness or injury. Should you be left with chronic symptoms after this they will not be covered by the insurance.

2. Your current health issues will not be covered
Any illness or even symptom of an illness that you had five years prior to taking out a policy will not be covered should you become ill from this. Even symptoms that do not seem related to any illness you have had can be included in this.

3. Health insurance can be complicated to purchase
There are many private health insurance providers and their policies can vary greatly from one another. Even within a company there can be several types of health insurance available with a variety of options to choose from. Because policy documents are legally binding agreements it is very important to read the small print so that you know what your rights are. Getting the help of a financial advisor is recommended when you are choosing a private health insurance policy.

4. Cancer is not well covered on all policies
Cancer cover is very varied. Some companies do not cover cancer at all and others provide fully comprehensive policies that cover palliative care should it be needed. As cancer is a one the main causes of death in the UK this is a factor which you need to consider carefully when looking into health insurance.

5. Comprehensive cover can be expensive
The most comprehensive policies are the most expensive. Most are also weighted depending on your age, sex and lifestyle. Its important to shop around and get the best deals.

6. There are many exclusions
Health insurance exclusions are great in number. Most are standard and are related to obvious risk factors for example alcoholism or drug use, dangerous occupations or hobbies, HIV. Others are less obvious - some policies will not cover mental health or pregnancy.

7. Mental Health is poorly covered
The statistics show that at any one time one out of ten UK citizens are suffering from a mental health condition at any one time. Some policies cover mental health others do not. Usually it is the top-of-the-range policies which include mental health cover.

8. Health insurance companies can be very stringent in following their rules
The health insurance industry has a reputation for repudiating claims on very minor details. Even though they have tried to remedy this reputation by providing guidelines which means that consumers are treated more fairly you still need to keep on your toes. If you have a claim that is rejected do not give up. Go back over the small print and see if there have been misunderstandings that can be rectified. You are within your legal rights to complain.

9. The NHS is improving
Some believe that the NHS has improved dramatically over last ten years and that therefore the private sector no longer has the pull it once had. The NHS has improved but it still lags far behind in the speed at which it can provide treatment compared to the private sector.

10. There are no official statistics for private health establishments
NHS statistics are published all the time. It enables the public to see what's going on. This does not apply to the private health insurance industry which is notoriously bad at transparency.

10 Advantages of Health Insurance

Taking out private medical insurance gives people peace of mind. Here are some of the benefits it offers.

1) A preliminary consultation is available quickly
Of course there are variations depending on where and by whom you want to be treated. As in all areas there will be consultants and hospitals that are more in demand than others. What is certain is that you won't have to wait anywhere near as long as you do with the NHS

2) A choice over which specialist or hospital treats you
Your GP will refer you to a consultant and hospital of your choice. However you do need to check the details of this with your provider. Different providers offer access to different hospital networks.

3) A single room with gives you greater privacy and confidentiality
Having said this,, some policies include treatment in an NHS facility under private health care terms. Its important to check the details.

4) Spreading your health care costs via the payment of a monthly premium
For people who always go for private health care, medical insurance is a way to budget monthly for unforseen illness or injury.

5) Being in an environment which pays a very great deal of attention to infection control
Bupa studies have found that better cleanliness and infection control is the main reason why people prefer to opt for private health insurance over the NHS.

6) Lower stress levels
High stress levels have been shown to increase recovery times. A patients' stress levels are lowered throughout. Quicker specialist referrals, quicker treatment times and a more private environment are all factors which lower stress and help with recovery.

7) You get back to work quicker
The longer you are out of work the more it affects your rights to sick pay. Being seen quickly enables you to retain your income levels. The financial impact of illhealth is an important factor.

8) Helps your employees get back to work quicker
Losing key employees to ill health affects productivity as well as morale in the workplace.

9) Short waiting time should you need an operation
This is not only a more pleasant result of medical insurance but can also improve your overall health over time. Leaving illness untreated can lead to complications and can worsen your condition which will then make it harder to treat.

10) With some companies you will get 24hr counselling helpline.
Different companies offer varying levels of 'extras' as part of their health insurance policy. This can include reduced rates and gyms as well as online and telephone help.

Health Spending Cuts

The UK Government has large debts which have to be paid for over the next few years. Public spending cuts are inevitable and the NHS is likely to suffer. But what kind of impact will this have on the private health insurance market?

According to the Windmill Report the NHS will have to plan for a 20-30% reduction in spending until 2011. Healthcare and the standards that the public expect are both advancing quickly that in real terms spending needs to rise. The Government aims to increase efficiency in order to make up the difference but according to the Windmill Report the funding gap could range between £21bn - £40bn by 2017.

One of the proposals in the drive towards greater efficiency is the move towards greater private involvement in the NHS. The report states:

'Both the culture of the NHS and input-focused procurement conspire to preclude effective engagement of the independent sector. There is still a great deal of wariness, if not reluctance, over using the expertise of independent sector providers - even when they may have proven solutions to the financial and demand pressures ahead - for example, in managed care, property and estate management, and in the expertise and technology to support care closer to home.'

If the government balance the needs of the NHS well the impact on the private sector could be great.

If the use of private companies increases in the NHS then the private sector will benefit. They will have larger volumes of work and less need to target the individual and business customers.

The economic climate has seen a decline in people taking out health insurance. This has been exacerbated by our perception that the NHS is improving.

This scenario is not so rosy for the health insurance market. As consumers we are less likely to take out medical insurance if we are satisfied with standards and waiting times in the NHS.

If the government cannot achieve their aims then the medical insurance market will benefit. In theory we will become dissatisfied with the NHS and move towards the security of health insurance cover.

Improving Hospital Rooms

Those with private health insurance already enjoy good levels of accommodation when they have to be treated in hospital. Its one of the reasons people take out medical insurance. Recently the NHS have been trying to improve patient accommodation.

Firstly the NHS is trying to eliminate mixed sex wards. The latest proposals aims to get down to only single sex wards by June this year. Although lots of investment has already been made in order to rectify the situation, according to recent inpatient survey one in ten patients is still sleeping in a mixed ward with women and ethnic minorities are most likely to report dissatisfaction with mixed sex wards.

Andrew Lansley, shadow health secretary responded to the report by saying: '

Time and again we have heard Labour ministers boast about how they are within touching distance of abolishing mixed sex wards. But sadly, the reality for thousands of patients is that they still have to suffer the indignity of sharing a room with members of the other sex when they are trying to recover in hospital.

'If we are going to get rid of mixed sex wards once and for all we need to focus on building more single rooms in NHS hospitals. But instead Labour have focused on buying thousands of extra curtains. This is simply not good enough.'

Single rooms are the norm in the private health sector but for the NHS this is still a long way off despite the fact that single rooms are more conducive to a full and speedy recovery.

Infection control
One of the benefits of single occupancy rooms is infection control. Single rooms help infections such as MRSA and c'difficile stay under control. Patients have their own ensuite rooms and are less likely to come into contact with the bodily fluids of other patients.

In 2011 Pembury Hospital will be the first NHS's all single room acute hospital. Other hospitals will follow. This is good news for UK citizens.

How does it affect the private sector?
The private medical insurance industry would do well to be concerned. Having single rooms in NHS establishments erodes some of the value of private medical care. Infection rates should go down and patient satisfaction rates should go up. How will this affect private medicine?

The reality is that the NHS is still a very long way from matching the private health sector. However public perception is very important and beliefs, whether they are founded in fact or not, are likely to have an effect on the future of private medicine in this country. How will the private health sector respond to this?