Conservative Drugs Access

In the run up to the general elections all the main parties are letting us know what they intend to do about the National Health Service should they get elected. One issue which has been of concern for both medical insurance companies and the NHS is how much can feasibly be spent on cancer treatments.

The conservatives state that they intend to raise £200m for cancer drugs by increasing the threshold for employers national insurance contributions. The extra money would make more drugs available for cancer.

According to a recent report by an independent health think-tank, The Kings Fund, the UK has widespread differences in how cancer is treated across different health trusts. The conservatives plan to change this by implementing a policy which will not deny patients any drug which has been licensed since 2005. Currently the National Institute for Health and Clinical Excellence (NICE) decide which treatments are available depending on their cost effectiveness. Currently even if NICE have sanctioned a drug a health trust may deny its use if it considers the treatment too expensive.

The cost of drug treatments is a concern not just to governments but also to companies that supply health insurance for cancer. Some companies only cover drugs that are passed by NICE and compared to the rest of Europe the UK uses only 60% of drug treatments available for cancer.

NICE has its critics who say that many drugs that are used to prolong life may be expensive but that to deny patients treatment that may prolong their lives is inhumane. Despite its critics the Kings Fund report says that NICE is one the NHS success stories. NICE is there to assess cost effectiveness. Some of the more expensive drugs it has declined only prolonged life by a couple of months.

International Health Insurance Costs

The rising costs of international medical insurance may lead to a service which is completely unaffordable according to the medical director of Bupa International, Dr Sneh Khemka.

International medical insurance covers expatriates or people who holiday or travel extensively abroad but according to Dr Khemka rising costs are proving problematic:

'This is something the entire healthcare community needs to address, but we are in a prime position to facilitate a strategy. We have to contain costs. Otherwise, private care will become uninsurable. The golden goose gets shot.'

There are several ways in which the issue can be addressed:

• Encouraging good health. This is something that private medical insurance companies are all doing in an attempt to help keep health cover down.
• Looking at corruption. Over time there have been many cases of medical insurance companies being charged more than they should have by unscrupulous health providers.
• Getting doctors to look at the treatments they are prescribing which in some cases can be replaces adequately by alternative, cheaper treatments. According to Dr Khemka, who spoke to The Telegraph: 'There are lots of treatments and doctors will continue to try them because they like to do something, and they make money out of it.'
• Choosing the best hospitals and sending more patients there, thereby driving down costs by the scale of economy.
• Keeping policyholders informed. Dr Khemka said: 'This is where we are trying to win customers over. Rather than using treatments willy-nilly, we are trying to get the right treatment, which will help the patient, and save cost.'

NHS Report

According to a new report from the health think-tank The Kings Fund, the NHS has made 'considerable progress' during 13 years of Labour Government rule. There were several areas of praise

NICE
The Kings Fund praised National Institute of for Health and Clinical Excellence (NICE) for being a 'big step forward in delivering evidence-based and consistent guidance to the NHS.'

Infections
The report also described as 'successful' the reduction in hospital-acquired infections such as MRSA and C.Difficile whose incidences were down by 34% and 35% respectively since 2007/08.

Waiting times
The reduction of NHS waiting times was also praised. Most people have to wait less than 18 weeks now from when they are given a GP referral.

Improvements
The report cited that the quality of surgery had improved and referred in particular to cardiac surgery.

Cancer
There have been improvements in the access to cost effective cancer drugs.

Criticism
The report said that there was a wide ranging disparity of provision and care across the country and also in comparison to other European countries. They made particular reference to cancer care where there was a big difference in the kinds of treatments given.

They also criticised the mental health services which they felt had failed to improve the quality of life of those with mental illness.

Mental Health Action Week

This week is Mental Health Action Week where The Mental Health Foundation is trying to raise awareness of what can be done to promote good mental health. Health insurance companies vary greatly in their offerings for mental health. Some offer no psychiatric cover at all whereas others offer limited amounts.

The problem for medical insurance companies is that mental health problems are more common that the general public realise. According to the statistics one third of patients visits GPs in relation to mental health concerns, in particular for mild depression and anxiety related complaints. What this means for us is that most companies cannot offer psychiatric cover because too many people would use it and this would force up the price of premiums accross the board.

Who Offers Psychiatric Cover?

• Pruhealth offers cover in both their midrange and comprehensive policies up to £7,000 and £20,000 respectively for inpatient psychiatry in any one year and £750 in inpatient care.
• Standard Life offers psychiatric cover in their comprehensive policy with an excess of £250
• CS Healthcare offer cover up to £1000 in any one year with an excess of 15% of treatment cost
• Aviva offer cover in their comprehensive policy of up to £1,000 a year for inpatient care and £500 for outpatient psychiatric care with the psychiatry element as an optional extra
• Bupa offer 28 days of outpatient care and up to £1,000 of outpatient care per anum
• The National Friendly Society offer up to 28 days of outpatient cover
• The Permanent Health Company offer up to 28 days of outpatient cover and up to £1,00o per year in outpatient cover.
  

Who Does not Offer Psychiatric Cover?
Budget policies hardly never include psychiatric cover however Health-on-line do offer a psychiatric add on option on their policies.

Self Help Steps
According to the Mental Health Foundation there are many steps that we can take to help us stay mentally well and reduce the likelihood that we will need medical intervention:

1. Talk about your feelings
2. Keep active
3. Eat well
4. Drink sensibly
5. Keep in touch
6. Ask for help
7. Take a break
8. Do something you are good at
9. Accept who you are
10. Care for others

Bowel Cancer Awareness Month

April is Bowel Cancer Awareness Month. Bowel Cancer UK is trying to increase awareness in an attempt to help people understand that bowel cancer is a serious condition that can in part be prevented by leading a healthier life. Its the same message that government bodies and health insurance companies are trying to promote.

According to the campaign someone is diagnosed with bowel cancer every 15 minutes in the UK. The symptoms of the disease are:

• A change in your normal bowel habit lasting four weeks or more
• Blood in your stools (poo) and/or bleeding from the bottom
• Unexplained unexplained weight loss and/or extreme tiredness
• A lump or pain in your abdomen (belly)

Reducing Risk
Living a healthier life helps to prevent many cancers and diseases. Like Bowel Cancer UK, most medical insurance companies are promoting healthy lifestyles in an attempt to improve the nation's health. Comprehensive insurance for cancer is expensive because treatments and drugs have improved so much over the last ten years. Some factors that can help you reduce the risk of bowel cancer are:

• Get to know your bowel pattern, so that you know what's normal for you
• Exercise regularly to help maintain a balanced weight
• Drink lots of water
• Eat a high fibre diet made up of at least five portions a day of fruit and vegetables
• Limit your consumption of red and processed meat to a maximum of one portion (approximately 80g) per day
• Do not drink more than the recommended alcohol limits of 14 units per week for women and 21 for men
• Increase unsaturated fats and avoid saturated fats
• Don't smoke
• Take part in the Bowel Cancer Screening Programmes when they roll out in your area and you are invited to do so
• Have a bowel screening if their is a history of bowel cancer in your family

Being Treated Privately

The latest figures from the NHS show that they have not quite hit their targets for single sex wards in hospitals. Being comfortable when you are in hospital is something which greatly helps aid recovery and the private single rooms given to health insurance patients are part of that whole package of care.

Like most things that are in the public arena at the moment in the UK this has been turned into a political argument. The Department of Health gave NHS trusts £100m in January in order to speed the final process along although it initially pledged in 2001 to abolish mixed sex wards by the end of 2002.

However, Shadow Health Secretary Andrew Lansley believes that the way forward is more single rooms. He said:

'Too many of their reforms are on piecemeal issues like curtains, screens and signs anyway. Patients needs to be given the dignity they deserve. That's why we've set out plans for a massive overhaul of hospital buildings so that every patient who wants one can be given a single room when they go into hospital for planned care.'

Single rooms that were usually the prerogative of private health hospitals are now on the increase in the NHS. Initially the conservatives promised an increase of 45,000 single NHS rooms but this does not appear in their manifesto. With the UK in financial debt it is unlikely that the NHS will see the increases in the level of spending that it has had over the last few years.

In the health insurance arena single rooms are still a priority, allowing for private consultations, treatment and recuperation. However occasionally some patients that are treated privately in NHS hospitals may have to stay in wards. If single rooms are a priority for you then check the details of which hospitals are covered by your medical insurance policy and what type of accommodation they offer.

New Exeter Friendly Plan

Exeter Friendly has launched a new health insurance product with a catchy and relaxed name: "Health and Stuff." Its clear and easily understood policy document is excellent and should enable prospective customers to easily understand what they are purchasing.

The new offerings are designed with an awareness of the cost conscious nature of the current economy. Richard Wyatt-Haines, sales and marketing director at Exeter Friendly, said:

'Our research shows that the needs and demands of customers can vary hugely according to their stage of life. With Heath & Stuff, we have built a plan which reflects this, allowing customers to buy their plan according to what is important to them and what they can afford. From there on it's simple. No hidden limits, no small print.'

"Health and Stuff" has several levels of cover: £2,500, £5,000, £10,000 or £20,000. Claimants have to pay the first 10% of any treatment. Cover includes: Cancer cover, in-patient and day-case hospital charges, CTI/MRI/PET scans; out-patient surgery specialists fees, specialist fees diagnostic tests, consultant fees, diagnostic tests, physiotherapy, osteopathy, chiropractic, podiatry, private ambulance, home nursing, parental accommodation, 24-hour GP helpline.

Unusually the cover provided enables parents to stay with their sick children up to the age of 18. Most policies only provide this cover when children are 12 or below.

They are currently offering two discounts:

• 10% discount if your body mass index between of 18 to 25
• 10% discount if you have not smoked for the last 12 months

The Exeter Friendly distinguishes itself by having a very clear policy document which warns prospective claimants that some of the more expensive treatments may not be covered by their annual limits. They detail the costs of common procedures so that consumers can see exactly what they can expect with each of the levels of cover. In fact the whole policy document is clear and leaves consumers fully aware of what is and isn't covered.

The Health and Stuff policy is likely to be a pioneer in clear and understandable policy documents which enable consumers to see exactly what they are and are not going to get when they sign on the dotted line. Well done Exeter Friendly Society!

New AA Health Insurance

Many more consumers will exposed to the benefits of health insurance as AXA PPP healthcare have teamed with the AA to offer their customers three levels of medical cover. The Automobile Association will also be offering the products to non-members.

Simon Douglas, director of AA Insurance, said:

'This is a logical expansion of our health and life related products which include life insurance and critical illness cover.

'The AA has built a trusted reputation amongst its 15 million members for helping to ensure the health of their cars.

'Looking after the health of our members and their families is an obvious step and we've launched into private medical insurance with one of the leading providers in this market.

'Private health care, once the province of the well off, is now available to anyone and we think that this cover will be widely welcomed. We expect to expand the range of services later this year with, for example, health screening cover. We already offer Accident Healthcare which provides medical treatment in the event of a car accident.'

Currently new customers are being offered one month free private medical insurance and customers who have had AA membership for a year or more are being offered two free months of health cover.

Health Tourism for Freedom Healthnet

Lots of people in the UK will now be preparing and looking forward to their summer holiday. Some of these travellers will be combining their trip with a visit to a hospital to have surgery. Health tourism is a booming industry for many countries across the world.

Freedom Healthnet provide an alternative type of health insurance which enables their customers to receive a cash lump sum should they need inpatient care. The advantage of getting cash is that customers can choose where, how, when and even 'if' they have their treatment in a private health establishment.

Some customers prefer to have their treatment with the NHS and then use their lump sum in some other way.

An alternative to being treated in the UK is to go abroad. Health tourism is on the increase. In over 50 countries, including Columbia, Cuba, Brunei, India, South Africa and Tunisia, health tourism is seen as a national industry.

Medical tourism is still considered risky by the general population but attitudes are changing. Standardisation of care is an issue across the globe but various bodies work towards promoting foreign medical establishments that have been accredited. In the UK the Trent International Accreditation Scheme is well known.

Differences in standards across the globe has been recognised by the World Health Organisation who launched the World Alliance for Patient Safety in 2004.

The advantage of getting treatment abroad is that the costs are often considerably less and people often combine surgery with a convalescence holiday. Medically speaking this is considered to be good practise as long haul flights increase the risk of post operative complications.

University Health Insurance Fraud Course

As consumers we want affordable medical insurance that covers us when we are in need. For health insurance companies it has become an uphill struggle to provide this. Health care is becoming more expensive and consumers are not prepared to spend as they once were. One way in which they can save money is to route out fraud.

Fraud has been on the increase in the health cover market and ultimately consumers bare the brunt of the deficit. This year the Health Insurance Counter Fraud Group (HICFG) will be launching the first university-accredited qualification in healthcare fraud investigation. The qualification will cover the standard fraud investigation modules but will also include additional elements that are relevant to health.

The development of this course is as a result of the HICFG opening its doors to cash plan providers. HICFG chairman Dr Simon Peck says:

'I am delighted to announce this development. We believe there is significant cross-over between the problems experienced by cash plan providers and those we see in private medical insurance and this is a great opportunity to pool our resources in a way which will benefit all of us.'

Saving on Company PMI

Just as the country is coming out of recession many companies are struggling with cash flow problems. This in turn can lead to reviews cuts in pay and perks. One way to keep health insurance for your staff is to review the provisions you have in place.

According to Hewitt Associates, an HR consulting company, reviewing health cover should be an annual thing as it can help to reduce costs. Colin Bullen, head of health and risk benefits from Hewitt said:

'Companies are losing out by not reassessing their current contracts. Shrinking budgets, coupled with the effects of the recession, have presented an opportunity to review and reset priorities. In many instances, benefit providers have become extremely competitive on price and are willing to adjust their rates to attract and retain business - a situation that is unlikely to last indefinitely. Savings are realistically achievable if companies act now.

'By seizing this opportunity, more advantageous terms for the next two to three years may be on the table; meaning that companies can lock in significant savings without damaging employee morale.'

In other words, private health insurance companies need your corporate business and they might be willing to negotiate on your current terms. That's great news for business and great news for your employees who won't have to miss out on medical insurance cover. Bullen warned against reducing cover. He said:

'Blanket benefit cuts do not lead to enduring business advantages. We are urging companies to start 2010 by acting with an eye to the longer term. A well-structured benefits policy that is valued by employees typically results in more engaged employees and is proven to boost workforce motivation. Rather than just taking an axe to current benefit structures to control costs, employers should reshape their benefits to meet member needs and demand the best value for money from their providers.'