Save the NHS: Control Health Insurers!

Spring is here!

 ©2014 Am Ang Zhang

It must be very obvious that all the talk about medical cover for visitors to England never mention the need for health insurance.

Could this be because insurers have managed not to cover for everything. One need to ask the question on how one ever travel to the US where cost of medical care is extremely high.

It may well be prudent for government to insist that non EU visitors to this country must have mandatory Health Insurance as part of the admission requirement. This should apply to students and tourists alike. After all nobody in their right mind would dream of going to the US without proper insurance.

We have managed to get people to insure their cars, why not their bodies.

There is of course the need to fully control Health Insurers for those that live in England if they want cover. 

Let people opt out of the NHS if it is so bad! But Insurers need to cover every thing. 

Citizens could be given a tax break and yet have the insurance policy incorporated into their NI/NHS number so that those with the tax break, the insurer will be charged for every kind of medical care they receive if they were within the NHS.

 ©2014 Am Ang Zhang

If we are not careful Private Insurance will creep into England without a single bit of control as it is singularly important to stop Insurers to reject those with pre-existing conditions or dump them once they have a chronic illness such as Type 1 Diabetes. 

NHS is going Dental, not Mental!

Patients could have to start to pay charges to use basic NHS services such as GPs because the health service’s finances have become so dire, the leader of Britain’s doctors has warned. 

Dr Mark Porter, the head of the British Medical Association (BMA), said that whoever takes office after the general election will inevitably be tempted to bring in charges and may not be deterred by the unpopularity of such a seismic change to the health service.

....“You say it’s politically toxic. It’s not, really, is it? Look at dentistry and look at social care. They carry with them exactly the same offer to the public by which the NHS was set up; that we will remove from you – this society, us acting collectively – the terrible fear of bankrupting yourself by having an illness, by needing healthcare.

“And yet we allow people to be bankrupted by social care and we allow people to be deterred from seeking dental care because of charges,” Porter said.

Can we think of ways round this?

There is little doubt that a system based on insurance will need smart legislation to control the insurers. If the NHS is going to make use of wealthier individuals to use Health Insurance, then the same smart laws will need to be enacted for the regulation of Insurers. We should have learnt through the banking failures that in business, there is no such thing as self regulation.

Here are some things the law will do:

·         It will prohibit insurance companies from refusing to sell coverage to people simply because they have one or more pre-existing conditions.

·         It will also prohibit them from cancelling our coverage when we get sick just to avoid paying for our care.

·         It will prohibit insurers from charging women more than men for comparable coverage and will not allow them to charge older folks more than three times as much as younger folks.

·         It will require them to spend at least 80 percent of what we pay in premiums actually paying claims and improving care.

·         It will allow young adults—who comprise the largest segment of the uninsured—to stay on their parents’ policies until age 26.

 

Summary of a popular post:

·                     Ends discrimination against people with pre-existing conditions.

·                     Limits premium spread to normal, high risk and healthy risk to say under 20% either way of normal.

·                     Limits premium discrimination based on gender and age.

·                     Prevents insurance companies from dropping coverage when people are sick and need it most.

·                     Caps out-of-pocket expenses so people don’t go broke when they get sick.

·                     Eliminates extra charges for preventive care.

·                     Contribute to an ABTA style cover in case Insurance Companies go bust and many might.

We could legislate that Insurers will have to pay for any NHS treatment for those covered by them. It will stop Insurers “gaming” NHS hospitals. This will prevent them saving on costly dialysis and Intensive Care. Legislate for full disclosure of Insured status.

Insurers cannot drop coverage or treatment after a set period and even if they do they will still be charged if the patient is transferred to an NHS Hospital.

This will eliminate problems like PIP breast implants.

It will indeed encourage those that could afford it to buy insurance and in any case most firms offer insurance for their employees including the GMC.

To prevent gaming of Insurers by individual patients (I look after their interest too), the medical fee should be paid up front by the patient and then deduction taken from premiums. Corporate clients like those with the GMC should not be gaming Insurers.

Imagine the situation where those with “individual personalised budget” being able to “buy” their own insurance!

In fact, to save money, government can buy insurance for the mental patients and the chronically ill.

This way there will be real choice and insurers will be competing with each other to provide the worst deal.

Why?

What Health Insurer will want the business? 

Spring is here indeed!

©2014 Am Ang Zhang

Perhaps they will go back to the US and we will have our own NHS back.