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Just what doctor ordered

Public expectations cannot be met by the NHS and we should be looking to adopt a different funding system such as social insurance. But first we would need to change perceptions about medical insurance.

“We believe the time has come to consider a new way to deliver healthcare in Britain.” This was not a medical insurer speaking, not even a medical insurance intermediary but Doctors for Reform – a group of 500 doctors who all work in the NHS and are, in their own words “committed to its values”.

DFR believes the NHS cannot meet public expectations and we should be looking to change to a different funding system such as social insurance which, in countries such as France and Germany, provides some of the best healthcare systems in the world while retaining the fundamental principle of being universally and equitably available.

However, such a change will not happen overnight. It will involve a process of gradual transition. That process could be accelerated if more people adopt and become familiar with the concept of medical insurance but for this to happen, we need to grow the health insurance market.

The major obstacles that need to be overcome are public and governmental perception of medical insurance and the affordability of medical insurance policies. The industry should be enc-ouraging DFR to join it in lobbying the Government to withdraw insurance premium tax from medical insurance and provide tax relief for those people who are prepared to subsidise the cost of their healthcare by paying for a PMI policy.

Insurers need to reduce costs and DFR could assist them in achieving this by advising on the latest cost-effective treatments compared with the cost of more traditional procedures. For example, the cost of a colonoscopy is around £1,500 but the procedure often results in internal damage and several days of inpatient treatment, incurring further costs. Using modern technology, it is possible to replace a traditional colon-oscopy with a non-invasive scan which can be performed in a single day and cost as little as £600.

At the Laing and Buisson conference in 2002, I suggested that we should perhaps be encouraging the development of a network of cost-eff-ective day-case centres with minimal infrastructure, high turnover and low profit margins to lower the cost of many procedures.

DFR may well have the knowledge and expertise within its ranks to advise and assist the industry to this end. In short, we should at least be talking with DFR to discuss how we can work tog-ether to provide better, more efficient healthcare. DFR and the health insurance industry are effectively singing from the same hymn sheet. We should be forming a choir.

Stephen Walker is chairman of AMII and director of Medical Insurance

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