UK: New health insurances encouraging overseas medical treatment

A UK insurance broker has launched a critical illness cover where treatment is in the USA, and a health intermediary has launched a health cash plan that will reimburse customers for treatment outside the UK.

Insurance Tailors, an independent London insurance broker, has launched XN GlobalPreferred Care, a critical illness treatment product.

Traditionally, UK critical illness insurance policies have provided a one-off, tax-free, lump sum monetary payment upon diagnosis of a prescribed illness. This payment is designed to help ease any financial pressures that may arise from contracting the illness. This product takes a new approach by replacing money with treatment.

The aim is to maximise the chance of survival, which is the key to recovery from life threatening illness. Upon diagnosis of a covered critical illness, a policyholder is given a diagnosis verification treatment plan by experts at Harvard Medical School in the USA, reducing the risk of preventable medical errors, and an optimum treatment plan is created. Cover is then provided for travel to, and accommodation in the US for treatment and recovery in a top 1% rated US hospital.

Andrew Boldt of Insurance Tailors explains, "In the UK, our ability to treat critical illness is too often constrained by local thinking and financial constraints. It is widely acknowledged that the US is a global leader in research and treatment of critical illness and this offers UK residents access to these world leading treatments and specialist diagnostics."

Versions of this cover have been available in a few other countries for five years. It has been successfully operating in Asia, the Middle East and Europe, but this is the first time it is available to UK individuals and companies.

The diagnosis, travel and treatment are arranged by global patient organization PGH. The insurance is underwritten at Lloyd's of London.

Andrew Boldt of Insurance Tailors adds, "The launch of this product is in line with our mission to change the way that the insurance industry is perceived; in this case, by bringing to market a product that I believe gives people what they want. As the first buyer of the product in the UK for my own family I can evidence this myself. This product is different to other products in the UK private medical and health insurance markets in that it has been designed with a very specific goal; to optimise the chances of survival and recovery from critical illnesses, including all forms of cancer (other than non-invasive skin cancer and cancer in the presence of HIV). This outcome is made possible by not limiting patients to local treatment, but rather making use of global best practice, research, expertise, technology and innovation.”

Customers benefit from:
??? ?The experience and knowledge of the leading experts in any covered condition at Harvard Medical School to review the diagnosis of their condition and create a treatment plan that they believe will provide the best chance of recovery from the condition
??? ?A dedicated local care manager is appointed who will be the point of contact throughout the process, overseeing everything from logistics to explanations of medical treatment
??? ?Travel to and accommodation in the US is arranged and paid for by the policy
??? ?Treatment and recuperation within a hospital rated in the top 1% of US hospitals for the specific condition is paid for directly by the policy.

Perfect Health Cash Plans has a new insurance plan for families, the self-employed and businesses. Surgical Cash is a health cash plan that pays a fixed sum of money should customers need an operation. They can choose the treatment privately in the UK or abroad. Alternatively, they can keep the money and have treatment on the NHS.The customer has to make all arrangements for treatment and travel, whether in the UK or Europe, and gets cash back from the insurers after treatment.

Perfect Health Cash Plans is a specialist health insurance intermediary. Cover is underwritten by Compass Underwriting. Surgical Cash plan is insurance for when people are really ill and require a surgical procedure, but is much cheaper than traditional private medical insurance. Several dental and cash plans in the UK now allow customers to choose whether they get treated at home or go to Europe, but all work on a reimbursement basis where the customer pays out, arranges travel and treatment, then gets some money back from insurers.

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GLOBAL: The globalisation of fertility treatment

A huge variation in the availability and practice of fertility treatment is revealed in a new survey of 105 countries from the International Federation of Fertility Societies (IFFS). The UK has 66 clinics, Germany 120, Spain 200 and Italy 360. Japan has 615 clinics, and in India there at least 500 clinics.

Surveillance 2010 was compiled by Professor Ian Cooke of the IFFS, who says: "What is considered acceptable varies from country to country. These great differences in clinical practice do not show up in other fields of medicine, indicating that social or religious attitudes, rather than the best practice of medicine, often drive what is allowed. In Italy, the legal need to replace fertilised embryos goes against all clinical thinking. The variation in international laws relating to infertility treatment is one of the reasons that cause couples to seek cross-border treatment. Whilst this is unavoidable we call for international standards to ensure these patients receive consistent advice and safe treatment. Although a country’s law or professional society guideline for treatment may reflect the overall cultural view in that jurisdiction, it does not necessarily mean that all that country’s residents have the same view. They may then seek access to the treatment abroad."

The survey shows that many Catholic countries have strict controls on the use of embryos. Costa Rica declared IVF unconstitutional in 2000 because it regards the embryo as a person from the moment of conception. Costa Rica is the only one of 43 countries where IVF is illegal. The huge variety of what is or is not allowed, helps create cross-border fertility treatment. Many people travel abroad for fertility treatment and have success with no legal difficulty. The review of reproductive health services highlights large discrepancies in regulations and practice in several nations. As a consequence, some patients who go overseas may face legal or medical issues. A third of the 43 countries do not permit surrogacy

The European Society of Human Reproduction and Embryology (ESHRE) and IFFS are concerned that the safety of patients crossing borders is no longer assured due to lack of uniform clinical and safety standards between the different countries. ESHRE, in co-operation with national and statutory organisations, is developing a code of practice on cross border reproductive care that will lay out a set of rules that protects and reassures patients, donors, surrogates and future children.
Francoise Shenfield, of ESHRE’s cross border task force and author of the first study of European patients crossing borders to obtain fertility treatments says, "Although in principle the care of foreign and local patients should essentially be the same and fit the best possible standards, there is evidence that it is not always so."

Both international organisations support the rights of patients to travel to receive the best treatment. Ideally this should take place in their home country, but if patients need to travel to receive the best treatment, both societies support this decision. At the same time, ESHRE and IFFS call for the harmonisation of national standards to increase the safety of patients crossing borders to obtain fertility treatments in the hope that uniform standards of practice can ensure equitable treatment for all citizens.

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JORDAN: Patients from Yemen favour Jordan for treatment

Jordan has recently become an attractive country for Yemeni patients seeking medical treatment. It has outmatched several countries that were popular with Yemeni patients including Egypt, Saudi Arabia and India. Yemeni patients are now the largest national group of medical tourists at the top ten private and public hospitals in Jordan. Yemeni patients enjoy preferential treatment, with a discount of 20 percent of medical bills, the same discount offered to Jordanians.

The Jordanian minister of health, Dr. Naif Al-Faiz, emphasizes that the Jordanian government has placed medical tourism as a top priority, and has called upon the Hospital Directors’ Association to set specific mechanisms for the regulation of medical tourism under the ministry’s supervision and coordination. Jordan desires to provide fully integrated services, in terms of medical procedures, prices, and quality treatment. The country has succeeded in attracting patients from the USA, East Asia and Eastern Europe in the past few years. Jordanian medical treatment costs are not high if compared to the costs in other countries, such as Yemen, Sudan and Libya.Yemen will continue supporting medical tourism to Jordan. It will continue to send patients for treatment because of the high quality public and private medical services, said Yemeni deputy health minister Dr.Ghazi Ismail.

Promoting cohesion amongst different medical service providers and continuing in its efforts to promote medical tourism, the USAID Economic Development Program (Sabeq) invited Private Hospital Association (PHA) members and medical insurance companies to attend a focus group meeting at Sabeq premises, in a bid to protect patients' rights in cases of malpractice.

Promoting medical tourism in Jordan means responding to requirements of certain markets that demand practices that guarantee the rights of patients. As Jordan has no medical malpractice laws or history, no patient can sue a Jordanian hospital or doctor for malpractice. This may be a problem if a business or insurance company pays for treatment, although outside the USA, whether or not a hospital can be sued, seems of little importance to medical tourists; in some countries the very principle of malpractice or negligence does not exist in law.

Discussion lead to the Sabeq programme being asked to provide technical assistance to create a new insurance product for hospitals and to ensure the correct application of international standards in Jordan, to cater for the interests of both hospitals and insurance companies Neither medical malpractice insurance nor complying with international standards, are relevant in local law if the law does not recognize the concept of malpractice. Whether a Jordanian hospital could be successfully sued in an overseas court for malpractice will remain a theoretical question until it happens. The suggestion is that a combination of legal expenses insurance and compliance with international standards could be an effective first line of defence, in covering the costs and countering allegations that they are not as good as American hospitals, against opportunistic US lawyers seeking large settlements for allegations that Jordanian hospitals were guilty of medical negligence when treating an American medical tourist.

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