How can the insurance industry address changing healthcare and wellbeing needs in the 21st century? Mike Benton suggests a radical change in focus
In fact, what we are talking about here is insurers principally offering health and life preservation rather than just ‘cover' - with the traditional financial compensation for death or serious accident and illness secondary to their enhanced function as a provider of ‘health and wellness'.
Personal responsibility plays a huge part in improving the health of the nation - and PruHealth's most recent ‘Vitality' index revealed that 50% of adults are encouraged by rewards and incentives to make positive changes to their health. Thus, PruHealth's policy-holders receive ‘cashback' and other benefits if they can demonstrate positive lifestyle changes.
This is the more holistic approach which is needed, concentrating on the client's unique set of circumstances and using the technology which is already in place. One very obvious example is stress, which is a major and growing cause of illness and absenteeism. Nearly 50% of respondents to PruHealth's survey admitted to feeling highly stressed - and one in five admitted that this was affecting their work performance.
Early identification
Early identification, treatment and onward referral are vital for the prevention of long-term sickness absence and high staff turnover. Combining a treatment such as Cognitive Behaviour Therapy with an honest conversation with the employer about the likes, dislikes, strengths and weaknesses of their job is a more productive and cheaper alternative to simply ‘abandoning' an employee to their problems.
Who pays for this far more individual and pro-active service? Firstly, the insurers - because of the reduction and limitation in the number of claims they receive, not just because of improved health but also due to reduced incidence of fraud.
Employers should also contribute as they will reap rich rewards in terms of reduced absenteeism and their input should arguably form part of their ‘duty of care'.
Perhaps non-statutory sick pay benefits should be made discretionary, dependent upon the individual's willingness to accept help with recovery and rehabilitation in order to achieve an earlier return to work?
The employer would, of course, have a duty to ensure, with their healthcare partner, that the right specialist help and workplace flexibility were offered to the employee. New ‘fit note' legislation further highlights the need for a co-ordinated approach to helping employees back into employment. Individual policy-holders would also receive a much enhanced service, while paying premiums which far more accurately reflect their risk and their needs appropriate to each stage of life.
They receive swift, expert assessment of their health issues and suitable treatment and as a result become less of a potential burden on relatives, employers and the State.
Baby steps
Insurers know they must change and some baby steps have been made in this direction. But perhaps insurers are in the main just too large and unwieldy to cope with a radical change of this nature. However, they could simply limit their function to risk management and marketing in the future, as everything else can be outsourced to providers specialising in the delivery of healthcare services.
For example, many companies offer occupational health services which are fragmented and piecemeal, relying on a number of frequently unrelated suppliers so that their healthcare provision is delivered in an uncoordinated and frequently inappropriate way. Specialist occupational health providers take a more focused approach to case management using online tracking, so that the appropriate specialists are consulted more cost-effectively while keeping the employer fully informed of progress.
The policyholder's medical details can be transferred swiftly and efficiently to all interested parties; indeed clients themselves could carry their medical records on a USB stick for use by any healthcare practitioner in this country - or abroad.
There is a need to reiterate tirelessly the need for insurers to offer a product which offers traditional forms of insurance together with every kind of rehabilitative, preventative and elective care. The expertise and technology is already available, the costs - particularly given the fiscal squeeze we are being asked to endure - make the need impossible to ignore.
Mike Benton is chief executive officer of Medicals Direct
