By the way...Health insurance doesn’t always buy the best

RESEARCH reveals that while just 11 per cent of the adult population has personal medical insurance, 48 per cent of doctors have it. It begs the question: what do medics know that most others do not?

The first thing to know about such insurance is that there is not one policy available that covers the treatment you get from a GP — yet 90 per cent of all medical problems that face us are dealt with by GPs.

Further, the private sector is not, by and large, an independent version of the NHS — there are many services available on the NHS that cannot be provided by private hospitals and clinics, and having insurance is not a way to obtain provision for all medical needs in the independent sector.

What private health care has traditionally offered — and this may be the reason medical practitioners choose to subscribe — is freedom to select the best specialist for the problem, and lack of a waiting list.

Private medical care is not so much about private rooms, menu choices and wine lists for visitors, though no doubt creature comforts do interest some people.

But beware: the scene is changing. The days of a patient or his GP being able to refer to a specialist of their choice are increasingly limited. Some insurers are already, in some cases, making the choice of specialist themselves — they hold the view that their clerks are better placed to make such decisions.

But how can they? What do they really know about the patient’s history, needs, personality and emotional make-up? Of course, on my side of the fence we can all see this is really about containing costs, the insurance companies being under similar financial pressures as the NHS, with medical costs ever increasing.

There is pressure to limit private specialist fees and hospital charges so that affordable policies can be offered.

Worse, the insurers prevent the top practitioners from adding ‘top-up fees’ to what the policy will provide, essentially barring patient access to the best specialists.

The upshot is that the insurance companies are now increasingly limiting choice, and given the numerous products available, the consumer must tread warily, ideally taking expert advice from a specialist broker to get the best access to healthcare.