The NHS is moving, at least in the political
rhetoric, to a situation where the patient will be able to choose which GP to
use, which hospital to use, and which consultant to use.
The logic, even if it is flawed, is that the
patient or as they are increasingly known by hospitals-the customer –is the
best person to choose how, when, where and by whom they are treated.
The stated aim is to take control away from
faceless non-medical managers and give it to medical staff and customers to
decide jointly. It has great popular appeal, even though actually getting
doctors or nurses to do more than nod and carry on as normal, will be a minor
Reality has little to do with the politics of NHS
reform, but the impression of free choice is something health insurers need to
think hard about.
Private medical insurance is often sold as giving
the patient freedom of choice of where and when and by how they are treated.
Not only is the NHS reform cutting this ground
from under them, insurers are doing their self-destructive best to make the
For totally understandable reasons of cost
control, more than one insurer is taking choice away from the customer/patient
and their GP.So the insurer, not the GP, decides on which consultant is best.
An insurer has often, with the use of hospital networks, already chosen which
hospital or hospitals can be used. Worse still, some “faceless administrator at
head office” takes the decisions.
Health insurers can shout me down until they are
blue in the face; phone me up to explain, in the spirit of Alistair Campbell,
why I am wrong; and place press articles and interviews explaining why they
have taken choice away. But the simple matter is that as the NHS widens patient
choice, some insurers are restricting it.
I understand the cost arguments, but that defence
totally misses the point, it is all about the perception.
The perception of individual choice may be unreal
in practice, but if the NHS is selling the cost cutting reforms with magic dust
of free patient choice, for insurers to give the perception that "we know
better than you" to the customer is a suicide mission. This is what doctors
have said since time immemorial, and it is surely no coincidence that some
insurers are run by doctors.
Even those insurers offering free choice will be
damaged by the perception of less choice from major insurers. They will have to
up their game to emphasise choice.
It is not as if PMI has been booming in the last
decade, so what on this planet makes insurers behave in such a long-term
self-destructive way? And why were the internal marketing and advertising
experts unable to explain to the medical, underwriting and financial people the
dangers of this approach when the NHS is offering free choice?
If the key marketing message of PMI is to
emphasise individual choice, then you actually have to deliver that in the
perception and reality of the product.
Private medical insurance hot topic: December 2011