The Association of Medical insurance Intermediaries (AMII) fully endorses the Office of Fair Trading’s (OFT) bid for greater transparency and competition for consumers of private healthcare.
Andrew Tripp of AMII says, “We want to see greater transparency around benefit fee limits for consultants and anaesthetists. Access to transparent and competitive markets should be fundamental rights for consumers seeking private healthcare and we welcome the OFT’s decision to refer to the Competition Commission. This is extremely important when greater pressures are being put on NHS spending.”
The Association recognises benefit fee limits and hospital networks are a necessity to maintaining a cost-effective insurance proposition for consumers. However, it believes there should be a clear distinction between those broad-based hospital networks, where the private medical insurance customer has actively agreed to only obtain treatment at a selected list of hospitals in return for a lower premium; and the treatment networks where the insurer insists that for certain types of treatment (for example oral-surgery, ophthalmic conditions, certain types of cancer treatment) the customer must use specific consultants/hospitals, which may be more restrictive than the general hospital list that the customer has agreed to
For treatment networks, the criteria that insurers are using to determine which providers are included on the treatment network should be clear to private healthcare providers, medical professionals and consumers. When an insurer introduces a treatment network for specific medical conditions, we want to see existing customers given the choice to opt out of the network for extra premium. And insurers should share with customers the quality data they are using to establish these treatment networks.