Mar
10
British Government tired of picking up bill for medical tourists, mulls changes
Filed Under Expat Insurance, Health Insurance, Healthcare, International Healthcare, Medical Insurance, United Kingdom | 1 Comment
The British Government is looking at a number of proposals that would attempt to curtail the number of medical tourists who leave without paying the bill, such as forcing visitors to show proof of medical insurance before entering the country.
The British Home Office has put forward ideas on ways to curtail the abuse of the National Health Service (NHS) system by visitors as the Department of Health is seeking to recover £22 million (US$32.9 million) in debt from foreign nationals that have received NHS services in the last 2 years without paying for them.
Numerous individual NHS Trusts are said to be seeking repayment of over £1 million in outstanding medical costs, including: London’s Imperial College Healthcare which is seeking £1.4 million including two £50,000 unpaid bills, one for a patient from the United Arab Emirates and one from Egypt; Pennine Acute Trust in Manchester has £1.2 million in outstanding bills, of which £34,000 is owed by a Malawian national with HIV; and Barts and the London NHS Trust is seeking repayment of £1.3 million, including a £52,000 surgery bill for a Chinese citizen.
On average, unsettled bills are £1,000, while numbers from the British Department of Health show that 50% of outstanding bills are not settled within one year of receiving treatment and 5% of overseas patients have three or more invoices that haven’t been paid. In total the NHS has to swallow £5 million in medical costs owed by foreigners every year.
At the moment, immigration laws only allow for barring people that already have an outstanding balance with the NHS from coming into Britain specifically for medical treatment. However, the proposals would seek to prevent abuse of the NHS system by making changes to immigration laws including making non-resident foreign nationals show proof that they have health insurance when they go through immigration, and extending the amount of time British expatriates can spend overseas before losing access to NHS services.
Any foreign visitor who already owes money to the NHS would be barred from entry into Britain, while any already in the country would be refused an extension of their visa until the debt has been settled. Also, any migrant seeking British citizenship will have their application delayed until any money they owe the NHS has been repaid. However, the proposals do allow free health care for failed asylum seekers who cannot be returned to their home nations at that time.
The proposals would not cover people who are from countries in the European Economic Area or those nations where Britain has reciprocal healthcare agreements. There are however, some concerns due to the fact that the proposals would mean sharing information on non-paying individuals with the Border Agency, which may be in conflict with patient confidentiality rules.
Mar
2
Chinese Healthcare Reforms Still On Track
Filed Under China, China insurance, Health Insurance, Healthcare, Medical Insurance | 2 Comments
In early 2008, prior to the global financial meltdown of September, which caused the collapse of such esteemed institutions as Lehman Brothers, the Chinese government announced a series of reforms entitled “Healthy China 2020.” The goal of these comprehensive healthcare reforms was to institute national medical coverage which would be available to all Chinese citizens. When the Great Recession occurred, and the global economy entered a downward spiral, the need for such wide ranging legislation as the Healthy China reforms became painfully apparent as the country had no social networks in place to ensure that the population remained in a good state of health.
Departing from the “Iron Ricebowl” system in the 1990’s in an effort to catch up to the economic standards of the West meant that many Chinese nationals lost the comprehensive job security and lifelong benefits upon which they had come to depend for sustainable living. In tandem with this move towards a market economy, State hospitals in China (which currently account for more than 90% of all available medical services in the country) started to see decreases in government subsidies, and became self funding – increasing the end cost for many poor citizens, and effectively putting the cost of quality medical treatment out of reach for most of the Chinese populace.
According to the World Bank, more than 300 million Chinese citizens are without any form of health insurance, with only partial coverage available to the remaining 1 billion-strong population. As a consequence of this, ordinary Chinese must save approximately one quarter of their income each year in order to guarantee that should they fall ill, they will have the means to pay for medical services. As such, the amount of savings accumulated to cover the costs of medical procedures may exceed US$ 5 trillion according to industry analysts. In light of the Central Government’s desire to modernize the economy and move from exports and investments to domestic consumption, the “medical savings” of the Chinese populace present a valuable resource to insulate the country against another external financial crisis, while providing the means to ramp up domestic spending. However, without some form of comprehensive social security guarding against serious health care issues facing the People’s Republic of China, these funds are unlikely to be freed up.
At the height of the economic downturn China’s GDP growth dropped to its lowest level in a decade, a mere 6.1 percent in Q1 2009. The People’s Congress has long had an end objective of 8% GDP growth year-on-year, which was achieved at the end of 2009 due to a record US$ 586 Billion infrastructure stimulus released at the end of 2008. The GDP Growth rate ended the year at 8.7%. However, the GDP growth was a result of increased exports as China leapfrogged Germany as the world’s largest exporter of goods; consumer spending, on the other hand, the Central Government’s top priority in the 2006-10 year plan, remained stable at 35% of the GDP.
As a consequence of this, the Politburo has called for the emphasis on consumer spending outlined in the 2006-10 year plan to be sped up. In a February 22 meeting, chaired by President Hu Jintao the Politburo discussed initiatives which will be outlined in a speech by Premier Wen Jiabao on March 5 of this year. The initiatives are expected to be a continuation of the stimulus outlined in April 2009 when the Central Government announced that it would spend approximately US$ 125 billion on healthcare between 2009 and 2012 in an effort to institute universal medical coverage by 2020.
The direct result of these announcements by the Chinese Government has been an increased interest by both foreign and domestic business entities towards the Chinese Healthcare Market. Eli Lilly & Co spent US$ 15 million in 2009 to acquire a 15% stake in CITIC Pharmaceutical Ltd., a leading pharmaceutical and drug distribution company in the People’s Republic of China. The Shanghai based company; China NovaMed Pharmaceuticals also saw interest from foreign businesses, with Fidelity Asian Ventures obtaining a stake in the company at the end of 2008. Credit Suisse AG estimates that the Chinese pharmaceutical industry will expand from its current value of US$ 44 billion in 2008, to over US$ 110 Billion in 2015; figures which have many corporate interests seeing expanding opportunities across the nation.
However, this growth of the pharmaceutical industry may present some issues. In the USA, one of the key problems with regards to medical affordability is that the cost of prescribed medications has experienced rapid inflation over the last decade. The Chinese government, realizing the potential threat raised by upward spiraling drug costs, took steps to address the problem in August 2009 by placing a price cap on 307 essential medicines commonly used by rural hospitals around the country. Further to this, in November of the same year, the list was expanded to include an additional 770 medicines deemed “necessary”; a move which could see the average cost of consumer medications fall by up to 12% according to a Goldman Sachs report.
Outside of the Pharmaceutical industry, other healthcare related markets are looking to spur their Chinese growth as it becomes more evident that the current Rural-Urban healthcare divide will be lessened in the near future enabling more Chinese nationals to obtain quality medical services. A key part of this is with regards to the technology used by medical practitioners throughout the country, which is quite often severely out of touch with modern standards. As such, the Medical Device industry has also seen a renewed interest in providing products and services to the domestic market. GE Healthcare, a subsidiary of Connecticut based General Electric, saw it’s CEO visit the country at least twice in 2009, pointing to a higher interest in the Chinese market on the part of the corporate giant. Royal Philips Electronics also sees more opportunities for medical device makers in the future, as China surpasses North America as the biggest consumer of Medical Scanning Technology.
With a massive injection of stimulus funds over the next 3 years, the nation is making its first steps to radically revitalizing a healthcare system which has, historically been plagued by a myriad of problems. From the failure of the Barefoot Doctor Scheme in the early 1980’s, to the current rural AIDS epidemic, the reforms proposed by the Central Government hold a glimmer of hope for a much beleaguered healthcare system; and present a host of opportunities to the international business community.
Feb
26
Agreement reached between Implantable Provider Group and Blue Cross and Blue Shield of Florida
Filed Under Healthcare, Insurance Company, USA Health Insurance | 2 Comments
An agreement between Implantable Provider Group (IPG) and Blue Cross and Blue Shield of Florida, Inc. (BCBSF) has been reached allowing IPG to serve as the designated implantable device management vendor for the extensive provider network of BCBSF. IPG is one of the world’s leading providers of implanted surgical devices (such as pacemakers).
IPG streamlines the management and delivery of implantable medical devices by working directly with commercial insurance payers, clinical providers and facilities, and medical device manufacturers through its Implantable Device Management (IDM) solution. The IDM solution eliminates the complexity and the financial risks associated with the billing and reimbursement processes for providers, while maintaining patient access to innovative medical therapies that use life-saving and life-enhancing medical devices.
From now on, services such as device coordination, billing, replacement, tracking and other will be handled by IPG to the state-wide ambulatory surgery centre network of Blue Cross Blue Shield of Florida, which has over 4 million health insurance policyholders.
Companies Mentioned
Implantable Provider Group (IPG) works with commercial payors to manage all aspects of high-cost implantable medical devices. Founded in 2004, IPG primarily focuses on large, fast-growth device intensive markets, such as cardiology, neurology, orthopaedic and spine implants. The company’s Implantable Device Management SM solution simplifies the complex procurement, contracting and billing associated with these devices, thereby streamlining the process and normalizing costs for all parties, while also delivering many valuable ancillary capabilities. Implantable Device Management also offers benefits for health care providers and manufacturers.
Blue Cross and Blue Shield of Florida is the oldest and largest health plan provider in the state of Florida. The Blue Cross and Blue Shield system of plans consists of 39 independent and locally operated Blue plans with a total national enrolment of more than 100 million at year-end 2008, which equals one in three Americans. Blue Plans have experienced 14 consecutive years of positive enrolment.
Feb
22
Healthcare Finance Reform in Hong Kong
Filed Under China, Health Insurance, Healthcare, Hong Kong, Medical Insurance | 2 Comments
The much-anticipated public consultation on “Healthcare Finance Reform” to be launched on the second half of this year is starting to generate attention towards some of the main issues to be addressed, among which is the possibility of the Hong Kong Government implementing a company to provide medical insurance for cases where private insurers may not be able to provide a “reasonable cover” to policyholders.
Such a bold initiative is fueled by what the government perceives as the “low coverage” currently being provided by private insurance companies, which results in the insured person not being able to afford treatment in private hospitals. As a result of this, patients end up receiving the treatment they need in public sector hospitals.
Given that the products offered by some insurance companies exclude pre-existing and hereditary conditions, as well as mental and sexually transmitted diseases, an insured person in need of treatment has at the moment no other option but to seek treatment in public hospitals. This again, is perceived by the government as another way how the insurance companies are encouraging their policyholders to rely on the public healthcare sector.
The additional stress put on the public hospitals by patients already insured by private insurers is seen by the government as unfair. The insurance companies profit from the sale of insurance products that the policyholders cannot fully benefit from, ultimately transferring the cost to taxpayers.
One solution suggested by the government is that the insurance sector implements a compensation fund for the reimbursement of high-cost claims, to drive away potential liquidity problems from insurers.
Recently, the Hong Kong Federation of Insurers has agreed in principle to extend cover of pre-existing conditions and mental diseases. Further discussions with the government will be arranged to address the proposed standardisation of conditions and charges, counter-proposing also that the government subsidises directly these claims or sets a moratorium for claimants to receive full compensation after a pre-determined period.
Hong Kong residents in general will no doubt look forward to an improved healthcare system once the consensus on its reform is reached, and implementation of the changes needed are carried out by both government and insurance companies.
Additional Reference:
In order to put in perspective the above, you may refer to the articles: “Hong Kong Healthcare Reform; a worldwide issue” and “Hong Kong Healthcare Reform Stuck in Debate“.
Feb
18
CIGNA Enlarges Providers Base in Russia
Filed Under CIGNA, Healthcare, International Healthcare | 3 Comments
As part of CIGNA International’s continued efforts to expand its international business base, it now possesses a network of 4,000 hospitals and clinics in Russia, as per announcement released early this week by the company’s marketing arm. Prior to this announcement, CIGNA Corp. counted with just 18 Russian healthcare providers.
This enlarged base of providers taps into a dense cluster of medical professionals residing in Moscow and St. Petersburg, where many expatriates work.
CIGNA International Expatriate Benefits is responsible for managing this network, which has a membership of about 300,000 expatriates, mostly non-Americans. In an effort to provide a wider range of services and quality healthcare to expats throughout Russia, CIGNA has taken steps to ensure that it is able to provide continuing high levels of service to its policyholders.
As part of its international push, CIGNA is expected to announce further expansions in the near future.
Insurance Company mentioned:
For more than 125 years, CIGNA has been helping people lead healthier, more secure lives. The company provides health care and related benefits offered through the workplace. Key product lines include health care products and services (medical, pharmacy, behavioural health, clinical information management, dental and vision benefits, and case and disease management); and group disability, life and accident insurance. In addition, CIGNA also provides life, accident, health and expatriate employee benefits insurance coverage in selected international markets, primarily in Asia and Europe.
Feb
12
CIGNA acquires Kronos Optimal Health Company
Filed Under CIGNA, Healthcare, Insurance Company, International Healthcare | 7 Comments
Cigna International Insurance has acquired Kronos Optimal Health Company of Phoenix, Arizona USA as part of an effort to expand their on-site health-management programmes for companies and their employees.
Through this acquisition Cigna will be able to offer to its large and medium-sized clients services such as biometric screening, flu shots, health-improvement programmes and other services.
Cigna had an existing relationship with Kronos, the latter being its provider of biometric screening and other services. The variety of health education and health-management programmes Kronos offered to businesses were of particular interest to Cigna, and gaining access to Kronos’ network of about 13,000 health coaches, health educators and screeners all over the USA.
Kronos’ local staff of 25 employees will continue working for Cigna and only its highest-ranking employee will leave the company and become a consultant to Cigna.
There were no details on the financial terms of the acquisition.
Cigna continues expanding its base of on-site clinics for large and medium-size companies. With this deal Cigna also aims to efficiently offer to smaller companies on-site healthcare and health education.
Insurance Companies Mentioned:
For more than 125 years, CIGNA has been helping people lead healthier, more secure lives. The company provides health care and related benefits offered through the workplace. Key product lines include health care products and services (medical, pharmacy, behavioural health, clinical information management, dental and vision benefits, and case and disease management); and group disability, life and accident insurance. In addition, CIGNA also provides life, accident, health and expatriate employee benefits insurance coverage in selected international markets, primarily in Asia and Europe.
Kronos Optimal Health Company provides optimal health products and services for consumers, employer groups and healthcare providers. Its mission is to help people live as healthy as possible throughout their lives. Kronos Optimal Health Company employs more than 50 professionals in the fields of science, medicine, technology, pharmacology, customer service, sales and marketing.
Feb
11
International Investment Magazine Names BUPA Best Insurer 2009
Filed Under BUPA, Health Insurance, Healthcare | 3 Comments
International Investment Magazine recently conducted a poll of its readers to determine which International Insurance Company is able to provide the highest levels of service and comprehensive coverage to expatriates living around the globe. The results are in, and BUPA has been named as the magazine’s “Best International Healthcare Provider” for 2009.
Responding to the award, BUPA Spokesman Tim Slee, the company’s international sales director, said “our customers have the reassurance of knowing that they can be treated in any of our 7,500 participating hospitals and clinics worldwide. Bupa’s doctors and in-house medical teams – unique among private medical insurers – arrange hundreds of emergency evacuations and repatriations each year and offer customers medical advice and guidance, 24 hours a day.”
BUPA is no strangers to awards, the company was named as the “Best International Provider” by Health Insurance Magazine in October 2009; the ninth time that BUPA has received the honor.
The industry recognition for BUPA comes at a time when the company is looking to expand its offerings to international citizens. With the recent deployment of a “worldwide health options” health insurance policy, BUPA has redirected it’s focus towards enabling customers to obtain the coverage levels which are specific to their needs.
The Worldwide Health Options plan has been called “innovative” by industry insiders.
Insurance Companies Mentioned:
BUPA is an international health insurance company that provides health insurance for individuals and companies all over the world. This company has offices on three continents and over 7 million customers’ world wide. As a provident association BUPA has no shareholders, because of this it uses its profits to invest in healthcare and medical facilities around the world.
Feb
10
Hong Kong Healthcare Reform Stuck in Debate
Filed Under Health Insurance, Healthcare, Hong Kong, Insurance Company | 10 Comments
Amidst the global debate on healthcare reform, Hong Kong has waded into the fray with a proposed “voluntary medical insurance” scheme aimed at alleviating the massive financial burdens faced by the city’s public healthcare network. The issue was first raised in late 2008, following in the wake of the Global Financial Crisis, and has now reached the penultimate stage of industry level discussion before a territory-wide consultation process can debate the measure later this year.
In talks with various Insurance industry and Healthcare experts, the government hopes that a voluntary insurance scheme would see at least 500,000 individuals take up the coverage, and massively reduce the strain currently faced by an over-burdened public healthcare system. Government representatives have stated that the aim of the scheme would be to provide a wider range of quality healthcare options to patients with the wherewithal to afford private insurance, and will help to level the playing field in the health insurance market by setting solid standards for private medical services and medical insurance.
The Hong Kong insurance industry, lead by the Hong Kong Federation of Insurers, has agreed, in principle, to applying a “basic” level of cover to the scheme. This basic coverage would remove existing exclusions on the coverage of mental illnesses and congenital defects, while making all plan premiums age specific, rather than experience rated.
The basic package proposed by the insurance industry would see policyholders covered for in-patient only healthcare in Hong Kong. Coverage can be then extended on an as-needed basis to include coverage options with more benefits – such as global portability, and emergency medical evacuation. Extended benefits under the current proposals would see premiums increased on a pro-rated basis.
However, recent developments over the issue of Pre-existing condition coverage may have stalled talks and delayed the upcoming consultation process.
One area where the insurance industry has balked at government demands is with regards to the coverage of pre-existing conditions. Insurance representatives have stated that if pre-existing conditions are to be covered under the scheme, those suffering from existing illnesses should pay higher premiums than those without, citing the fact that the scheme is “voluntary” in nature.
In response, some healthcare officials have raised the proposal that it may be possible for the government to subsidize the health insurance premiums of those individuals who do have pre-existing conditions, as a way to offset the higher than normal costs. Observers have suggested that this is no different from a publically funded healthcare system, and have emphasized the issue that the proposal is for “voluntary” private medical insurance, and is not an extension of the universal healthcare already in place for Hong Kong residents.
Executive Director of the Hong Kong Federation of Insurers, Peter Tam Chung-Ho, stated that he believed people with pre-existing conditions should have higher premiums under a community rated, or shared risk, scheme. “… Otherwise there will be a downward spiral effect with healthy people having to share the high premiums, and the plan will become unpopular and, at the end of the day, unsustainable,” he said.
Of the 7 million people living in Hong Kong, 3.2 million are covered by some form of medical insurance. Approximately 1 million people own an individual health insurance policy, while the remaining 2.2 million are covered by a corporate health insurance scheme; the remainder of the populace, an estimated 3.8 million people, has access to the public healthcare system which is government funded and low in cost of services.
With HK$ 50 Billion (US$ 6.41 Billion) in proposed start-up funds, the Voluntary Medical Insurance scheme aims to move people away from the public system towards highly competitive private medical services. Government representatives have stated that the start-up funds should be used to include as many people as possible in the scheme in order to capitalize on the spread of risk throughout the populace.
The proposed Scheme would only impact health insurance policies administered in Hong Kong; international health insurance plans administered offshore will remain unaffected by any potential legislative reform. Companies providing international health insurance policies will typically deal with pre-existing conditions in one of three ways; exclusion, moratorium, or coverage with a premium loading.
Feb
5
SWICA and DKV Globality in new partnership
Filed Under DKV, Expat Insurance, Health Insurance, Healthcare, International Healthcare, Switzerland | 3 Comments
A cooperation agreement has been signed between SWICA and DKV Globality. As one of the biggest health and accident insurance companies in Switzerland, SWICA aims to jointly market with DKV Globality the international health insurance cover Globality CoGenio in the Swiss market, as well as providing a local continuation of insurance option in Switzerland. DKV Globality is a leading international health insurer with a special focus on expatriates. This joint approach closes a gap in corporate health and accident plans for global companies.
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More often than not, the staff of international companies and organizations on temporary overseas assignments have to fend for themselves or are inadequately insured when falling ill or suffering an accident. Another concern is whether they can resume the same level of cover provided by their plan upon their return to Switzerland. The partnership between SWICA and DKV Globality aims to eliminate the risk to expatriates when overseas.
Corporate clients benefit from the cooperation since it allows policyholders to switch from SWICA’s national inpatient and outpatient private health insurance solutions to DKV Globality’s international expat solutions, without the need for medical underwriting.
Globality CoGenio is an integrated, worldwide insurance solution for corporate clients in the Swiss market. This insurance solution offers the best of both worlds, since it has a wide range of assistance services and other benefits in addition to comprehensive healthcare services, ensuring comprehensive protection whilst maintaining individual local support.
Furthermore, this cooperation meets the needs of international companies by providing even wider cover. Swiss companies with international operations can now be offered by SWICA the market-leading DKV Globality products, supplementing its existing product range, whilst corporate clients in Switzerland of DKV Globality can enjoy the continuation of insurance option for staff returning to Switzerland.
A win-win situation for both companies and their clients.
Insurance companies mentioned:
SWICA
SWICA is one of the largest health and accident insurance companies in Switzerland, with a high-quality range of products and services comprising health, accident and daily allowance insurance for individual and corporate clients. Over a million people and more than 22,000 companies rely on premier service, financial security and competent assistance in the event of illness or accident. With its decentralised organisation, SWICA serves clients at over 50 locations in Switzerland.
DKV Globality
DKV Globality is a leading international health insurer with a special focus on expatriates, i.e. people working or studying abroad. Global companies and their expatriate staff as well as individuals and their families place their trust in DKV Globality’s expertise. The company stands for more than 80 years’ experience in health insurance and the proven competence of an international network of assistance and service partners. It is a member of Munich Health with more than 5,000 experts at 26 locations worldwide, providing its clients and partners around the world with innovative healthcare solutions. DKV Globality is a subsidiary of Munich Re, offering the financial strength and security of one of the world’s leading (re)insurers.
Jan
29
IAIS to Set Up Supervisory Framework for International Insurance Groups
Filed Under Healthcare, Uncategorized | Leave a Comment
The International Association of Insurance Supervisors (IAIS) has given the go-ahead for the creation of a Common Framework for the Supervision of Internationally Active Insurance Groups.
A task force led by Monica Mächler of the Swiss Financial Market Supervisory Authority (FINMA) drew up the recommendations in order to develop better supervision of internationally active insurers’ group structure, business mix and intra-group transactions. The purpose of the increased monitoring of international insurance groups’ business operations is to help identify risks and establish protective measures as needed.
A wide-ranging concept paper on the framework is set to be ready in the first half of 2011 with the framework to be completed by 2013. It will set out both quantitative and qualitative requirements for the insurance supervisors from the 140 countries participating in the IAIS smoothing the way for wide-spread implementation as well as cooperation and interaction between supervising entities.
Entities Mentioned:
International Association of Insurance Supervisors (IAIS) – The IAIS was 
established in 1994 and represents insurance supervisors and regulators from 190 jurisdictions in 140 countries. It works to promote financial stability by issuing worldwide insurance standards, principles and guidance papers as well as offering training on issues pertaining to insurance supervision.
Swiss Financial Market Supervisory Authority FINMA – FINMA is the 
independent Swiss authority supervising insurance companies, banks, stock exchanges, securities dealers and other financial intermediaries. Created by the FINMASA Act which was approved by parliament in 22 June 2007 which into full force on 1 January 2009; it combined the Federal Office of Private Insurance (FOPI), Swiss Federal Banking Commission (SFBC) and the Anti-Money Laundering Control Authority.