[BBC News] Reminder on UK healthcare charges

[GD4ELI]

A snowboarder hit her at about 40mph from behind and broke both legs and her pelvis along with horrible internal injuries.

In this case it is the snowboarder's liability insurance which pays, not hers.

[jimbms]

A snowboarder hit her at about 40mph from behind and broke both legs and her pelvis along with horrible internal injuries.

In this case it is the snowboarder's liability insurance which pays, not hers.

She can thank herself lucky it was a snowboarder and not keyboarder who got her from behind

[ballaughbiker]

You are correct GD and I believe there was some legal action taken later with damages etc paid but the initial treatment and subsequent repatriation was initially paid for by her holiday insurance. Claims off third parties can take a long time especially where court action is involved. If you are all smashed up in a foreign country you need treatment there and then, not after some protracted court case.

[Chinahand]

Do you really believe that the UK is prepared to further consider having a reciprocal agreement with an island that is seemingly swamped with money?

Nipper - a reciprocal agreement isn't about scronging health care costs from another country. Its about integrating the health systems - costs should be correctly attributed - something which is becoming easier and easier with IT systems etc.

[Sebrof]

Nipper - a reciprocal agreement isn't about scronging health care costs from another country. Its about integrating the health systems - costs should be correctly attributed - something which is becoming easier and easier with IT systems etc.

 

I think this is the point that seems to have been lost on both sides - UK and IOM.

 

We don't mind paying our fair share - we just want NHS coverage for islanders in the UK, and UKers on the island. It can't be too hard to organise.

 

S

[Albert Tatlock]

I suppose one way of solving it would be to set up an effectively nationalised insurance company here, perhaps ran by the Dept of Health (or contracted to a local company for a fixed annual admin fee), that dealt solely with health claims to and from the UK.

 

If the difference in operating costs (excuse the pun) is around £2 to £4m the money has to come from somewhere and £4million for a working population of 40,000 is e.g. £2 a week on NI. Then you've got the running costs to consider: flights/ambulance/staff; though I would guestimate that surely those costs wouldn't be more than £500 - £700K a year - as I'm sure it would only be a relatively handful of people that would get stuck over there each year under the new 'lack of' agreement? Obviously the total costs depend on the whole cost model which I haven't seen, and which I understand they are still debating.

 

That would be a fair scheme to me, as £2 a week isn't that much for those working (that element of the NI contribution could even be easily linked to salary to make it much fairer) i.e. earn minimum wage pay £1 a week, earn £50K pay a bit more etc.

 

That way everyone on the island could still be covered, whatever their age and whatever the risk, and Joe Public would effectively have a 'transparent system'. Visitors too could be covered, perhaps by a one off payment a year from the DTL so that they can state one of their perks for attracting people here is that we pay for your insurance.

 

A lot of people are going to be confused otherwise, and if they don't keep travel to and from the island transparent health-wise, I expect the number of visitors from the UK to take a major drop.

[Tugger]

I think Chinahand's points are very well made. If we leave it to private insurers, it is unlikely to interest many of them (not enough to make the market competitive anyway) so people seeking insurance will be clobbered by high rates. The fact is, that when you get referred to a UK hospital for treatment from the IOM, the IOM government simply pays the relevant UK trust for your services. Cash transfer - that simple. Why couldn't the same practice be adopted for emergencies? The funding is another question, but some of it could be covered by MHKs foregoing their gold-plated pensions.

 

Edited to add: a departure charge is perhaps the best way of getting the right people to pay for the service (after the MHKs pensions of course)

[Sebrof]

I suppose one way of solving it would be to set up an effectively nationalised insurance company here, perhaps ran by the Dept of Health (or contracted to a local company for a fixed annual admin fee), that dealt solely with health claims to and from the UK.

 

If the difference in operating costs (excuse the pun) is around £2 to £4m the money has to come from somewhere and £4million for a working population of 40,000 is e.g. £2 a week on NI. Then you've got the running costs to consider: flights/ambulance/staff; though I would guestimate that surely those costs wouldn't be more than £500 - £700K a year - as I'm sure it would only be a relatively handful of people that would get stuck over there each year under the new 'lack of' agreement? Obviously the total costs depend on the whole cost model which I haven't seen, and which I understand they are still debating.

 

That would be a fair scheme to me, as £2 a week isn't that much for those working (that element of the NI contribution could even be easily linked to salary to make it much fairer) i.e. earn minimum wage pay £1 a week, earn £50K pay a bit more etc.

 

That way everyone on the island could still be covered, whatever their age and whatever the risk, and Joe Public would effectively have a 'transparent system'. Visitors too could be covered, perhaps by a one off payment a year from the DTL so that they can state one of their perks for attracting people here is that we pay for your insurance.

 

A lot of people are going to be confused otherwise, and if they don't keep travel to and from the island transparent health-wise, I expect the number of visitors from the UK to take a major drop.

 

Unless the IOM is being subsidised by the present arrangements (which is quite possible), then there is no reason for any overall increase in costs.

 

S

[Grandma]

If I am retired on a basic IOM OAP pension, do not own my own house and have no travel insurance and I fall ill whilst visiting the UK and need in-patient care, who pays? Would the UK health system refuse to treat me after an A & E visit and throw me back out onto the street to die in the gutter?

[Albert Tatlock]

If I am retired on a basic IOM OAP pension, do not own my own house and have no travel insurance and I fall ill whilst visiting the UK and need in-patient care, who pays? Would the UK health system refuse to treat me after an A & E visit and throw me back out onto the street to die in the gutter?

You pay - after A&E. You'd still get a bill, whether they can get it off you is a wholly different matter, but I would imagine with no agreement it would involve a court chase.

[Tugger]

The most economical way to deal with you under the proposed new arrangements (assuming no deal gets struck) would be to get you back as soon as possible so that you are in Nobles, where you are covered for free. That said, I can see situations where people will be difficult to move, even the short distance over the water.

[ballaughbiker]

Well our brave itchy scalp sufferer had another call from the insurers this morning. (No, it's not me btw......). Following Utah's assertion that none of this should have been declared and it was a big waste of both parties time, it was asked if perhaps the traveller had been too honest. "Not at all" came the reply. If you are waiting for a hospital consultation or had one in the last three months for ANYTHING, we need to know, even if it's an ingrowing toenail! (Quite a remarkable coincidence to use that example after Utah's post). When asked what would happen if this ingrowing toenail consultation wasn't declared, the answer was any claim could be refused.

 

Soooo, after another dozen questions the happy traveller got this email within minutes:

 

 

 

We regret to advise you that for the Annual Multi-Trip Policy shown above, we are unable to provide

cover for claims arising from the declared condition(s). This will also mean that other people will be

unable to claim under this insurance where the claim is as a result of your declared condition(s).

This insurance will still provide cover for other illnesses or injuries which are unrelated to the declared

condition(s).

If you choose to accept these terms and have purchased the relevant policy, we must warn you that

without this cover, you may incur cancellation charges and large medical bills which you may need to pay

immediately if no other insurance has been arranged. You should be aware that overseas medical fees

and repatriation costs to the United Kingdom can be significant and may have serious financial

implications for you. You may find that an alternative insurance which provides cover for the declared

medical condition(s) is more suitable for your needs.

If you wish to accept this insurance, this must be on the understanding that the above condition(s) will

not be covered and that you will meet the cost of any claims which occur from the condition(s). We

enclose a copy of the questionnaire to be retained with your insurance policy and this letter; please check

your answers carefully and notify us immediately of any necessary amendments.

Our decision to exclude the condition(s), on this occasion, does not mean that we will be unable to

consider offering you cover in the future, at renewal or under a single trip insurance.

If there is a change in your circumstances during the period of insurance, we may be able to reconsider

offering you cover and you should contact the xxxxx Health Line if this applies.

 

This restriction lasts ONE YEAR

 

 

Remember unless something is sorted, this could be you after next April, even if you just want to go shopping for the day across. Brave new world innit?

[Tugger]

To be fair though, I'd probably take the chance on being able to get back to the island with an itchy scalp.

[Sebrof]

To be fair though, I'd probably take the chance on being able to get back to the island with an itchy scalp.

 

Quite so. I think I'd risk an ingrowing toenail, too.

 

There is nothing new here. You have always had to declare existing conditions for medical insurance, and that's fair enough.

 

What IS a problem, is that people may in future be refused insurance because of existing conditions, whereas now they are covered automatically. This is what is going to make some people prisoners.

 

S

[ballaughbiker]

Exactly. I hope everyone realises that a very trivial complaint has been used in these examples (rather than say, a heart attack victim or a poorly controlled diabetic etc) to illustrate just how rigidly these call centre automatons think. More importantly though, it has proved that the non-disclosure of trivial complaints could cost you your house (when your claim is refused) if you have a bad accident across after next April. The trivial complaint is still trivial but is now effectively costing you a fortune. Nowt funny in that......

 

At the risk of repeating an important point, if you are young, fit and well without previous claims, this change in policy is manageable. If not, you will be at the complete mercy of some faceless suit in an office across. If they decide "no" you are going to be a prisoner here unless you are willing to take a very big risk indeed!