The Association of Medical insurance Intermediaries, or AMII, announces that it fully endorses the Office of Fair Trading’s bid for greater transparency and competition for consumers of private healthcare.
AMII Chairman, Andrew Tripp said, “We want to see greater transparency around benefit fee limits for consultants and anaesthetists. In the UK access to transparent and competitive markets should be fundamental rights for consumers seeking private healthcare and as an Association we welcome the OFT’s decision to refer to the Competition Commission. This is extremely important, especially now, when greater pressures are being put on NHS spending raising the important role the private healthcare market has to play.”
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 (PMI) policyholder 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 PMI policyholder must use specific consultants/hospitals, which may be more restrictive than the general hospital list that the PMI policyholder has bought into.
In the latter case (“treatment networks”), the criteria that these insurers are using to determine which providers are included on the “treatment network” should be clear to private healthcare providers, medical professionals and consumers.
In addition, when an insurer introduces a “treatment network” for specific medical conditions, AMII would like to see existing policyholders given the choice to “opt out” of the network (albeit, at a higher premium). And insurers should share with intermediaries and policyholders the quality data they are using to establish these “treatment networks”.
Tripp concluded “These are really important issues which need addressing for the benefit of the consumer.”
Source : AMII
