In response to my recent blog about “gap” invoices being increasingly used to mitigate fee reduction(s) imposed on consultant surgeons, many emailed me and disagreed.
It is of no surprise the vast majority who disagreed work for insurance companies.
Some were quite vocal in the dislike of “gap” invoices.
They were of the opinion cost extraction was the ONLY way to reduce the cost of premiums.
That alone would make private health insurance more attractive.
Faced with a smaller number of potential or existing policyholders, insurance companies have sought to make the offering more attractive by making it cheaper.
But is cost extraction really the only way to make private medical insurance more attractive?
The implication of such a view, confirms the belief that price is the single factor when a patient takes out insurance.
GAP invoices, being diametrically opposed to that aim, should be resisted.
However, are patients really that fixated by cost?
Or are there other factors they consider?
Some patients are happy to pay Gap invoices. That suggests the cost is not the only factor.
Some are completely unaware of the fee reductions being imposed on their consultant.
So are they really that concerned with the cost?
To a certain extent of course they are.
All patients looking for a package with a private hospital, for example, will be price conscious.
However, that may not be the overriding factor.
Whilst they will certainly be looking for a value for money, it is more likely the perceived value of the package is more of a driver than just the cost.
Deeply involved in the perceived value is the reason the patient wants to be seen privately in the first place.
The prime reason a patient takes out private insurance is that they wish to be seen as quickly as possible, as conveniently as possible and by the consultant they want.
Yet insurance companies seem almost fixated with taking cost out of the private insurance market.
Seldom do they seem to be interested in what else the patient is seeking?
Seldom do they emphasize that a patient with medical insurance can be seen quicker and more conveniently.
Private health care is deemed to be expensive.
Whether it is or not is actually secondary.
What is more relevant is the perception it is.
So the insurance companies react by trying to take cost out. They begin a race to the lowest fee or to the bottom if you will. In doing so they sometimes shifting the emphasis away what the patient really wants.
To be seen not only at a reasonable cost but as quickly and conveniently as possible.
Keep reducing fees and sooner or later the fees will be so low the private consultant can no longer make a reasonable return.
Add in the fact there are fewer people who have private medical insurance now than at any time since the early 90s – and consistently reducing costs in search of a smaller pool of potential patients creates almost a perfect storm.
All of my clients have substantial NHS obligations which, incidentally, they perform to exactly the same skill level as their private work.
They are hard-wired to perform both in the best possible way.
So why does an NHS patient ask an MHM client if the consultant can see them privately?
By no means does that suggest a patient will pay any price to see their consultant of choice.
They want to see their consultant of choice and the most convenient time to themselves.
They do not, for whatsoever reason, want to wait
So why is it that insurance companies concentrate so much on taking cost out of the private healthcare offering, whilst almost failing to point out that private medical insurance offers rapid convenient access to a high level of facilities and a choice of whom the patient may see.
Doesn’t the existence and acceptance of GAP invoices, actually suggest that patients are prepared to pay more and not less to see a consultant as soon as they possibly can and where they wish?