Mentioning the unmentionable – medical insurance

‘The last time, I felt this way was when I wrote about private pensions.’

The last time, I felt this way was when I wrote about private pensions. Not on my radar. Not in my economic vocabulary. Not, in this case, in my political vocabulary. I am a supporter of the NHS, the idea that health care is free and available equally at the point of delivery. At surgeries, at hospitals.

I stay away from NHS doctors and surgeries, never mind private ones. I’m from Yorkshire originally and I can feel my granddad’s dismissal of malady and all the hubbub around it in my air space. He was a man who did wear a flat cap and say it like it is. He had an allotment, working in a printing roller factory and smoked a pipe. He wasn’t ill for long and died in his bed at home from lung cancer at 78.

But now I am 73 myself. And although – like so many of us – I am for increased spending on the NHS to bring it back to its own fine health again so that operations would be readily available. But the reality is, they are not. And for all my fine politics of denial, there is a reality around pain that I have observed in my partner who lives in North Wales.

Two years ago, his hip joint was reduced to bone on bone. He could hardly leave the house in terms of mobility and he’s a climber. He was in lots of pain. He’s a retired GP and wanted to support and wait for the NHS initially. However, when he asked his GP he found out that the operation would more than likely be in two years’ time. He couldn’t wait that long. He was 81. He dipped into his savings instead. £12,000 and he had his new hip in two months.

Because Lateral – a company that specialise in affordable medical insurance – are sponsoring Advantages of Age’s first conference, Rebel Later Life: the ideas party on Oct 10^th, I put a question into our FB group asking whether our members would be interested in medical insurance. In other words, what would make them take out health care?

And the number response was affordability. These are three typical answers from women in their 60s.

‘Speed of treatment; severity of the condition, and it needs to be affordable.’

‘Being desperately ill and being able to afford it.’

‘If it meant I was able to access a particular treatment not offered on NHS.’

A few people already had medical insurance and this is what one man in his late 60s said.

‘It’s our biggest single monthly expense. Access and quality time with medical professionals are the first benefits. Second, we get treatment for accidents and other major needs. The NHS has let us down in all these areas, and there’s no fix on the horizon. Looking at our total life costs recently, I realised that health and wellbeing is by far and away our biggest expenditure area - everything from gym membership to private healthcare. I guess that’s better than spending it on drink and debauchery.’

And choice was mentioned. Like this woman in her 50s who already has medical insurance.

‘Choice. I’m with a company that pays for some acupuncture, homeopathy, physiotherapy, osteopathy, podiatry, and optical and dentistry. I have to manage it carefully so that I do use it and it doesn’t cover all my needs, but it is a bit that helps.’

Other members of AofA are clubbing together as families to create enough money for a private operation.

‘We are using pension savings so a close family member can have appropriate treatment for endometriosis. She will be getting surgery in a fraction of the time it would take just to get a first NHS consultant appointment with another couple of years wait for her operation after that. The condition is affecting her physical and emotional health and endangering her employment. It’s not cheap, and we recognise we are privileged to find the resources to pay, but to us, it’s money well-spent.’

Cancellation of NHS operations is another issue that is affecting our members. Particularly this woman in her early 70s.

‘I know people who have geared themselves up for major operations and been cancelled three or four times. So if I could afford it, I would pay privately just to be able to pick a date that fitted into my life (being out of the country four to five months a year) and that could be relied on.’

Although there were some members who declared they absolutely would never use medical insurance or private health care, I got the impression that those members had never been put in a position where treatment was crucial because of the severe pain.

And I admit I would have been one of the former, however watching my partner in pain, made me realise that I am pragmatic around this issue. The NHS doesn’t seem like it will be entirely able to bear the brunt of all the procedures needed in the near future, and therefore the ageing population are all facing having to pay because it’s the only way…whether through savings or through funding initiatives like gofundme.

Laura Ashforth, co-founder of Lateral, a specialist 60+ health insurer, says: “I think the reality for many people is becoming much less binary than NHS versus private healthcare. People want to continue supporting and using the NHS, but they also want the reassurance of having another option when waiting for treatment could stop them living the life they want to lead. That’s particularly true for active people in their 60s and beyond who have no intention of stopping.
“We built Lateral around that idea. Rather than trying to replace the NHS or insure absolutely everything, we provide more affordable health cover designed to sit alongside it, giving people private access for many of the procedures and diagnostics they are more likely to need as they get older. We also include an annual health assessment because we think insurance should be about helping people stay healthy and independent for longer, not just paying out once something has gone wrong.”

Case History – ‘A miracle happened. Within 30 hours, she had the money.’

Ann (not her real name) is in her late 60s. She had a chronic pain issue over a 12 year period where she was sent from pillar to post within the NHS. ‘My pain was escalating and my mental health was deteriorating,’ she says, ‘I saw someone different at the hospital every time and no-one was really seeing me or reading all my notes. I have a brilliant GP but she was often not informed enough. I had MRI scans and x rays but nothing conclusive was happening. And I was on increasing amounts of pain medication and sleeping medication.’

Eventually she developed a more strategic approach. ‘After steroid injections that did nothing, I eventually found the right surgeon and told him that I was dealing with no-one else but him. It worked, we had a date for surgery booked’.

And then it happened. The cancellation. Just before Covid. There was not enough equipment so the operation was cancelled. ‘I lost it,’ she says, ‘I had booked in pet care, made arrangements around work, had a friend staying.’ She went to bed that night and realised in the morning that she had to ask for help. This was huge. She didn’t have savings of this amount.

‘I had researched this operation privately with the same surgeon. I knew it was about £30,000. I put out the word on FB. I felt incredibly vulnerable and exposed,’ she says.

A miracle happened. Within 30 hours, she had the money. People she didn’t know shared and gave. She had originally had the operation booked in for the Thursday, by the Tuesday, she was in the same surgeon’s Harley Street practice and being operated on.

I’d like to say there is a happy ending to this story but despite the operation – she was pretty good for a couple of years – she is still in pain.

Would she have gone for affordable medical insurance if she could have?

‘Yes, if it had been affordable and I know what I now know, I would have gone for medical insurance. I do have concerns about social equality but in the end, the pain would have won out. I would have felt safer.’