to think private healthcare is a con?

[ChocolateBiscuitCake]

DH has private health cover for our family through work. It is a very comprehensive scheme and we have claimed for a few things over the years and never really thought much of it.

DH starts a new job next month which does not have a healthcare policy so I have been shopping around today to find a policy for my family.

But the more I speak to insurers, the more I am starting to think that the whole thing is a complete con when you are no longer under a company scheme?

The general gist of getting new cover is:

• We are no longer covered for pre-existing conditions (DS's reflux, my PCOS and monitoring of moles)
• If we make any claims, we lose a no claims bonus so the cost each year will increase if we make claims (previously, the cost may have gone up but DH's ex-employers covered the cost).
• Bupa, for example, will only pay 'up to' a certain amount to see certain consultants. They essentially cover for adequate doctors and may not cover the 'top' consultants so we would have to pay anyway
• No pregnancy related cover (have ongoing SPD post pregnancy and have an abdominal hernia that will need attention once I am certain we are having no more children!)

They want to charge £3-4k for our family of five for a year.

AIBU to think that we are unlikely to spend that much even if we pay to see specialists directly? Other than the absence of a private room and TV (!!), surely the NHS cover if one of the children got really sick suddenly?

I am so confused - it all just seems a bit of a con. Or am I missing something? What is the real benefit of Private Health Cover (when not through a company policy?)

My dh has has an operation recently, I sadly no longer agree that the NHS is as good as private. He had had exactly the same operation done on the NHS too, so we were in a good position to compare. It's probably very simelar for some things, but it wasn't in our experience. The biggest thing that made a difference were the waiting times. We would have waited 8 months on the NHS. We are not well off, but it was worth the money just to save months of stress waiting, and who knows what damage could have been done in that time anyway.

OP, in your position I would just save the money and self pay if you ever decide you want or need to use private healthcare. The NHS can be brilliant, but so much of it depends on the reason you need medical care in the first place. For some things, the NHS is dire.

£3-4k sounds expensive until you think about what health care actually costs to provide. This amount in cash may just cover two nights in intensive care.

This is why the NHS is such a gift, yes we pay through our taxes but the maxim "From each according to his ability, to each according to his need" is a wonderful example of how this health care system works.

We all pay in to it, the wealthy pay more and history tells us are also less likely to get ill however we can access as much care as is required regardless of whether we have paid loads or little.

In some cases, if you have paid privately for any aspect of your treatment then you can't have NHS treatment. Ann Marie Rogers v Swindon Primary Care Trust is good for a google. It goes against the founding principles of the NHS which is the ethical theory of egalitarianism. You shouldn;t have priority just because you can pay. Whether this is right or wrong is a huge ethical debate!!

but Grimma, am I right in thinking that your DH's cover is being paid for under a company scheme? Because when a company pays for it, it is great! But when you pay independently, like I am looking into, your policy cost will increase annually if you claim on it. So suddenly you are incentivised not to claim, which is ridiculous.

Having worked in a private hospital, I'm NHS all the way.

You're paying to see someone quicker in a better decorated room and that's it.

Things like paediatric cancer care don't really exist in the private sector, NHS children's hospitals are at the cutting edge there.

I have always thought of private health cover as 'you would be mad not to have it', like motor or travel insurance. Unless anyone can persuade me otherwise, it is an employment benefit/perk of the job, but when self-financing, far from essential?!

My Dh has quite a rare form of cancer and the Nhs have been incredible. All the drugs and treatment he has needed have been provided, quickly and efficiently. He's had access to top surgeons specialising in this illness, and I just don't think the private health care could have come close to providing what Dh has had. In fact he'd have probably been referred back to the Nhs anyway. Same with my mum, as soon as she was diagnosed with breast cancer the care she has been provided with has been fantastic. Can't fault them on the big stuff, I really can't. I think we're so lucky to have the Nhs.

Yes - if I lost my job I'd look hard for the sort of 'continuing' policy which someone mentioned and keep it for his op (and more consulations if necessary on his other serious issue). But that's a sort of cheat of the way insurance works , we know he's got issues which the NHS isn't great at dealing with. I've got PCOS and have had moles removed, certainly wouldn't bother paying for insurance for that sort of thing.

But private hospitals don't tell you:

The surgeon is doing this in addition to his "day job", many have done a full day in an NHS theatre and then do some private work.

The surgeon may not have the same level of assistance he would have in an NHS hospital, no other consultants around to help if the surgery gets tricky, sometimes not even a registrar.

The same goes for the anaesthetist. If they're having a tricky intubation, patient poorly in recovery, they're on their own.

Many private hospitals have no where near the emergency/resus cover. Some only have 1 junior doctor on site at night. All NHS hospitals have anaesthetists 24/7 and a resus team. Many private hospitals will often just have to send a patient to the nearest NHS hospital if the patient takes a turn for the worst.

IMO its far from essential, especially if you can save up and are lucky enough to be in a position that you could find a few thousand in an emergency.

Grumpy, that's interesting! It would never have occurred to me that the NHS would ever refuse treatment just because someone had paid privately. I think that is very very wrong, except maybe in cases of uneccesary cosmetic surgery. Thankfully DHs private consultant is also the head of the local NHS unit, and he's more than happy for his patients to flit between the two.

Actually this is what frightens me most about private health insurance and if we went down this route in this country

I've had a pre existing condition that has been treated extensively with some more experimental treatment but because the long term outcome isn't known getting my life insurance extended is prohibitively expensive or simply not possible. I can't imagine I would ever manage to get private health insurance.

Sorry bit off topic but it got me thinking - hopefully I'm worrying about nothing!

Actually this is what frightens me most about private health insurance and if we went down this route in this country

I've had a pre existing condition that has been treated extensively with some more experimental treatment but because the long term outcome isn't known getting my life insurance extended is prohibitively expensive or simply not possible. I can't imagine I would ever manage to get private health insurance.

Sorry bit off topic but it got me thinking - hopefully I'm worrying about nothing!

Sorry no idea why that's come up twice!

I doubt you'd get it for a pre existing condition runningdownadream private health care is a bit like having a bet on with them. They bet you won't get something, you bet you will, you pay heaps of money on the bet, and they cough up the cash if they lose the bet.

The problem is noone knows what the long term effects of the drugs are - I'm on a national register which will follow my health now for the rest of my time here looking for possible side effects and links.

I am fairly sure no healthcare company would take me on given the unknown

Yes, grumpy
That is exactly what happened to my OH when he needed follow up radio therapy. Because of what went previously was private we had to carry on and cough up £ 20.000 for the treatment at the local hospital.

gothanne is also absolutely right about her observation. When private locally,
you only get the same quack - and tired as well -, after his day job.
It pisses me off if I see a consultant privately it has to at 7.30 AM or 7.30 PM.
They are moonlighting obviously.

However, if you can get a policy which would cover insurance for the top guys I would go for it. They are properly organised and will have a proper NHS/Private Schedule.

And with regard to private prescriptions, it the same as the NHS.Always make sure you do not get a generic.
These private hospitals are there to make money, not because they love you.

I found a lump in my breast got an appointment with my GP that day, she referred me to hospital got appt 4 days later had tests etc, 1 week later got breast cancer diagnoised and had full CT scan same day. 10 days later had surgery and am now having chemo. This is all on the NHS I cannot fault them at any stage.

Having lived in the USA, Asia and UAE as an expat and seen their health care. I can't believe how lucky we are in this country and now having experienced the NHS at its best I'd never waste money on private health care.

Outraged and others, no, you cannot just flit between the two! If your consultant is doing that then at some point he'd better stop! It is now really not possible for a Consultant to see you privately and then "bump" you over to his NHS list-you would have to go back to your GP and get an NHS referral and start the process all over again. This is obviously now to do with PCT's and funding, as some PCT's are now refusing to pay for certain conditions, eg ganglion removal.

Operations have to be done within the magical 18wk wait. However, one of the hospitals DH works out are ahead on many of their targets, so takes the hit for not complying with the 18wks. Another does comply and wouldn't allow a patient to breach that time without getting their op.

Cancer patients have to be seen within a 2wk timeframe.

To be guaranteed of having your consultant actually do the operation, then the only way is privately as most NHS consultants will be teaching their juniors, who have to practice...

BUPA are quite frankly shit. They are trying to case manage their clients and reduce patient choice, by forcing them to only see certain consultants who have been forced to sign an agreement whereby they will only charge the fees that BUPA say they can-and if they don't sign then they won't get any patients referred to them through BUPA! On top of that, despite BUPA putting up their fees to patients, they have now reduced fees paid to consultants by between a 25-40% margin! BUPA are also removing some conditions/treatments from policies, such as steroid injections as they say they are non-curative, and they will only pay for cure, not easing of symptoms!

I think if it's going to cost 3k and your previous conditions/operations needed will be covered, then I'd put the money in an account each month to access when needed.

Also there is the Choose & Book scheme for patient choice, with many consultants running NHS clinics in a private hospital but with a smaller wait.

Am going to stop now, am wittering enough! :o

Health care costs soo much. I moved from the UK to the USA 7 years ago and the thing I miss most (apart from my family) is the calmness and confidence of knowing that the NHS is there for us.

DH and I both get medical insurance through our work (big dis-incentive to change jobs or risk going freelance or starting up own company there!). Mine pays 80% of my medical stuff. I'm pregnant with our second child and the booking-in appointment (blood test, wee in a jar, chat with nice midwife) was about a month ago. I've just got the bill - $2,600. Not an ultrasound or anything like that - blood test, wee in a jar, chat with nice midwife. Because of some deals that my insurance company has with that medical group, I only have to pay about 11% of that. But it still means I have to cough up $280-300 for a booking-in appointment. I've got the 12 week scan this week and I'm petrified about how much that will cost. We've just had to spend a lot of money on repairs to the car, and suddenly this month money is extremely, extremely tight. I never worried about that kind of unexpected bill when the NHS did my care.

DS needs to see an allergist to get a skin scratch test done. He's nearly 2. I've no idea how much that will cost, either. I am considering putting it off till July, so I know that I will be able to pay for it, but hearing him cough at night is so heartbreaking.

Oh, and there's a $30 charge each time I see any kind of doctor - the GP, the allergist, my midwife, whatever. That's just an at-the-door fee, before the actual bill comes in.

God bless the NHS. It's a brilliant idea and I miss it like mad.

I love the NHS, just thinking about the treatment DS who is 2.5 has had via the NHS - for emergency care the NHS is fantastic, you can turn up at A and E and be treated no question of how you pay for it or anything else. Even if you have private healthcare that doesn't cover emergency treatment.

As well as treatment for acute problems DS also needed an operation for something unrelated. The surgeon travelled to see DS in the HDU ward he was on (at a different hopsital) because we couldn't make the initial consultation, she said ideally the operation would be done at around 18 months. At 19 months he had it done and again couldn't fault the care.

Having experienced private healthcare too, although it obviously has it place I wouldn't pay into a scheme - I would rather save the money for individual times you need to see someone as they occur,

Wow! 4k for a family for a year in a country where theres already the NHS!

I can only assume that the people who do pay that for private health care make a lot of claims and that pushes the premiums up.

Very sensitive for me this a girlfriend is still alive thanks to the bowel resection that the NHS didn't think she needed that found cancer followed by three rounds of chemo including two types of drug that the NHS would not pay for thanks to her private health care. She is beating the odds she will never be cured and rightly feels bitter that if she had had the bowel resection she asked for at 21 for her crohns disease rather than waiting till she was 36 and privately having it she would now be fighting against a 5 year survival chance of slim. She was never allowed to see a consultant at 21 to have the reasoned argument about how she understood the risks and benefits. She was told she was too young well guess what NHS she probably isn't going to get the chance to be old.
So yes I pay my private healthcare premium happily, you see a private consultant at unusual hours as they are working outside the hours they are contracted to the NHS so unlike thousands of other people who have second jobs.

I have health cover for me and my family through work. With regards to a consultant doing NHS work and then dealing with you, does not necessarily work like that. When I had an op done in the private ward of an NHS hospital, I was on the same list as other NHS patients....we were just sleeping somewhere different. The only benefit I had was that I was guaranteed a room rather than being on a ward and with a 6 mth old baby at the time, I did not want him spending a good part of the day stuck in a small place behind a curtain.

I don't really really have an opinion on it. Ive had it for 15 yrs through work free but now pay extra to cover DH and DS. DH has never used it in the 9 yrs he has paid for it and DS has used it once for an eye appt but we ended up seeing the NHS consultant who didn't actually charge us as we were in with her for about 5 mins. Follow up for DS is now annually on the NHS. Dont think CIGNA cover monitoring of conditions.

Why would a insurance cover an event that's already happened.. You can't insure a house that's burnt down or a car that's crashed ...

Company plans bulk buy so are able to purchase "MHD" cover (Medical History Disregarded) - individual plans have only the "risk" of your family claiming, which is MUCH higher that a nice big group.

That price is ridic though, I work in the industry, do an Internet search, Tesco is quite good? If they still do it.

Also, for pre existing conditions if you approach the actual under writer of the company plan Aviva? AXA PPP? BUPA? Pru Health? within 30 days of the co cover ceasing and ask for a continuation policy, even just for you, it should be possible. You get a load on the premium for it which is why I suggest just for you, and do the Internet shop for the others. Try searching Secure Health?

My company deals with specialised clients so you wouldn't fit our criteria unfortunately cos we'd only be about £1400 for you lot I reckon

I think you'll find there's a big difference between a private or company scheme. It's all to do with morbidity which is a little complex to explain here.