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Time for change in critical illness insurance – supporting prevention can save lives

By: Dr. Howard Fixler, Medical Director, Trustmark Voluntary Benefit Solutions

Dr. Fixler recently hosted a webinar through EBN on why doctors and insurers should speak the same language. View the webinar on demand or read on to learn about why it’s time for change in the critical illness insurance market.

In the first article of this series, we looked at how insurers and medical practitioners are two key elements in the care continuum yet far too often aren’t in alignment; especially when it comes to critical illness. A doctor may treat a patient in a different way than how some voluntary insurance is set up to cover the patient, leaving consumers without the financial protection they thought they had, during a much-needed time. But, the gap between the medical and insurance worlds goes far beyond that. 

The reality is that medical practitioners and insurers take fundamentally different approaches to critical Illness. Critical Illness insurance provide benefits when a person is critically ill; which can be a tremendously helpful gift to a person in a time of immense difficulty. A doctor’s goal is to prevent illness, the very thing that triggers insurance benefits. If doctors always had it their way, no one would ever need critical illness insurance, because diseases would never become that serious. Of course, this isn’t realistic and there is a need for critical illness insurance. But why not do more to bring medical practitioners and insurers into alignment?

Let’s change the numbers

Here’s an interesting number to consider: 23 percent of people report that they have foregone medical treatment due to the cost, even though they have insurance.1 How many of those people may have needed to be examined for symptoms that could be early indicators of a serious critical illness such as a heart attack, cancer or stroke? How many, if they had the financial support they needed, could have received heart medication or treated an early stage of cancer before it became more serious? 

You see and hear these numbers all the time: “Every 40 seconds someone in the United States has a stroke.”2 Insurance companies react to these numbers, but doctors try to be proactive about them. If we brought these two entities into greater alignment and provided more support for proactive treatment, how many lives might be saved? How many illnesses might we help prevent? How might we be able to change those numbers? How much money, for everyone involved, might be saved by avoiding these costly medical treatments?

A look toward the future

Fortunately, new critical illness insurance policies are beginning to support the goals of both doctors and patients. Rather than reacting to illness, these policies can offer early identification and early-stage diagnosis benefits that provide support before people become ill. It’s a huge step forward because it supports the goals of both doctors and patients: avoiding a more advanced stage of a critical illness. Yet they still offer protection for when a condition progresses. Because even better than supporting a policyholder when they have a heart attack is offering the support to help prevent that heart attack in the first place.
As the medical and insurance worlds become better aligned, the future for consumers will look significantly brighter as it relates to both their health and finances.

1 Report on the Economic Wellbeing of U.S. Households. Federal Reserve, May, 2017.
2 Impact of Stroke. American Stroke Association. 2016.

Posted on December 21, 2017 in Critical Illness Industry

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