PMI faces US-style prices
without tackling sustainability

We are pushing organisations to go to whole of workforce insurance.

At that point you can have a better wellbeing discussion with them, even if it’s a 20-person organisation or a 60-person organisation.

But if we stay where we are and where the market really is as a top tier, managers-only policy which includes a bit of flexible benefit cover in there if you can afford it, we have an issue.

When we have policies which are £100 a month before they are taxed on it and that is the flex option, guess what, people are voting with their feet.

They are going in the opposite direction unless they really need it and then we have self-selection and a risk spiral in that self-selection.

In the flex market that is a major issue and is driving claims but is also destabilising the whole thing.

Is it going to work out in three to five years? I think it might blow up before then because sustainable healthcare is right, but you need the whole workforce or you need to hold the risk pool and they take it on the chin.

We have a client which is at £200 a month for a single rate, but they have got a fixed risk pool and it’s just going up and up. It was 33% incidence, it’s now 49% incidence.

And last year’s data is junk because it’s all about the last 12 months and that’s what their risk pool is going forward.

Yes they do want to do something about it wellbeing-wise. They want to increase screening, but no one wants to have a screen coming up to Christmas. They want to do it afterwards.

Medical insurance is still not that much money in a payroll. Yes, it is going up, but it’s still not as a quantum, it’s still not that much money in the UK.

If you deal with the US, they always laugh at our rates, but we’re going that way.

If we all keep driving primary care and pipeline it through to secondary care, we’re all going to get pressure in tertiary care as well, because that’s coming; 25% of the population has got diabetes, 10% of the cancers are under 50-year-olds now.

We are going to get massive pressure in the medical space, which will knock into group risk as well.