Please introduce yourself and background in the international private medical insurance industry?
I was an ACII and for many years worked for brokers and insurers in the London insurance market in a range of roles. These included negotiating national schemes and policy wordings, market research, product development, product comparisons and marketing/advertising. And I was a co-founder of the General Insurance Market Research Association.
In the last - cough - years I have made a living by writing and researching about insurance, financial products, global healthcare and medical tourism for a wide range of magazines and websites. This includes various activities for the Chartered Insurance Institute and editing parts of Kluwer's Handbook of Insurance.
Books include ones on international directors and officers liability, and on competitor analysis in financial services. I have also published 200 plus research reports on insurance, health, medical tourism and finance. Until recently I actually forgot that I had written the first ever study of international health and health insurance for a publisher now long gone. The 2016 IPMI report is the sixth one in over a decade- and at 1500 pages the biggest ever.
In your most recent report, International And Expatriate Healthcare And Insurance 2016, you layout how IPMI, healthcare and health insurance works in over 150 countries. Why do 1- insurers; 2- corporations; 3 - brokers; 4 - international hospitals; 5 - assistance providers; 6 - ground and air ambulance providers, need this information?
Keeping up with what is happening on healthcare, insurance, legislation, expats insurers and brokers- takes me a couple of hours a day at least. By speed reading and knowing what I need to find and how to find things, it is manageable. So if you have to do your normal job and then keep up with all that too it is impossible and easy to miss trends, new competitors, new product and marketing ideas and all the techie stuff too.
244 Million People live away from their country of birth. There will be 60 million expatriates by 2020. What does this mean for payors and providers in the business?
It used to be easy- you had locals, refugees, and expats. Some workers are now global rather than temporary expats- and then you have economic and social and political migrants. When does an expat become a migrant? Many countries now refer to citizens and non citizens- and have rules on who gets what on healthcare. So referring to expats as a specialist class is out of date and not how laws and rules are made. In a global business world, with increased rules on who they can and cannot employ- it is hard for insurers to offer cover A to expats and cover B or no cover to locals. For each country you have to understand the rules on healthcare, health insurance, local cover, and even price and cover regulation-before you even try to offer a policy. There are far more risks on offering offshore covers than five years ago - and sadly, some insurers and brokers still offer a " one size fits all" cover that may neither be legal nor appropriate.
Risk is changing. Does insurance require reinvention in 2016 to mitigate new risks that pose major threats to global travellers and expats?
The number of insurers rushing to add health information and help on relocation has been overtaken by those offering help and information on terrorism, political risk and other non-medical help. What concerns me is that some just offer advice, which to my mind is useless unless you have a way to evacuate or protect people who suddenly become at risk.
How can we educate the entire IPMI industry about global trends and what do payors and providers need to get their head around?
As well as all the factors I mentioned before, you need to keep up to date with the way technology and social media is changing how insurers, intermediaries, customers and healthcare providers work and interact. There are mind blowing changes happening and those that do not keep up will vanish. For insurers and brokers there are companies from Asia, China, Africa, The Middle East and Latin America who want a multi country presence on health insurance- and some of these are so new that they look at new ways to design products and link technology with health. Stand still and you risk being trampled.
Insurers are rebranding as global health services companies. Insurance is a given. What opportunities exist?
With PMI, IPMI, health cash, major medical, micro health and other variations there is a health policy for everyone. But many insurers are stuck with just offering one or two of these. Some new insurers have combined categories or change how it is done. It is easy to get into a UK, US or European mind set of what a health insurance product is and ignore how technology can be used to simplify the historic practices.
How can we define IPMI in 2016?
Health insurance with an increasing raft of add-ons, extra services, options and non-insurance extras ranging from cheap cinema tickets to a risk profile of the country you may move to next. This is in danger of being a car that has been retuned, added to and with so many functions that the focus is lost. Car dealers reckon that motorists use, or even know about, only a fraction of the features in their car- and health insurance is going that way.
How will we define IPMI in 2021?
Those thinking ahead see that it is no longer about having insurance and tacking everything else on to it like some mad scientist- but in offering health and lifestyle assistance and protection to individuals and companies- where insurance is just a back stop when everything else fails. It is bringing wellness, health (in mind and body) and humanity to the forefront and hanging on services of which insurance is just a part. But at the other extreme you have micro health cover with low price, simple cover, little or no choice or extras, direct billing and all done by social media in the cloud so hardly any admin. You could have virtual insurers with no offices- and before dismissing this as barmy, publishers of web magazines are closing their offices and just have a handful of people working remotely.
What more can be done to assist the under insured and those on low incomes access decent healthcare globally?
Micro health insurance targeting people who would not normally buy health insurance is a huge growth market in Africa and Asia - where major insurers see that if they can make money on low price products they can use that technology and methodology to simplify how they handle PMI and IPMI. One country has 34 people with micro insurance including micro health and expects that to be 50 million by 2020.
What reports are you working on next?
My annual Medical Tourism Facts and Figures one is being updated- but that has become a settled market.
After that I am doing a brand new one on micro insurance - with a focus on micro health. That is something I have followed for years but only recently have major insurers taken it seriously.
And then - some time off; with the next one and area that insurers are struggling with- peer-to-peer insurance. I have done reports on peer to peer lending but how p to p insurance works and why it is different from traditional mutuals is something to get my head round.
What annoys you?
As well as lying politicians, celebrities who are famous for nothing, techies of driverless cars that think lorries and buses will give way to cars at junctions- and the way my football team is playing - boiler plate research reports which confuse PMI and IPMI, mix both in with accident and critical illness, mix it with life insurance and income protection cover- and most recently, thinking medical cover under travel insurance is part of health insurance and not part of travel insurance. Other pet hates are press releases with" we are delighted to" or " we are announcing the launch" or " really unique" or " X will help us take the company to the next level' or" Z has been specially designed to cater for".
What enthuses you?
Insurers and brokers used to be grey men in grey suits with grey minds, with a few girls there for show. It is now far more equal and with many bright people using technology and ideas that perhaps those running the companies do not really get. If it can bring in more scientists, engineers, social thinkers and not just those with a financial background or are happy to follow orders-then it can thrive. It needs disrupters, people who annoy bosses by challenging how anything is done, and those who can look at health insurance upside down and insight out.
iPMI Magazine Speaks With Ian Youngman About International Private Medical Insurance (IPMI)