The Price We Pay: How To Insure Against Oncology. How it works in the world and in Ukraine
Stas Ostrovsky is Madanes' Head of Business Development in Ukraine and the CIS
The coronavirus situation gave impetus to the growth of the voluntary health insurance (VHI) market in Ukraine. However, a low culture of insurance leads to the fact that people are afraid, do not know or do not understand the need for even the most basic (VHI), not to mention cancer insurance. According to a study conducted by Madanes in January 2021, more than 60% of Ukrainians expressed their readiness to insure themselves and their entire family against cancer, if possible. At the same time, 63% of respondents do not know that cancer and other critical illnesses are exceptions to the standard VHI insurance packages.
International practice shows that the development of the medical insurance market for critical diseases is driven by compulsory health insurance (CHI), the implementation of which significantly increases the awareness and public responsibility in these matters.
In terms of numbers, the global critical illness insurance market will show an average annual growth rate (AAGR) of more than 15% by 2025, reaching almost $68 million, compared to $25 million in 2018. And what is important, the oncological segment accounts for more than 57% of this volume.
Ukraine also will not stand aside from these trends, if compulsory health insurance (CHI) is soon implemented in the country.
How does it work abroad?
In countries that have had compulsory health insurance for a long time, for example, Israel and the United Kingdom, the culture of insurance against critical illnesses is at a very high level. Every year the state allocates most of the budget for affordable medicine for citizens. According to the WHO, in Israel in 2017 the figure was 7.4% of GDP, in Germany — 11.2%, and in the United States — as much as 17.1%. Over time, these citizens get older, start to get sick more, the amount for treatment increases, and as a result, the allocated budget becomes insufficient. And people get used to a certain level and, choosing quality, decide on private medicine.
The cost of insurance against cancer in the UK, for example, starts from £2 to £3.5 per month (UAH 80-135) per 18-year-old non-smoker insured (prices increase with age). This cost is quite commensurate with the Ukrainian realities. However, taking into account age factors, existing diseases and bad habits, the cost of insurance is growing rapidly and can be up to £100 a month (about UAH 3800). And the British are ready to pay for it.
A more complex example is the United States. There is no compulsory health insurance system. As they say, Heaven helps those who help themselves. At the same time, the cost of medical services in America is very high, in particular, due to the huge number of lawsuits against specialists because of malpractice. The cost of medical services is also influenced by expensive liability insurance for medical workers. As a result, private medicine is too expensive, while public medicine is not ready to help in the absence of insurance. That is, the Americans simply have no choice. If a person does not have an insurance policy, in fact they do not have access to full-fledged treatment.
In Far Eastern countries such as China, rapid advances in medicine have not affected government support in any way. There is state health insurance there, but it is not available to everyone. The high cost of medicine and the lack of sufficient funds for high-quality treatment among the majority of the population increases the demand for health insurance.
At the same time, insurance is an integral part of the people’s everyday life. Regardless of the format, the population of the above countries has an understanding of the market and its specifics, and this directly affects the awareness of the importance of life insurance and the inclusion of such options as "onco", "cardio" and "neuro" in it.
What are the predictions?
The number of cancer patients is increasing every year, largely due to the fact that this disease began to be detected at very early stages. And here the indicator of "five-year survival" is important, which has grown significantly in recent years for this very reason.
It is also important that the incidence of cancer is not always correlated with the overall mortality rate in specific countries. In some regions, more resources are available to treat cancer patients and improve their chances of survival. For example, Europe and North America have lower cancer deaths compared to the total number of cases, while Asia and Africa have a higher number of deaths. Ukraine, as we see, is not yet a leader in the fight against oncology.
One of the factors affecting survival is the practice of regular check-ups, which are also common in countries with developed compulsory health insurance or voluntary health insurance. This is not typical for Ukraine yet. Although we have already accustomed part of the population to regular examinations by gynecologists and breast physicians, unfortunately, we cannot count large-scale involvement. Not to mention other types of check-ups and diagnostics.
What does oncology insurance give?
More than 19 million people around the world are diagnosed with oncology every year, and about 160,000 of them are Ukrainians.
Critical illnesses treatment today can range from UAH 100,000 to several million. In addition, it is not easy for a sick person to independently find a specialist in a particular field, despite the availability of clinics and doctors. If there is an appropriate insurance policy, the decision on finding a clinic and paying for treatment falls not on the patient's shoulders, but entirely on the insurance company.
Unlike VHI, cancer insurance plans do not reimburse treatment, but are fully organized and paid for, depending on the budget covered. The specialists of the insurance company accompany the patient in the hospital, explain to them every step, help them to make decisions, even in the case of treatment abroad.
Ukraine is gradually approaching a civilized health insurance market in this field, but so far this is happening slowly. The price of such insurance in Ukraine varies from UAH 300 (for children) to UAH 14,000 per year (and sometimes more), depending on the coverage, age and limits of the insured amount.
The good news is that cancer diseases are becoming more and more curable, however, only on condition of timely detection and provision of quality medical care.
At the same time, the success of the treatment of critical diseases directly depends on the timely (early) diagnosis.