Following the release of his book Beat the Booze, which looks into alcohol addiction, Edmund Tirbutt provides a few sobering thoughts for the insurance community.
Like most protection journalists, I have become more than a little weary of being preached to about the wonders of 'integrated healthcare'. The term, like the equally tedious 'managed care' that preceded it, has become massively overused and largely meaningless.
Employee assistance programmes (EAPs) and occupational health services, which are two of the main ingredients that get thrown into most conversations about integrated healthcare, have therefore inevitably suffered damage by association. Although I have diligently bashed out countless quotes from providers enthusing about the merits of both, my gut feeling has always been that I was assisting with the reproduction of a great deal of hot air.
However, while researching Beat the Booze, which I co-wrote with my wife Helen, I have undergone a dramatic transformation from sceptic to supporter. I was, for a change, hearing from independent experts who had no vested interest in talking up either EAPs or occupational health services and, instead of receiving the barrage of ridicule and condemnation, I received a definite series of thumbs ups.
EAPs, which originated as a way of combating alcohol and drug abuse in the US, were promoted as a way of helping employees explore the underlying issues behind their drink problems. Stress guru Cary Cooper, who is professor of occupational psychology and health at Lancaster University Management School, was the only one to volunteer anything approaching lukewarm. While acknowledging that referring employees to EAPs may help them move closer to the source of the problem, he warned that they do not necessarily deal with underlying structural problems in an organisation or its culture.
Referral to an occupational health service, both in-house and outsourced, is universally considered the most effective solution when a drink problem has progressed to the stage of becoming an absenteeism issue. The fact that occupational health specialists are non-judgemental means that an employee will be more likely to feel comfortable talking to them about a problem, instead of a colleague.
When touching on individual insurance issues, however, the results of my research left me with decidedly more mixed feelings. As an insurance journalist, I have always supported an insurer's right to turn down claims when there has been deliberate and relevant non-disclosure. However, I found myself furnishing my readers with details of how to keep their drink problems off their medical records. For example, private rehabilitation therapists are able to phrase requests to GPs for medical histories in a way that gives nothing away.
There is clearly a fine ethical line to be trodden here but, having overcome a serious drink problem myself 21 years ago, my only regret is that I allowed details of it to find their way onto my medical records. A 'history of alcohol abuse', combined with some extremely unremarkable visits to those in the medical profession, were considered sufficient grounds for a protection insurer to decline my request of a menu-type policy in 1995.
My GP, who unsuccessfully appealed against the decision, was furious, and volunteered that because I had been teetotal for eight years I was probably more deserving of a discounted premium. My personal gripe is that I never needed medical help to overcome my drink problem, but was penalised simply because I chose to volunteer this aspect of my past to a man in a white coat.
Revealing the past
Having to declare that you have been declined for an insurance policy can be extremely awkward, and I have considerable sympathy with those who would prefer not to reveal past drink problems to insurers if they never required medical help to recover.
Former problem drinkers who no longer touch a drop tend to pay far more attention to diet and exercise than the average drinker, and are far less prone to a whole host of long-term health hazards. I long for the day when they will be viewed as better than average health insurance risks, as opposed to subjects of suspicion. n
Edmund Tirbutt is a freelance journalist and author of Beat the Booze
