The future of PMI

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The evolution of health insurance is likely to continue, characterised by an increasingly international scope and scientific considerations. Ron Buchan gives his insights

LONG-TERM OUTLOOK

Longer term, trends in medicine will continue to evolve in line with scientific developments, ultimately affecting the way in which health insurance is delivered.

Currently, treatment is sought primarily in response to unexpected events such as accidents or illnesses, which could happen at any point during one’s life.

However, science is driving the study, and treatment, of genetic diseases and this will have an impact on health insurance in terms of the life stage at which medical treatment and costs are highest.

Most conditions that kill, such as cancer and diabetes, are genetically linked.

These are pre-programmed illnesses that can be understood only through DNA, the genetic structure that makes up every living organism.

To combat these types of illnesses, full genome sequencing will play a key role.

Also known as whole genome sequencing, this is the scientific process for identifying the complete data structure for DNA.

The whole genome has been sequenced successfully, which means that it is now possible to take a strand of DNA and identify patterns within the genome sequence.

There is a huge amount of study dedicated to understanding genetic structures and linking them to genetic predispositions or conditions.

This means that when a baby is born, a doctor could, with reasonable certainty, identify whether or not that baby will be prone to a specific disease later in life.

In addition, through developments in treatment via stem cell or virgin cell growth and nanotechnology, it will be possible to correct the genetic sequences that cause predispositions.

The result will be genome correction at birth. At some stage in the future, when a baby is born, their genome will be sequenced and any abnormalities will be understood and corrected immediately.

From the perspective of the health insurer, genome sequencing will have a huge impact on the costs associated with insuring a person.

Medical insurance industries will be focused on preventative rather than reactionary medicine.

Birthing costs and many of the costs related to health problems will be identified at the beginning of a child’s life rather than throughout that person’s life, while unforeseen medical events will be limited to unexpected accidents or infections.

Health insurers will move away from a model where funding for medical claim costs relates primarily to unexpected illnesses and accidents, to one where funding is partly ‘front-loaded’ (to cater for anticipated medical costs at the point of birth) while also catering for unexpected accidents and infections.

The healthcare industry will continue to evolve and face new challenges in the short, middle and long term.

The challenge for all players is to anticipate and respond to those changes, be it in healthcare financing, delivery, portability of cover or harnessing the latest scientific advances.

­Ultimately, they have to ensure the solutions implemented address the changing needs of the people they serve.  

Ron Buchan is chief executive for Allianz Worldwide Care

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