Following on last year’s survey of American health customers, the Deloitte 2010 Survey of Global Health Care Consumers from the Deloitte Center for Health Solutions looks at similarities and differences in health care behaviors, attitudes and unmet needs among consumers in the United States, Canada, France, Germany, Switzerland and the United Kingdom.
The US report is the one from last year. There is one new global report and five new reports, one for each of the other countries. Paul Keckley of the Center for Health Solutions comments, “We found that consumers across Europe, in Canada and United States shared common ground in assessing their health care. Many don’t really understand how their systems of care work.” Deloitte researchers contacted 1,000 consumers each in Germany, Switzerland, France and the United Kingdom, and 2,300 people in Canada. In the global report, one conclusion is that proximity and reputation are the most important factors in choosing hospitals. The Switzerland report is not yet available.
The Canada report says-
• 2% have traveled outside Canada for health care in the last two years.
• 23% would travel outside Canada for any treatment if they had to pay 100% of expenses.
• 17% would travel outside Canada for elective treatment if they had to pay 100% of expenses.
• 23% would travel outside Canada for necessary treatment if they had to pay 100% of expenses.
The German report says-
• 1% have traveled outside Germany for health care in the last two years.
• 10% would travel outside Germany to have a necessary medical or surgical procedure if the health insurance provider paid the cost of standard treatment.
• 3% would travel outside Germany for necessary treatment if they had to pay 100% of out of pocket expenses.
• 89% are fully insured with a health fund and 14% have private health insurance.
The France report says-
• 2 % have traveled outside France to consult a physician, take a test or receive treatment in the last two years.
• 17% would travel outside France for treatment if the public health insurance provider paid the cost.
• There is no figure for the % if private health insurance paid for treatment.
• 10% would travel outside France for necessary treatment if they had to pay 100% of out of pocket expenses.
• 86% have top-up private health insurance as well as public health insurance.
The UK report says-
• 3 % have traveled outside the UK for healthcare in the last two years.
• 24% would travel outside the UK for treatment if the NHS paid the cost.
• There is no figure for the percentage if private health insurance paid for treatment.
• There is no figure for the percentage that would travel outside the UK for necessary treatment if they had to pay 100% of out of pocket expenses.
• 35% have private health insurance as well as public health insurance. (This figure does cast some doubt on the accuracy of the sample. The true figure is around 13%.)
For European countries, the main reason that people travel from the UK, France and Germany is for dental treatment. Most of those who travel for dental treatment are happy to repeat the experience. So when 1, 2 or 3 % travel abroad in the last two years, repeat travel means that it is likely to be less than 1, 2 or 3 % a year.
Using the same questions and categories for the UK as for France and Germany causes problems, as the NHS in the UK is a public healthcare system; it is not state insurance as in other EU countries. The British do not have to pay for care and seek refunds, as the NHS is free to use.
In their global report, Deloitte correctly say that only about one in ten Brits has private health insurance, so suggesting in the UK report that one in three have private insurance seems to have escaped the eagle eye of the report writers. Much more misleading is the suggestion that one in four Brits would want the NHS to pay for care outside the UK. For the British public, they have more chance of winning a major prize on the national lottery, than getting the NHS to pay for treatment overseas! There is a double missed opportunity of not asking those with private health insurance if they would go overseas if the health insurer paid or asking how many people would go overseas if they paid 100% of the costs themselves. Minor quibbles aside, the reports show that there are major differences between Europe and the Americas on medical tourism. It suggests that Europeans may consider medical tourism if someone else pays for it, but their keenness drops dramatically if they have to pay all or some of the costs.