Chapter 1 UK Healthcare insurance market

Question 1

Which report recommended the set up of the NHS?

Answer 1

Beveridge

Question 2

In what year did the NHS come into be

Answer 2

1948

Question 3

Are GPS self employed?

Answer 3

Yes

Question 4

When is healthcare free under the NHS?

Answer 4

At point of use

Question 5

How is the NHS funded?

Answer 5

General taxation

Question 6

Identify three areas where patients are now charged

Answer 6

Glasses
Dental
Prescription

Question 7

Identify three reasons why NHS costs increase faster than inflation

Answer 7

Ageing society
Medical developments
Cost of drugs

Question 8

How many employees does the NHS have?

Answer 8

1.7m (1.3m in England)

Question 9

How much did the NHS cost in 2021/22

Answer 9

159BN

Question 10

Which body provides strategic leadership to the NHS?

Answer 10

Department of Health and SocialCare

Question 11

Which independent body is responsible for health in England

Answer 11

NHS England

Question 12

Who commissions services from hospitals and private providers on behalf of patients

Answer 12

GP led Clinical commissioning groups

Question 13

Which body is responsible for national leadership to promote public health in England

Answer 13

Public Health England

Question 14

Which body recommend the treatments that the NHS should and should not provide

Answer 14

National Institute for Health Care and Excellence (NICE)

Question 15

Which act set up GP led clinical commissioning service groups and eliminated primary care trusts

Answer 15

Health and Social Care Act 2012

Question 16

What is the median waiting time for hospital admissions

Answer 16

11.6 weeks

Question 17

Which insurer dominated private health insurance?

Answer 17

BUPA

Question 18

Which form of private health funding is not an insurance policy and is managed by trustees

Answer 18

Health trust

Question 19

Are contributions to health trusts subject to IPT

Answer 19

No

Question 20

Are benefits under a health trust guaranteed?

Answer 20

No

Question 21

What insurance may be arranged to limit an employer’s liability under a health trust

Answer 21

Stop loss

Question 22

If an employer promises to pay employees private health costs but does not purchase insurance this is called

Answer 22

Self funding

Question 23

Why is self funding rarely a good idea for individuals?

Answer 23

They often under estimate the cost of treatment

Unexpected complications can increase costs

Question 24

What tax is payable on private medical insurance and at what rate?

Answer 24

Insurance Premium Tax 12%

Question 25

If an employer purchases private health insurance on behalf of its employees how is is taxed?

Answer 25

As a benefit of kind reducing the employees personal allowance
Companies can offset the premiums against corporation tax but do pay National Insurance Contributions on the PMI benefits at 13.8%

Question 26

What can employers do to save cost?

Answer 26

Select the right level of benefits
Choose cheaper hospital bands
Have an excess or deductible

Question 27

What is the maximum waiting time for consultant led treatment

Answer 27

18 weeks

Question 28

What is the maximum waiting time for consultant led treatment where cancer is suspected

Answer 28

2 weeks

Question 29

What is the maximum waiting time for cancer treatment after diagnosis

Answer 29

31 days

Question 30

Identify three ways that there is greater use of the private sector

Answer 30

NHS contracts with privately run treatment centres
Patients can choose to go private if they do not get treatment within NHS timescales
NHS hospitals can earn up to 49% of their income from private patients

Question 31

Identify seven key principles of the NHS

Answer 31

1. Comprehensive service available to all
2. Access is based on clinical need not ability to pay
3. It aspires to the highest standards of excellence
4. Patient at heart of everything
5. Works across organisational boundaries
6. Provides best value for taxpayers’ money
7. NHS is accountable to the public

Question 32

Identify differences private healthcare v NHS

Answer 32

1. No or shorter waiting lists
2. Choice of “hotel” facilities
3. Choice of specialist
4. Different techniques and technology
5. Private may have no intensive care
6. Private may have no A&E

Question 33

Where do patients usually get cosmetic surgery done

Answer 33

Privately unless as a direct result of illness/treatment

Question 34

Where is emergency treatment usually provided

Answer 34

by NHS often excluded under by Private Medical insurance

Question 35

What do provident insurers eg BUPA not make ?

Answer 35

A profit

Question 36

Identify seven advantages to patients of private medical treatment

Answer 36

1. Less waiting time
2. Choice of consultant
3. Choice of admission date
4. Choice of hospital
5. Private room
6. Cleaner hospitals
7. Different treatments

Question 37

What to reinsurers offer to the private healthcare market?

Answer 37

1. Capital
2. Stop loss cover
3. Protection against large risks
4. Help with research, product design, underwriting and claims

Question 38

Identify the three key elements of the private health insurance market?

Answer 38

1. Individual or personal paid
2. Company or employer paid
3. . Affinity or voluntary employee - paid groups