Chronic
Medical Conditions And Critical Illness CoverIntroduction
Critical Illness cover (CIC) is an insurance whereby a tax free cash lump sum or regular tax free income is paid on diagnosis of a defined Critical Illness. Typically the core conditions covered are Cancer, Heart Attack, Stroke and most plans cover significantly more defined Critical Illnesses.
Critical Illness though should not be confused with Terminal Illness where life expectancy might be measured in days. With the aid of modern medicine many patients who suffer a Critical Illness will recover and go on to lead normal lives. In fact most Critical Illness Plans will only pay a claim if you survive for 28 days after diagnosis.
All to often Critical Illness is seen as a protection to cover liabilities such as mortgages or to provide a cash reserve to make things easier in times of serious illness.
GoForCustomer.co.uk advocates that for people dependant on regular income (salary) sufficient Permanent Health Insurance (PHI) commonly referred to as Income Protection should be a primary insurance in most peoples armoury. Thus maintaining regular income to afford continuing expenses in times of being unable to work due to Accident, Illness or Disability.
The Cost of Living
So where does Critical Illness fit into peoples protection requirements?
Consider the following:
The demand for pharmaceutical drugs from the NHS has never been greater. Medical progress means more and more drugs are available to cure acute conditions or provide remission from chronic illnesses.
The theory is the NHS funds whatever treatment doctors prescribe but with the NHS drugs bill now around £8bn. per annum and rising, occasionally someone somewhere is saying no.
That someone is The National Institute for health and Clinical Excellence or NICE.
Of course unlike the latest electrical gadget getting cheaper, the latest revolutionary drugs and treatments can be extraordinarily expensive. The media appears to highlight daily the latest person to be refused possibly life enhancing or even life saving treatment due to the cost of drugs.
The challenge facing the NHS is an ever increasing availability of treatments with the associated spiralling costs and a budget that cannot keep up. NICE provide guidelines determining who will get what and therefore who gets nothing!
These tough decisions are taken by calculating the impact of treatments in "Quality-Adjusted Life Years" or QUALY. Treatment providing a patient with 5 years of able body life is far better than a treatment providing 5 years alive but in a coma. Recent discovery that some patients may be aware of their surroundings whilst in a coma will further complicate the value judgements NICE make in an extraordinarily difficult decision process.
A further indicator NICE uses to make these decisions is the cost put on one extra year of our life. At the moment that figure is around £30,000 !
To give a recent example, bowel cancer drugs Avastin and Erbitrux have a combined cost of over £28,500 per annum which is therefore at the boundaries of an "effective spend".
Although bowel cancer may be treatable if diagnosed in the early stages the drugs in question are usually prescribed for seriously ill patients whose cancer has spread. Use of the drug at this advanced stage can extend the patients life by four to five months.
Therefore NICE recommends that the NHS does not fund this treatment as the sums do not add up.
More information about NICE is available at www.nice.org.uk . Try typing in "QUALY" to the search facility and see the extraordinarily complex discussions that emanate as experts debate treatments and of course funding them.
New advances, new breakthroughs, new drugs to improve quality and quantity of life and we feel we should have access to them if required. Perhaps we don't consider the financial question of "who pays?"
In an increasing number of cases it will not be the NHS.