The post-Brexit healthcare problem

ITIJ 198, July 2017
Dr Eric R Miller, global head of corporate at Doctor Care Anywhere, discusses how Britons in Europe could access healthcare after Brexit.
The starting pistol has been fired on Brexit and insurers, expats and travellers are unsure what to expect when the UK leaves the European Union (EU). With reciprocal healthcare agreements in doubt, the cost of treatment abroad seems certain to rise. Online technology, which many insurers have already begun to incorporate into their provision, can provide an affordable solution for travellers who seek peace of mind when they go abroad for holidays or business. 
Foreign languages and unfamiliar health systems already act as barriers when accessing healthcare abroad, limiting options and making it difficult to get the necessary help. With Brexit, new arrangements need to be made to cover healthcare requirements, as it seems likely that the European Health Insurance Card (EHIC), which gives British citizens the right to access healthcare in the European Economic Area (EEA), will be withdrawn when the UK leaves the EU. 
It is always important to take out travel insurance and yet millions of Britons fail to do so each year when they travel to European countries because of an over reliance on the EHIC. The Association of British Travel Agents (ABTA) estimates that 34 per cent of people currently do not take out insurance when visiting Europe, with close to a quarter of 25 to 34-year-olds saying that they don’t do so because they rely on the EHIC. Losing the right to the EHIC post Brexit therefore makes it even more vital that travellers obtain comprehensive health and travel insurance cover.
As well as affecting travellers to Europe, millions of expats living in the EU, who have previously been entitled to receive healthcare as part of reciprocal agreements between EU states, will now be forced to choose between either taking out private medical insurance or returning to the UK for their healthcare needs. 
For insurers, the loss of the EHIC means additional pay-outs to cover travellers’ health expenses and repatriation for travellers if they cannot be treated within the country they are visiting. In cases where a traveller does need to seek treatment or advice, the costs to insurers to arrange hospital or doctor visits abroad are already exceptionally high, especially for emergencies that would be quickly dealt with by a GP, such as an emergency prescription for an asthma inhaler. In 2015, health expenses for travellers cost insurers £196 million, 36 per cent more than the combined cost of lost baggage/money (£16 million) or cancelled trips (£128 million), according to the Association of British Insurers. Insurers will also have to consider the cost of offering and servicing policies that cover prescriptions abroad, particularly those for pre-existing conditions.
Insurers are increasingly recognising that technology and digital health services are a solution to these challenges – keeping costs low and offering a convenient and accessible service for travellers. As barriers to public healthcare systems go up around Europe, one option insurers can offer is a consultation with a virtual GP in the UK, who can be accessed via a secure video or phone. We at Doctor Care Anywhere already work with a growing cohort of travel providers and private medical insurers seeking a solution to these challenges, including Flight Centre, Aetna International and AXA PPP healthcare.
Video and phone appointments are easy to set up and provide travellers and expats access to a UK-trained doctor from anywhere in the world. It is very similar to seeing a local GP, only from a hotel room or villa, or even in a cab on the way to a business meeting. There is no language barrier so it avoids any confusion over whether patients are being treated by the right person. Such services also provide private prescriptions, which enable patients to have prescriptions delivered directly to them from the UK, or sent to a local pharmacy, or the GP can simply provide over-the-counter advice, depending on the local regulations of the country the customer is in. Patients can also track their individual symptoms, conditions and lifestyle factors while abroad to aid consultations with the doctor through our Health Tracking app.
Following Brexit, insurers, expats and travellers will need to adapt to a changing market to overcome barriers to accessing healthcare in Europe. With an estimated one in five people not taking out any insurance when travelling, according to ABTA data, insurers will also need to evolve their offering more broadly to encourage travellers to cover themselves when abroad. Digital healthcare initiatives, such as virtual GP services, provide an opportunity to address these challenges through innovation, keeping costs low for insurers and providing travellers and expats with timely and convenient access to healthcare, in the UK as well as abroad.