Expat Focus International Healthcare Update November 2018

British expat healthcare in the EU to be safeguarded

The UK government has revealed that it is planning to safeguard the healthcare rights and costs of British expats living in the European Union after Brexit.

The government has introduced the Healthcare (International Arrangements) Bill which will provide the powers to implement and fund future healthcare deals.The law will cover 190,000 expats living in the EU and its member states, along with 50 million people who travel overseas every year.

Jackie Doyle-Price, the health minister, says the legal basis will help implement and fund reciprocal healthcare schemes and share data with other organisations. The move will now protect the right to medical care for millions of British expats, tourists and students who visit European EU countries from the UK every year.

The new law will also establish a new arrangement for the popular European Health Insurance Card (EHIC) so that it will continue from 2020 when the Brexit transition period is due to end. However, this will need to be in agreement with the EU’s member states.

The EHIC enables British nationals to access free healthcare overseas with EU and non-EU countries including Norway, Australia and New Zealand.

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A spokesman for the Department for Health said:

"Whether working, retiring or holidaying abroad, British people want to know they will have access to high-quality healthcare as they enjoy in the NHS. This bill will enable us to implement a healthcare arrangement with other countries in the EU and elsewhere so that British citizens can travel abroad with confidence."

Mercer to offer trans benefits for its global employees

Benefits consultants Mercer has unveiled plans for a range of trans benefits as part of its private medical scheme offer to its staff. There will be medical support including consultations and surgical treatment.

The firm’s UK HR director, Dr Siobhan Martin, said: “Being an inclusive and diverse company which is aware staff’s identity, we are among the first in the UK to offer trans healthcare benefits and support for those who need it.”

Growing numbers of health insurers are now offering similar policies to meet the needs of employers who have a diverse workforce.

Travelling expat employees at risk from disease

Expats and business travellers are at risk from a range of potential health issues, particularly pregnant employees, says one international security and medical firm.

Helix International says that employers and employees heading overseas need to be aware of diseases in the country they are heading to. For example, the firm says that a rubella outbreak in Japan has heightened risk for pregnant employees, while in Europe there’s a measles epidemic, so staff will need to be vaccinated before travelling.

Helix also says that there is a zika epidemic in India, which poses a risk for travellers, those considering starting a family, and those who are pregnant.

Mental health issues a concern for expats and business travellers

Business travellers, as well as expats, say that extensive travel can have a negative impact on their mental health, a new survey reveals.

The findings from International SOS surveyed 200 international business travels and 45% of them said they were more stressed than normal while on a work trip. Emotional exhaustion is also an issue for 31%, while 25% said they struggled with depression and anxiety.

Other problems for business travellers include not eating a balanced diet while overseas for 76% of respondents, and 73% saying they struggled to sleep.

A director of the firm Kai Boschmann said:

"There are business opportunities with international travel but research suggests that regular business travellers are making three times as many claims for psychological treatment compared to those who do not travel for business purposes regularly."

He added that employers need to appreciate their duty of care obligations and better understand how they can help detect the physical well-being and mental health of employees who travel overseas regularly.

The world’s riskiest countries for expats revealed

For expats and regular international business travellers, knowing which are the riskiest countries to live in and visit is of great importance and the latest country risk map from Drum Cassac will help.

The global security and risk consultancy says that over the past year travel overseas has become a riskier prospect.

The firm’s intelligence and analysis services team has looked at every listed country for a series of potential issues including political stability, infrastructure, access to healthcare and the frequency of natural disasters. As a result, the firm says that the world’s high-risk countries are Syria, Yemen and Afghanistan. The country offering the lowest risk is Aruba, an island off the coast of Venezuela.

A spokeswoman for the firm said: “Unsurprisingly, North Africa and the Middle East emerge as the most high-risk destinations for travellers with much of central America and Africa also posing a threat.”

She added that for countries with more than 1 million people, the safest destinations for travellers and expats are Singapore, Taiwan and Uruguay.

Meanwhile, the UK consumer watchdog Which? has also published details of the countries that offer risks to travellers and found that Japan and Iceland are the destinations where a terrorist attack is least likely to occur. Iceland also has the lowest risk of violent crime, followed by the UAE and Singapore.

The lowest risk for health issues are France, Italy, Iceland, the US and Japan, with Barbados offering the lowest risk of a natural disaster. The worst countries for crime are South Africa, Turkey and Thailand.

Health benefits attract talent

A survey highlights that employers are increasingly turning to better health benefits to attract talent; with five different generations now in the workforce, standard medical coverage needs to be improved as a result.

The Gallagher Benefit Strategy and Benchmarking survey found that 60% of employers have placed retaining talent as their number one operational need.

Also, 37% of employers want to control their benefit costs, while 45% have chosen not to increase employee costs for healthcare benefits. This could be an issue with employers struggling to find and retain talent in the face of low unemployment in leading nations.

The firm’s president, William Ziebell, said: “Today’s workforce comprises five different generations, which means it is not good enough to offer standard medical coverage and a retirement plan.”

However, growing numbers of employers are looking at taking a more holistic view of their employees’ well-being and are developing strategies that appeal and engage their team including healthcare benefits with a telemedicine component so staff can connect with clinicians around the clock.

The survey also found that employers are encouraging employees to live healthier lifestyles in a bid to reduce their medical expenses with moves to introduce flu shots, health risk assessments and help to stop smoking.

And the healthcare awards winner is…

A number of awards ceremonies to recognise achievements in international and expat healthcare have been held. The ‘Best Group Private Medical Insurance Provider’ winner at the Cover Excellence Awards 2018 was AXA PPP Healthcare.

Global travel risk and international medical assistance firm Healix International has been named the winner of the International Healthcare and Risk Management Provider of the Year at the Expatriate Management and Mobility Awards. Meanwhile, Generali Global Health picked up the International Travel and Health Insurer of the Year at the ITIJ Awards in Geneva.

Aetna International picked the Best Group International PMI Provider at the Health Insurance Awards in London.

In other news…

International Student Insurance has unveiled a multi-media package to help universities and colleges in the US educate staff and students on maintaining and managing their mental health and emotional well-being. A spokesman said that the number of cases involving mental illness is increasing and is affecting schools throughout the US.

Media outlets in Kuwait are reporting that the Ministry of Health is planning to ban expats from receiving treatment in public hospitals in less than three years. The Ministry has also rejected a Parliamentary request to exempt some expats from increased health fees; these can now only be enjoyed by domestic helpers and children of Kuwaiti women. The Ministry says too many expats have been exempted, including health ministry staff.

New laws in Ireland will enable VHI to sell international healthcare plans directly to citizens and expats without an intermediary. The state-owned health insurer is the largest in Ireland, though they will need ministerial approval before selling any of its plans.

Healthcare professionals and regulatory bodies in Singapore have welcomed a move to publish the benchmark fees for surgery carried out in the private sector. Along with insurers and private hospitals, they say that this greater transparency will empower patients and also help tackle Singapore’s rising healthcare costs. New rules will also simplify the process of accessing health insurance for surgery and patients will no longer need to wait.

The Ministry of Health in Oman has revealed that it is looking to improve the health insurance offering to expats living in the country. The Ministry says it wants to allow specific levels of health insurance to cover normal diseases with other levels covering noncommunicable diseases and other illnesses. The new system will replace the current insurance set up with a range of coverage and prices to choose from.
Generali UK has unveiled a new business travel insurance solution aimed at employers with staff who travel overseas. The aim is to help employers meet their duty of care responsibilities and offers round-the-clock multilingual global assistance and essential cover, including disability and accidental death.

Risk consultants International SOS has found that 43% of key business decision-makers say that travel risks for international business travels will rise in 2019. A spokeswoman for the firm said: “With nearly half of decision-makers believing that travel risk will increase from 2019, the evolving travel habits of a modern workforce are being overlooked by many organisations.” She added that employers need to keep their policies relevant and for expats and travellers to be better informed to keep them safe.

It has been reported that growing numbers of expat doctors and nurses in Ireland’s hospitals are leaving because they believe they are unfairly treated. The expats say they are not considered for promotion, training opportunities and are simply filling vacant doctor positions. The situation is being compounded with hospitals struggling to recruit from overseas and Irish doctors heading abroad for better jobs.

Research reveals that female business travellers fear for their safety, with eight in 10 saying they’ve had at least one or more safety-related incident over the past year while travelling for business. The findings from the Global Business Travel Association reveals that 90% of female business travellers say that worries over safety have also had an impact on their leisure activities while travelling.

South Africa’s Health Minister, Aaron Motsoaledi, says that expats there are a ‘burden on the country’s health system’. He was speaking at a nurses’ union summit in Johannesburg and said that more clinics and hospitals are needed to cater for foreign and local patients. He added that a big influx of foreigners is the reason why the country’s health system is struggling.

A report from Willis Towers Watson is predicting that healthcare benefit costs in the UK will increase by 6.3% next year – and around the world policy costs will rise by 7.6%. The smallest rises are predicted for Europe – 5% – while the biggest price increases will be seen by policyholders in the Middle East and Africa where they could rise by 12.4%. In the US, costs are set to grow by 7.9%.

Healthcare quality around the world will be boosted by artificial intelligence (AI), says OptumIQ. The firm says this will be key to reducing healthcare costs and boosting quality. They questioned 500 healthcare leaders in the US with many of them saying that their organisations are investing heavily in AI resources to improve the delivery of healthcare.


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