Private Health Public Good:

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1 Private Health Public Good: Towards a new coordination between Social security and private health Guillaume Sarkozy G. Sarkozy, Australia November 2010

2 MALAKOFF MÉDÉRIC : SOCIAL PROTECTION LEADER, WITH TWO BRANCHES Pension Insurance Health and Benefits N 1 14 bn subsidies 2,7 million retirees companies N 2 in group insurance 3,4 bn turnover 3 bn in own equity 3,6 time solvability margin 3,2 million employees insured companies Social Aid 100 M employees and 49 outlets G. Sarkozy, November

3 SUMMARY 1. A changing environment 2. Coordination between private and public 3. In-house healthcare 4. A new social contract G. Sarkozy, November

4 A. A STRONG INCREASE IN PUBLIC DEBT GDP % WHAT REQUIRES THE SEARCH FOR NEW BALANCE G. Sarkozy, November

5 A. RECURRENT DEFICITS IN THE NATIONAL HEALTH SYSTEM Source : chiffres clés de la sécurité sociale 2009 DO WE NEED A NEW MODEL? G. Sarkozy, November

6 A. EVOLUTION OF HEALTH COSTS 7, Due to technology and LTC, senior are expected to spend x 7.7 more than junior in ,9 5, A rapid increase considering it was x 5.5 in ,7 2,1 1, y - 40y 41y - 60y 61y - 80y >80y Etude Jalma G. Sarkozy, November

7 B. CHANGE IN BEHAVIOR Need to reduce the personal out-of-pocket expenses Greater demand for higher quality Higher requirement for results and services Individualism, Impatience, Simplicity CONTRADICTIONS G. Sarkozy, November

C. CHANGE IN THE PROVISION OF CARE CHANGES

average age 55 years WHICH CREATES A NEED

8 C. CHANGE IN THE PROVISION OF CARE CHANGES IN MEDICAL DEMOGRAPHY Doctors in workplace - 50% in 8 years Medical students Only 10 % of students set up their own practices Doctors average age 55 years WHICH CREATES A NEED FOR MEDICAL DIRECTION G. Sarkozy, November

9 D. NEW MEDICAL SCIENCE PREVENTION NEW TECHNOLOGY: E-HEALTH GENETICS PERSONALISED MEDICINE PREDICTIVE MEDICINE THAT IMPACTED THE LIFE G. Sarkozy, November

10 SUMMARY 1. A changing environment 2. Coordination between private and public 3. In-house healthcare 4. A new social contract G. Sarkozy, November

2. PUBLIC COORDINATED WITH PRIVATE TO FINANCE HEALTH EXPENSES Public Social security Taxes Access to care Monopoly Inflation of costs Reluctance to change

11 2. PUBLIC COORDINATED WITH PRIVATE TO FINANCE HEALTH EXPENSES Public Social security Taxes Access to care Monopoly Inflation of costs Reluctance to change Private Insurance 1 Insurance 2 Insurance 3 Insurance N Competition leads to: Improved efficiency Cost regulation change management G. Sarkozy, November

Private complementary Insurance Out-of-basket 14% 30%?

12 2. COORDINATION BETWEEN PRIVATE AND PUBLIC THE WELFARE SYSTEM Today Tomorrow Individual" Out-of-pocket 9% 10%? Private complementary Insurance Out-of-basket 14% 30%? Basket Social security Basket Monopoly- Taxes 77% 60%? G. Sarkozy, November

2. CARPAL TUNNEL SYNDROME TWO MEDICAL TECHNOLOGIES The classic one with a cost of 100 leads to 6 weeks of patient rest and absence at the workplace.

13 2. CARPAL TUNNEL SYNDROME TWO MEDICAL TECHNOLOGIES The classic one with a cost of 100 leads to 6 weeks of patient rest and absence at the workplace. The second, a new technology with a cost of 200 leads to 3 days off work for the patient Social security will choose the first approach because of lower cost G. Sarkozy, November

MSO : Medicine surgery obstetrics HH : Home hospitalisation FRC: follow-up and rehabilitation care ROAH : Retirement and

14 2. A TRANSITION FROM REACTIVE INSURANCE TO A PROACTIVE STRATEGY INSURER INTEGRATOR SERVICES PARTNERSHIP PREVENTION (MMS) DETECTION Networks labeled ROAH INFORMATION /ADVICE (ex : quote) ORIENTATION ORGANIZATION FRC HOME MAINTENANCE HOME CARE MSO : Medicine surgery obstetrics HH : Home hospitalisation FRC: follow-up and rehabilitation care ROAH : Retirement and old age homes HEALTH EXPENDITURE Reimbursment Reduction of the Out of pocket expense MSO HH G. Sarkozy, November

15 SUMMARY 1. A changing environment 2. Coordination between private and public 3. In-house healthcare 4. A new social contract G. Sarkozy, November

16 3. IN-HOUSE HEALTHCARE: PRODUCTIVITY AND WELLBEING OF EMPLOYEES Baromètre Sociovision «Companies need to be more concerned with the effect of their actions on the environment, social harmony and the personal development of their staff» «Companies ought to concentrate solely on their economic role and that of an employer G. Sarkozy, November

17 3. EMPLOYEES WOULD BE INTERESTED IF THEIR COMPANIES OFFERING THEM SERVICES Taking exercice 62% Better healthcare 61% Preventing sleep difficulties 55% Controlling diet 52% Getting better diagnosis 51% Be better at managing their personal life 40% Get better medical monitoring 38% Receive psychological help in times of stress 28%... THAT REQUIRES A NEW CORPORATE COMMITMENT Study Malakoff Médéric / Sociovision 2010 G. Sarkozy, November

18 3. SITUATIONS FOR EMPLOYEES OVER 50 YEARS OLD Study Malakoff Médéric / Sociovision 2010 Sight difficulties, even with glasses 38% Hearing difficulties 32% Chronic illness 28% «I feel I shan t be capable of doing the same job in 10 years time 57% G. Sarkozy, November

3. PERSONAL AND PROFESSIONAL WELLBEING ARE LINKED Study Malakoff Médéric / Sociovision 2010 32%

or lack of physical activity) 34% of employees have personal worries that affect their health and

19 3. PERSONAL AND PROFESSIONAL WELLBEING ARE LINKED Study Malakoff Médéric / Sociovision % of employees suffer from disturbed sleep 33% of employees suffer from a major health risk (diet or lack of physical activity) 34% of employees have personal worries that affect their health and their attendance at work 15% are caring for a dependent or sick person G. Sarkozy, November

20 3. IN-HOUSE HEALTHCARE : PRODUCTIVITY AND WELLBEING OF EMPLOYEES Health Orientation Control and assistance to work resumption 5 Metrics and diagnosis Prevention and toolkit Detection 3 4 E-health E-medicine 2 1 G. Sarkozy, November

21 SUMMARY 1. A changing environment 2. Coordination between private and public 3. In-house healthcare 4. A new social contract G. Sarkozy, November

22 A NEW SOCIAL IN-HOUSE CONTRACT DUE TO LESS PUBLIC FUNDS AVAILABLE A new equilibrium has to be found between social security and private insurance HEALTHCARE PROVIDERS ARE ALSO FACING AGEING Orientation in the healthcare system and technology will be needed AT THE SAME TIME THERE ARE NEW EXPECTATIONS FROM EMPLOYEES: WELLBEING IN LIFE A corporate commitment is essential Prevention, monitoring, well-being in search of new productivity A new market for group insurance operators G. Sarkozy, November

23 TO SUMMARIZE THE MALAKOFF MEDERIC GROUP COMMITMENTS Protection of our client s employees and their families, throughout their life Provider of group insurance and supplementary individual insurance packages Help in advising and guiding them within the healthcare system AS WE UNDERWRITE PENSIONS, BENEFITS AND HEALTH RISKS, OUR AMBITION IS TO OFFER A GLOBAL COVERAGE TO OUR CLIENTS G. Sarkozy, November

Increase access to the number of webinars from vendors for all employees

Increase access to the number of webinars from vendors for all employees ENCOURAGE EMPLOYEES TO LEAD HEALTHY LIFESTYLES THROUGH EDUCATION AND USE OF HEALTH BENEFITS September 18, 2018 Background: Combining risk assessments with wellness education is the most powerful tool we