Juan Pablo González
Plan Seguro
View from the Top

Prevention: Basis of Good Healthcare

Tue, 03/26/2019 - 16:07

Q: How does Plan Seguro differentiate from other companies offering similar insurance services?
A: Since we do not have any other verticals, we need to be self-sufficient in healthcare. Over the past 22 years we have been meticulous in our operations, which has led to a more efficient operation with fewer errors. At the same time, rather than focusing on price, we bet on higher quality products and services. In the Mexican market there is a distinction between major medical expenses and what is more broadly classified as health insurance. The former is associated with accidents and severe diseases whereas health plans also include preventive healthcare. Companies authorized to offer this wider range of health products and services need to be certified as Insurance Institutions Specialized in Healthcare (ISES); Plan Seguro was the first company in Mexico to receive this distinction.
Q: How can combining traditional and preventive insurance models alleviate Mexico’s disease burden?
A: Our approach has a long-term impact on the health of the population. However, if people do not consider their health as part of their life plan, it will be difficult to effect real change in terms of promoting preventive insurance models, especially considering that only 25 percent of the population has insurance coverage. Part of our strategy is to make people think about their future.
Q: What role will digitalization play in providing better healthcare?
A: Traditional insurance products are too complex and tend to be mediated through a broker and a specialist insurance agent. We think this model is going to continue for the time being. Making a product more accessible through an app would require simpler and more automatic processes. There is definitely a demand to adapt and become more flexible, but there are people who may not necessarily have access to the technology required to use such a tool. For now, we mostly benefit from technological innovations through increased efficiency by trimming costs and ultimately lowering product prices. Today, we have an insured base of 130,000 clients and cover almost the entire country through a network of more than 4,000 doctors and 500 hospitals.
Q:  How would you envision a public-private partnership to improve the insurance sector in Mexico?
A: In other successful international models, such as the Netherlands’, this partnership was designed by the government and the private sector working together. The former pushed for strong social incentives but it had to find an economically viable model regulated by clear rules. What the Netherlands’ government did was assign 100 percent of the healthcare insurance to the private sector and forced every citizen to acquire a basic health insurance package. Citizens can then choose to contract additional coverage. Another successful case is Chile, where citizens have the choice to have a private plan or a government plan. In this case, the government invited private hospitals and health providers to collaborate in public-offered plans. The problem we have in Mexico is that there is no such cooperation between the government and the industry.
Q: What is the best way to prevent further rises in the price of insurance policies and boost penetration in the Mexican market?
A: Insurers must ensure clients do not end up paying for inefficiencies or errors in the operation of the policy. However, the health of the population is the main factor that determines the price of healthcare in Mexico. Chronic diseases like diabetes, heart diseases and orthopedic conditions have now become the main cause for expenditure among insurers and costs for such treatments have seen steep increases in Mexico. To reduce the impact of health trends on insurance prices, it is important to develop flexible products and services. Portfolios should be able to adapt to target groups with different health risks, they should be managed easily and adapt to changing circumstances. However, we must also exercise caution to avoid reaching the point where there is not sufficient coverage for the client.