MANAGED CARE May 2008. ©MediMedia USA
When it comes to runaway medical costs, the United States isn’t the only country with a problem. In a survey conducted by Watson Wyatt involving 85 insurers to global employers throughout Asia, Africa, Europe, and the Americas, 71 percent of respondents said they expect higher or significantly higher medical costs over the next five years, and 81 percent report that medical costs eclipsed the general rate of inflation in their country. The countries with the highest expected increases are in Asia, Africa, and South America.
Pharmacy directors and medical directors will need to adjust plan design and premiums accordingly, says Francis Coleman, senior international consultant at Watson Wyatt. “They can take some of the managed care techniques learned in the United States and adapt them to local countries and cultures.” Premium sharing, like member coinsurance, appears to be the most widely used form of cost-sharing arrangement globally.
| Global medical costs (% change from previous year) | ||||
|---|---|---|---|---|
| 2006 costs minus inflation | 2007 medical costs (projected) | 2008 medical costs (projected) | Compared to current rates, expectations over the next 5 years | |
| Above median (yellow shading) |
Top quartile (orange shading) |
|||
| Asia and Africa | ||||
| Bangladesh | −2.2 | 13.0 | 13.0 | Higher |
| China | 12.3 | 21.2 | 19.6 | Higher |
| Egypt | 2.6 | 15.0 | 17.5 | Higher |
| Hong Kong | 6.8 | 8.8 | 9.1 | Higher |
| India | 16.7 | 25.0 | 30.0 | Significantly higher |
| The Philippines | 6.5 | 11.4 | 11.5 | About the same |
| Russia | −2.8 | 13.7 | 15.7 | Higher |
| Saudi Arabia | −2.8 | 13.3 | 16.3 | Higher |
| Singapore | 5.3 | 6.5 | 7.5 | About the same |
| Europe | ||||
| France | 3.7 | 6.6 | 7.3 | Higher |
| Netherlands | 4.5 | 5.2 | 6.0 | Higher |
| Switzerland | 2.4 | 7.5 | 6.0 | Higher |
| United Kingdom | 3.6 | 8.0 | 8.0 | Higher |
| Italy | 3.7 | 11.0 | 11.3 | Higher |
| Americas | ||||
| Brazil | 4.9 | 5.9 | 7.2 | About the same |
| Canada | 10.0 | 11.5 | 12.0 | Higher |
| Chile | −5.9 | 6.5 | 7.1 | About the same |
| Mexico | 7.5 | 12.8 | 12.6 | Higher |
| United States | 5.4 | 8.0 | 11.0 | Higher |
| Venezuela | 14.4 | 25.0 | 25.0 | About the same |
| Source: Watson Wyatt. Global Medical Trends: 2008 Survey of Medical Insurers | ||||