Mexican firm covers patients for $5 a month

This is one of a number of overseas healthcare services that could provide alternatives to the UK model, according to a presentation at the NHS Confederation conference in Liverpool. Medicall, which has approximately 1m accounts covering 4.3m people, charges users $5 a month through their telephone bill. It offers discounts for those who need to follow their call with a visit to doctor. Mexico lacks a comprehensive health insurance system, with 57% of people lacking any coverage, either private or public. Tom Kibasi, of consultancy McKinsey, told the conference that Medicall is "a fascinating solution" and an example of how healthcare can be provided effectively at much reduced costs. Kibasi and his colleague Nicholas Henke told a conference session that standardising work in specialised "factories" was a key method for saving money while maintaining or increasing quality. They outlined the work of LifeSpring, a chain of maternity hospitals in India that has standardised the medical processes involved so that three doctors are able to manage as many as 94 births a month, and has cut the cost of a birth for mothers by 85%. Other Indian hospital chains, NH Heart and Aravind for cataracts, have also dramatically reduced charges. Henke told the audience that much of the best thinking has come from the developing world, due to the lack of established systems and the need for low fees to make the services widely affordable. But he said that Valencia's public health system in Spain has made savings by adopting technology from budget airlines and retailing, such as automated check-in, the widespread use of barcodes to track patients, and the use of paperless health records. Henke said that all health systems in the developed world will face financial crunches over the next few decades. In response to a question from Brian James, the chief executive of Rotherham Foundation Trust, on how British patients could be encouraged to move to cheaper methods of delivery, Hencke said that some techniques could be introduced into the current system. These include specialised factory hospitals and better use of technology. But he added that others would only work if – or when – Britain moved away from healthcare being free at the point of delivery. "We have to deal with the fact that there is an almost unlimited demand for healthcare in developed countries," he said.