Three European countries are all heading towards different forms of supplementary insurance, which will change the private healthcare sector and the balance of power between insurers and healthcare providers.

In Germany, hospital groups Asklepios and Helios, with their planned top-up policies aimed at employers, are upsetting private insurers. In Romania, the government is likely to finally pass reforms that will limit the basket of services that citizens can access for free, leading to possible growth in insurance. In Poland, government talk of introducing supplementary insurance is finally coalescing into policies that would see massive growth in occupational insurance.

In Germany, big private healthcare insurers are telling Healthcare Europa that they are really worried by the threat posed by a Helios/Asklepios product sold to corporates as a perk to encourage employee retention. As one tells us: “Until now, in Germany, we have had statutory insurers or private insurers. Helios and Asklepios will introduce a third force. Almost everyone in Germany is now 50 kilometers from a Helios hospital. So what if Helios says to the statutory insured, who make up 90% of the German population: ‘For €10 a month, you can see a specialist in one of our hospitals within two days, guaranteed, rather than waiting 4-6 weeks as you do now’?” That is the real game changer.

In Poland, if planned reforms are introduced, we will see further consolidation. Insurer Bupa has already bought LUX-MED, the country’s largest subscription healthcare services provider. Under a reformed regulatory climate, we would expect to see PZU, the big domestic insurer that already has a stake in hospital privatisation group EMC, buy more assets.

In Romania, insurers hope that a smaller public basket of services would lead to a big rise in demand for insurance products. But this is not clear. The real growth in Romania, thus far, has been in fee-for-service. Hardly surprising, given that 90% of Romanian households have an income of less than €800.