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NHS picking up the bill as businesses taxed out of offering healthcare

Findings from independent economic experts Cebr and Bupa has not only verified the link between rising Insurance Premium Tax rates and increased burden on the NHS, but it has quantifed the cost to the service –  £126m a year – of looking after the extra 200,000 patients driven back to the NHS since 2015
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Healthcare is one of the most attractive perks to offer employees – but businesses are being priced out of protecting their people – leading to a greater bill for the NHS in the process. Contributor Alex Perry, CEO – Bupa Insurance.

Findings from independent economic experts Cebr and Bupa has not only verified the link between rising Insurance Premium Tax rates and increased burden on the NHS, but it has quantifed the cost to the service –  £126m a year – of looking after the extra 200,000 patients driven back to the NHS since 2015.

The study has also put into perspective the rate of taxation businesses face if they chose to provide health cover for their employees. When added to benefit in kind taxes and to National Insurance, the doubling in the rate of IPT means employers and employees can between them face an effective tax rate on health insurance premiums of between 49 percent (for those employees paying income tax at 20 percent) and 72 percent (for those employees paying income tax at 40 percent).

Furthermore, Bupa warns that if this tax were to be set at the same level as VAT, a further 250,000 people could move from private health into public care, doubling the existing cost to the NHS of caring for formerly private patients, to nearly £300m a year.2 As such, the health provider claims that using this tax to even partly fund the extra £20bn that has been promised to the NHS is the health equivalent of ‘robbing Peter to pay Paul’.

Alex Perry, CEO of Bupa Insurance said: “We want to highlight to the Chancellor that raising this tax is unfair, and a case of robbing Peter to pay Paul, as it drives consumers away from health insurance straight onto the NHS at a time when the service would struggle to increase capacity.

“The danger is that when businesses or individuals stop or downgrade their health insurance policies, they are solely reliant on the NHS for their healthcare needs, including costly care and treatment for conditions such as cancer, heart and joint surgery which their health insurance policy would have covered.”

Insurance Premium Tax has almost doubled since 2015 (from 6.5 percent to 12 percent), putting additional cost directly on to the consumer.  Insurance Premium Tax is applied to motor, home, travel and pet insurance policies however most consumers (65 percent) are not aware what the tax even is, or they’re unsure of who pays the tax or wrongly view it as a tax on the insurer (36 percent).  Furthermore, consumers don’t see additional taxation as the route to ‘fix’ the NHS, with just 27 percent approving of additional taxation, versus 47 percent against (DeltaPoll).3

Cost is the main factor for the public when choosing to buy health insurance, which explains the high attrition rates for individual policies. When questioned, one in three (33 percent) policyholders say they would consider cancelling their policy if their premium went up while a third (33 percent) of the wider UK public would consider taking out insurance if costs were lower.

Our research found that two thirds (63 per cent) of people say that health insurance allows others to access NHS treatment earlier and over half (55 per cent) view it as important in relieving pressure on the NHS. 4 Alex Perry continued: “Insurance Premium Tax is essentially a tax on acting responsibly. As a society we should be encouraging people to take responsibility for making sure that their homes, cars and health are insured.”

“Ahead of the Budget Statement we’re calling on Government to commit to freezing the standard rate. If the decision is made to increase the rate of tax on health insurance again, the NHS and all those using it will be impacted.”

Steve White, Chief Executive at The British Insurance Brokers’ Association (BIBA):

“It’s enlightening to see the full economic scale of the impact of Insurance Premium Tax shared within this report. We’re concerned that the UK public aren’t aware of and don’t understand the full extent of this hidden tax on their policies, so the more information we have about the impact of IPT that we can use to spread awareness, the better. The public are being penalised for choosing to pay for insurance. We, along with our members, insurers and industry bodies, are making these concerns clear too. It’s our members’ view that current policy on Insurance Premium Tax is discouraging people away from choosing insurance, and the more people and businesses that remind Government of the detrimental impact of IPT, the more difficult it will be for them to push through with any further increases.”

Stuart Scullion, Executive Chairman at ‎The Association of Medical Insurers & Intermediaries (AMII): “The findings within this report shed a great deal of light on the true cost of IPT, and allow little room for argument over the wider economic impact of the tax on health insurance. This report shows us that the government is not considering the wider implications of generating revenue from IPT, particularly in relation to the costs to the NHS and health sector. We’re expressing our concerns about this with the aim of asking the industry, the government and the public to wake up to what’s going on and the consequences of it. There are manyß consumer purchasers of PMI, including many older citizens, who are going to be forced back into using NHS services if the cost of their PMI becomes unsustainable. How does that benefit the NHS? The government should be encouraging the purchase of PMI as a means of reducing the strain on an already overstretched NHS, not pushing thousands of people back onto it.”

John O’Connell, Chief Executive at The TaxPayers’ Alliance: “It was deeply concerning that the Labour manifesto singled out health insurance for specific punishment, especially as those who protect themselves with health insurance save taxpayers’ money and lighten the load on the NHS. However the current Government has fared no better in comparison – by hiking Insurance Premium Tax across the board it is punishing those who do the right thing and protect themselves and their families. If the government wants to show that it really is on the side of hard-working people it would cut or at least freeze IPT at the Budget.”


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