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EF: 2020 was the year of diagnostics, 2021 the year of vaccines, what will 2022 be the year of?
DB: From an insurance point of view, we are the payer in the health system, we continue to play a very important role in this. At AXA we have decided to also adopt the role of provider, we do not only want to be paying the bill after. We started this in 2019 with an integrated health system called AXA Keralty in which we opened physical clinics and we started with teleconsultations. In 2022, we must go further with prevention and care, in a country like Mexico where we have one of the highest mortality rates worldwide, and that is how I look at the pandemic. Not through the number of infections or diseases because they are not known. We can compare mortality rates and the reasoning behind the rates in Mexico are bad health habits that result in obesity and chronic diseases. I hope that 2022 will be the year when Mexicans become healthier.
EF: Can you elaborate on the AXA Keralty initiative and how did it evolve during the pandemic?
DB: It is important to first understand that the Mexican health system is fragmented. There is a Health System if you are employed by the state and if you are privately employed, you are part of a different system, and if you do not have insurance there is a third option, where you participate in a different system. Our system works with private hospitals and private doctors. Less than 10 million have this private insurance, which is called Gastos Médicos Mayores, Major Medical Expenses. What we traditionally covered were severe diseases such as cancer, heart, and orthopaedic diseases. In AXA, we decided to increase access in the private healthcare market with ten specialities and take a preventative approach. The planning process started in 2016 with the launch in 2019 and Keralty had the necessary infrastructure in place before the pandemic started. The integrated health system always starts with a check-up, depending on what we find we then send them to programs to keep them healthy.
During the pandemic, we saw much more teleconsultations. Last year, almost 40% of consultations were through teleconsultations, we had 103,000 consultations and 37,000 were via telemedicine. Telemedicine drastically increased during the pandemic, and ours were different for some reasons:
- The same doctors that are employed in the clinics give video consultations, meaning that the customer can choose whether to see the doctor in person or through video consultation.
- The doctors follow the same protocols.
- We have an electronic medical record that is available for the doctor and customer for both types of consultations.
We also introduced homecare, and we are very proud that we assisted many patients in detecting Covid-19 and assisted in their care, either by sending them to hospitals, performing daily telephone check-ups or sending a doctor to their home. In a country like Mexico, this is something that was new during the pandemic and could make a real difference going into the future.
In terms of performance evolution, in 2020 when Covid started, people postponed going to hospitals for any disease other than Covid. They were postponing their visit to reduce the risk of contagion. From a financial point of view, it was a good year for AXA. 2021 was completely different, we realized that from April people were going back to the hospital to catch up with check-ups and their normal procedures and surgeries. Because they were postponed for so long, we had a lot of procedures in a short time, which compensated for the financial situation from the previous year, and Covid did not stop. In terms of health insurance, 2021 was a year of a lot of expenditures, not only because of the increase in requests but also because the costs increased.
EF: How do you see the role of healthcare infrastructure in restoring the economy for Mexico?
DB: We must distinguish between the public and private sectors, as they are independent. Looking at the private sector you can see investment into hospitals and new hospitals opening. In the big cities, I do not see a problem with infrastructure, along with the doctors - they are excellent. It is true that there are big differences in Mexican society, and there is a lot of work to be done to ensure all Mexicans have equal access to healthcare.
EF: Could you elaborate on your spillover in Mexico and how did you manage your employees?
DB: We have around 5,000 employees in Mexico and because we were declared as an essential service, we were allowed to go to the offices. Whilst insurance is essential, it is also a privileged activity as we were able to carry out activities remotely from a home office. We grew the top line in terms of both premium volume and terms of insurers in all lines of business. We did have people on the field, such as workers that needed to assess car accidents for insurance customers. People were very engaged, happy, and grateful. However, in Mexico, Covid-19 impacted all generations and this correlated to the morale of our colleagues.
EF: Could you elaborate on the relative importance of AXA Mexico to the group?
DB: AXA Mexico is admired for its unique integrated health system. Within AXA, Mexico is an innovator, and we are convinced that it is key for tackling the health problems in Mexico. There are many roles to play, and we must be integrated, everything must start with prevention, a good checkup, and a good diagnosis.
It is very important that everyone not only plays their role, but we do more than our traditional specialities. We are traditionally payers but are investing in prevention which will pay for the long term. I think that we need to tackle the issues from the start with much more prevention, education and helping people live healthier lives.
EF: Looking back at this time, how would you like to be remembered?
DB: I hope that AXA will be remembered for being much more than just a payer, that we did more than we were obliged to do. When the hospitals were crowded and COVID patients were not receiving beds, we put in place a team of twenty colleagues that worked day, night and over weekends in finding availability for hospital beds, ideally in the residence of the client. If not, we would transport them either by road ambulance or air ambulance to another place. Our extra efforts saved many lives and people were very grateful. Now we have our own clinics and infrastructure, last year we opened six clinics across the country, and this means that we can help the population in living healthier lives and fighting against chronic diseases and conditions. In the clinics, we have a general discipline and ten specialities and the one that was most popular last year was nutrition, this showed that many people were aware of it being a route cause of the challenges we are facing in Mexico. I am proud of this and grateful for our nutritionists. It is a big country, but we are contributing to the field in which we are experts.