The cardiac surgeon who pioneered CI (critical illness) insurance says inspiration for the product came to him after he realized that, while giving his patients extended lives, he was also giving them years of financial misery. Twenty+ years later, having himself survived prostate cancer, he is ceaseless in spreading the word about CI insurance and trying to design improved products. The following interview is by Sam Shaw and Nicola York.
Now in his eighties, the architect of critical illness insurance, Dr Marius Barnard, is inexhaustible in his crusade to close the protection gap.The South African heart surgeon, who helped his older brother Christiaan perform the world’s first human-to-human heart transplant in 1967, is a technical consultant with Scottish Widows. Despite being diagnosed with prostate cancer nine years ago and given two years to live, he campaigns to introduce staged payouts from CI (critical illness) policies with a passion that never wanes. He recalls how, as a cardiac surgeon in Johannesburg in the 1980s, he came to realize there was a need for a product to help people cope with the financial aspects of surviving a major illness. He found that many post-op patients could not afford the continuing treatment.” When I perform a coronary heart bypass, my patients survive between five and 10 years. I had never realized what we were doing. We give them years but we give them hell because of the increased costs of living.” He explains that when patients undergo severe operations or suffer critical illnesses such as cancer, heart attack, stroke or coronary heart bypass surgery, not only is their lifestyle suddenly more expensive but their ability to earn also diminishes significantly. ”That is when it came to me. There were two sides to this - the medical side and the financial side. Patients need money from the initial diagnosis. We started looking around for a niche product form but there was nothing so we developed it ourselves.” Barnard’s decision to take the product idea overseas saw late-stage discussions with an Australian company - his first choice of market - fall at the final hurdle. “They said at the 11th hour that their shareholders would not want to be associated with a South African company so we made our next move and brought it to England.” In 1986, Barnard introduced critical-illness cover to the UK, with Abbey Life being the first provider. He says his biggest regret is that severity-based payouts were not introduced at that time but this was done in ignorance. Barnard’s decision to enter the medical profession was by no means an easy choice, given his upbringing in a small, semi-desert, sheep-farming community in South Africa. Neither of his paternal grandparents could read or write and his missionary father went without new clothes and food so his four children could have a decent education.”My mother was very forceful. She would give me a hell of a hiding if I did not come top of the class. What else could I do in a hick town? The local doctor had the biggest house, the best car and the prettiest wife. I had no intention of becoming a missionary so I became a doctor.” His brother Chris, who died of a suspected heart attack in 2001, was five years older than Marius. They were never close as children but it was Chris who eventually gave Marius a job with Cape Town University’s cardiac team. “I was a general surgeon, keen on vascular surgery. My brother was head of cardiac surgery at Cape Town University. I went over to Houston, Texas, to learn vascular surgery because in America they did cardio-vascular, not cardio-thoracic. When I came back home, despite being the only properly trained vascular surgeon, the doctor of surgery refused to give me a job. He was kind of miserable - medical politics are worse than any other kind. So Chris did his little brother, married with three kids and no job, a favor.” They began working together in March 1967 and performed the first human-to-human heart transplant nine months later on December 3. They were well aware it would be a world first but had little idea as to the scale of interest it would receive.” This was no great surgical or technical breakthrough. We had done plenty of other heart transplants on animals and there had been human organ transplants before. But this was important because it was the heart. When you come home, you say to the person you love: My heart belongs to you. You do not say: My kidney belongs to you.” The successful operation brought with it overnight fame, for which neither Marius nor his brother were prepared. “If I had not been part of the team to perform the first heart transplant, then I would not be sitting here today. Everything followed from that and we did not really realize that what we were doing was so big or the impact it would have on our lives. We thought maybe it might make local radio or newspapers but that was about it. We did the operation on Saturday night and at about three o’clock in the morning my wife woke me up. She said: The press are here, they want to take a photo of the team. But I told her: I am tired. I am not having my photo taken. And I went back to sleep.” Barnard struggled to deal with the media frenzy that followed the transplant. “We had to take on the world press but we did not stop operating. I panicked and shied away very badly. I am a modest man. I have nothing not to be modest about in my life.” When asked how he copes with the media now, he says, “I was the luckiest man in the world. I had a brother who took on the press and I learned from all the mistakes he made.” But he is saddened by the way the press hounded Chris and says they latched on to aspects of his life, such as his affair with Sophia Loren, and refused to leave him alone. Despite his father being a missionary, Marius is the only one of the brothers who is religious. He says he lives his life by the bible and his love of nature stems from this. “I need to see the sky and the sun. I need to see the horizon with a big storm brewing or a beautiful sunset or I am not happy.” The UK is now one of the most advanced protection markets in the world but, when Barnard’s product was introduced, he found UK advisers negative and wary - until an LIA conference in 1991. “Now, I am not going to be modest. CI struggled in this country but in 1991 I gave a talk at the LIA at the Barbican and that is where it kicked in. I got a standing ovation and I started crying and I have never experienced that in my life. That is where the graph of sales started.”You see, I can bring something to the CI market that nobody in this industry can, not because I am clever or special. I bring credibility because I am a doctor.”
Born: Beaufort West, South Africa, November 1927
Lives: Hermanus, South Africa, with Inez, his wife of 60+ years