GPs are proposing a scheme in which patients pay 5p a day to ensure any gaps in their NHS treatment are met by their GP without the need to go private.
The scheme could cover 170,000 patients across 32 practices in a local commissioning group in Leicestershire.
Leicester GP Dr Teck Khong was due to present the idea to BMA leaders, as well as his commissioning consortium, possibly creating the first large 'civil society' insurance-style scheme of its kind.
It would aim to provide items which 'the NHS rations away' said Dr Khong, highlighting Herceptin and Alzheimer's drugs as two recent examples of treatments the scheme could support.
'With such high expectation of the NHS in the public and the pressure to keep a lid on patient referrals and prescriptions, the only way forward I can see is a trust fund,' said Dr Khong.
A panel of patients and doctors would decide which treatments were provided by the fund with the emphasis on 'providing things that the NHS can no longer offer'.
He told GP that unlike traditional insurance schemes the plan was aimed 'to serve the poorest in the community, as rich and poor can afford 5p a day'.
Dr Khong has been developing the idea since 2000 and set up a similar insurance plan in 2002 (GP newspaper, 15 July 2002), but he eventually sold the scheme.
However, he thinks that 'the political climate has changed and now is an opportune moment for a scheme like this'.
'This is a basic philosophy of empowering patients and addressing an excluded group,' he added.
Dr Khong said that the initial reaction to the scheme from patients in his practice has been a positive one. Leicestershire and Rutland LMC chairman Dr Vijoy Singh supported the idea.
'It's a radical scheme but the more I see of changes in the NHS the more I like his ideas,' he said.
However, Dr Singh added that some members of the LMC may take more convincing because they were 'staunch supporters of a traditional NHS'.GPC chairman Dr Hamish Meldrum said the scheme might be possible to do if patients were donating to a 'charity' rather than their doctor. An MDU spokeswoman recommended that anyone offering the scheme take legal advice.