Protest long raised by the ADA on private health insurance

The Australian Dental Association (ADA) has been raising many objections regarding private health insurance throughout the year. Recently they welcomed the government’s announcement of roundtable discussions about private health insurance.

private health insurance dictate healthcare

June 2015

Following the concerns raised by the opposition in the House of Representatives about the Private Health Insurance (Prudential Supervision) Bills, the ADA urged the Australian Parliament to take more time to scrutinise these bills and consider the potential impact on consumers. Under these Bills, from July 2015, the role of Private Health Insurance Administration Council (PHIAC) would cease, its prudential and regulatory functions will be transferred to the Australian Prudential Regulation Authority (APRA).

This transfer entailed unclear situations on whether the obligation to provide statistical and financial data about the health private insurance industry will be carried over by the APRA. The PHIAC has been the only place that provide an unbiased overview of historical data about the health private insurance, and genuinely helped consumers to make informed choices. President of the ADA, Dr Rick Olive AM RFD, said that the existing bills did not appear to guarantee that same information would still be accessible.

July 2015

The ADA supported Calvary hospitals’ protests against attempts by Medibank Private to dictate the terms of health care provided in Australia. Medibank Private was seeking to impose measures that would restrict its Fund member’s access to Calvary facilities and care. Dr Olive said that these aggressive moves to interfere in the clinical practices and appropriate health care are mainly driven by financial considerations.

The ADA maintains that PHIs are obliged to meet their obligations to insure services for patients who undertake treatment outlined on the advice of their dentist. When private health insurers demand that policyholders change their health providers, those policyholders should consider changing their private health insurer instead.

August 2015

The alarm long sounded by the ADA was echoed when the Australian Medical Association (AMA) protest over Medibank Private’s attempts to impose penalty provisions as part of its contract negotiations with Calvary hospitals. The proposal was couched in the language of “quality”, yet not based on evidence-based clinical best practice. The ADA again called upon the Australian Government to provide legislative safeguards and reforms to ensure that safety and quality is not compromised.

Late 2015

In October, the Australian Government announced that they would hold roundtable discussions with consumers about private health insurance. The ADA welcomed the enquiry and hailed it as a chance to place PHI under the microscope as never before.

These roundtable sessions will focus on possible reform of the regulations governing PHI with the aim of reducing costs to consumers. The ADA argues that the focus cannot simply be on reducing costs alone and must maintain the focus on the importance of health outcomes for Australians. The enquiry must take into account the growing gap between premiums and rebates, which have not kept pace with CPI increases.

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