Individuals and organisations are invited to send their submissions to the Senate inquiry on affordability of private health insurance and out of pocket medical costs by 28th July 2017.
Issues around private health insurance have been on the radar of a number of industry organisations for some time, with the Australian Dental Association (ADA) having lobbied for a senate inquiry, and in March this year delivering a submission to the Australian Competition & Consumer Commission on anticompetitive conduct in the sector.
Occupational Therapy Australia (OTA) is keen to provide a submission on behalf of members as some of the inquiry’s terms of reference are particularly relevant to occupational therapy. OTA seeks to receive any feedback from its members, including cases of:
- Out-of-pocket expenses incurred for occupational therapy services funded through MBS programs such as Chronic Disease Management (CDM) and Better Access to Mental Health (BAMH);
- Inconsistencies in Medicare rebates for allied health services funded through the MBS;
- Occupational therapy being excluded from extras cover offered by private health insurers.
Back in April, the Australian Medical Association (AMA) launched the AMA Private Health Insurance Report Card 2017, which provide consumers with clear, simple information about how health insurance really works. The report is expected to help people understand their product, and allow them to make changes to get better cover and better value for money.
The AMA advises that people must not be deceived into downgrading to a “junk policy” that do not provide the cover patients expect when they need it. Private health insurance should be simplified, more transparent, and cover the real costs of treatment.
AMA President, Dr Michael Gannon said, “We need to ensure that patients retain the right to choose the doctor that is right for them, and to have their treatment at a facility that suits them. Equally, we need to ensure that doctors can refer patients to the right specialist – not just the one that an insurer deems appropriate. Insurers do not know the difference between specialist and sub-specialist treatment.”
The Australian Dental Association (ADA) has stated that dental fees have been lower than premium and health CPI increases over many years. These practices are consistent across the private health insurance industry, and not only damage consumer’s access to dental care, but their access to other healthcare providers.
ADA President Dr Hugo Sachs said “A Senate inquiry is critical because the ADA does not believe that the Australian Government and the Health Minister’s Private Health Ministerial Advisory Committee adequately focus on general treatment (extras) policies. The focus of private health insurance industry reform has been on hospital policies, particularly prostheses. However, more Australians have private health insurance policies for general treatment or ancillary (extras) services than hospital policies – 13.5 million vs. 11.3 million policies.”
Dr Sachs also said “Not only are private health insurers failing to adequately increase their rebates for general treatment services, they use discriminatory rebates making it harder for consumers to see the healthcare provider of their choice; interfering with their continuity of care. Common in private health insurance, discriminatory rebates offer higher rebates for the policy holder seeing a health provider contracted to that private health insurer; yet another policy holder paying the same premium for the same policy receives a lower rebate if they choose to maintain a relationship with their existing healthcare provider who is not contracted to that same private health insurer. Discriminatory rebates make one policy holder have higher out-of-pocket costs while effectively subsidising the other policy holder who sees the insurer’s contracted practitioner. This also has the effect over time of driving out small business independent practices. It’s a triple whammy.”
Click here for details on providing a submission for the senate inquiry.
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