AMA issues insurance warning
The AMA has warned private health insurers are moving to maximise profits and reduce care.
Australian Medical Association (AMA) president Dr Michael Gannon says changes being pursued by Australia’s biggest private health insurers will reduce patient choice of doctor and hospital, and signal a broader push by the health insurance industry to intervene in the doctor-patient relationship.
“The big insurers are pursuing a US-style managed care agenda to save costs and further increase profits by making it harder for patients to receive care from the doctor they want in the most appropriate hospital for their condition,” Dr Gannon said.
He singled out Bupa, one of Australia’s largest health insurers, as an example.
“Bupa’s new arrangements, which only provide maximum benefits for patients in hospitals with Bupa contracts, undermine the role of the doctor in providing and advising the most appropriate care - and could ultimately drive up out of pocket costs for patients,” Dr Gannon said.
“Public confidence in private health insurance is already at an all-time low. These changes will further devalue policies, which are a major financial burden for Australian families, and will place dangerous pressure on the already stressed public hospital system.”
Dr Gannon says there are a lot of policies on offer that provide significantly varying levels of benefits, cover, and gaps.
“There are also a lot of policies on the market that will not provide the cover that consumers expect when they need it,” he said.
“If people have one of these ‘junk policies’, they should consider carefully what cover they really need.
“The Government has undertaken some important reforms to private health insurance to help people understand the different conditions that each policy category – gold, silver, bronze, and basic – will cover.
“The funds must not be allowed to sabotage these reforms.”
The comments were made at the launch of the AMA’s latest Private Health Insurance Report Card.