The latest private health funding dispute brings the issue of private health regulation into sharp focus.
The AMA has spoken with Bupa, Healthscope and Australian Health Services Alliance (AHSA) to express the need for immediate resolution to their current funding disputes and to request clear communication to doctors.
The ongoing disputes between Healthscope and each of BUPA and Healthscope and the AHSA emphasises again the need to reform the private health sector.
In the immediate term we need to see parties get back to the negotiating table, otherwise patients will be collateral damage – facing higher out-of-pocket costs that will be imposed by Healthscope from 26 November.
Doctors are caught in the middle of these disputes, with limited information about the proposed new fees and are alarmed they are being pushed into a situation where some patients will inevitably ask for advice on whether they should switch funds. Our focus as a profession is on providing the best possible clinical care, not becoming de facto financial advisors for our patients.
The long-term viability of the private health sector is critical. We have long called for reforms to ensure the sector remains viable, patients get value for money and doctors maintain clinical independence. We are calling for the creation of an independent Private Health System Authority (PHSA) to drive long-term reform and ensure the sector is appropriately regulated and patients get real value for money from their private health insurance.
An independent authority could also have a role in helping to solve disputes between insurers and hospitals.
We look forward to the release of the Department of Health and Aged Care’s Private Hospital Sector Financial Health Check that can inform the development of robust policy reforms and will work with the government and policy makers on addressing any findings.
Patients may well have questions about the implications of the decision by Healthscope to impose additional out of pocket costs on Bupa members and members of AHSA funds – noting this decision has been publicly disputed by both Bupa and AHSA. In this regard, Bupa has published some information at the link below.
