register

News & Trends - MedTech & Diagnostics

AMA urges health insurers to deliver value for money for policyholders

Health Industry Hub | January 12, 2023 |

MedTech News: People paying premiums for private health insurance face products that can leave them paying hundreds of dollars more, depending on their health fund, when they undergo the same procedure in the same hospital performed by the same doctor.

The private health insurance landscape has changed over the last couple of years. Before the COVID 19 pandemic we saw the proportion of people with insurance for hospital treatment plummeting. Many insurers had little, or no profit margins left, the regulator was suggesting that we were about to see the start of a wave of amalgamations – maybe leaving us with only a handful of insurers.  

We have now had two years of continuous growth in the proportion of people with hospital treatment insurance and along with this insurer profitability (on the back of reduced demand) has never been higher.  

The Australian Medical Association (AMA) released its annual Private Health Insurance Report Card calling on health insurers to deliver value for money for policyholders. The report card said the challenges for private health insurers was to deliver better and fairer value for their policyholders, including the 235,699 new members with hospital cover in the last 12 months (an increase of 0.7%).

AMA President, Professor Steve Robson, said the report found that the benefits paid by different health funds for the uncomplicated delivery of a baby differed by $550 (34%) from the lowest to the highest, for coronary artery bypass the difference was $747.35 (21%) and for femoral or inguinal hernia surgery there was a $300 difference (45%) between the benefits paid by the different health funds.

“Two patients having the same operation done by the same surgeon in the same private hospital can find that there is up to a $700 difference in the amount they get back from their health fund. And that is a situation that has us scratching our heads. We don’t think it is particularly fair for the people who spend a lot of money on their private health premiums and we think it’s time it was really dealt with fairly,” he said.

Professor Robson added “I think one of the big things that has happened over the pandemic with more customers joining up health funds because of the chaos in the public health system and less surgery being done, is it has been a profitable time for a lot of the health funds.

“And we have seen an increase of 16% in what is called management fees — that is the sum of money that they take out of your premiums to run their health funds. So, we have seen some big increases across the board and we think that customers in Australia, patients, who are having medical procedures want value for money.”

Professor Robson said the AMA has been calling for an independent regulator – a Private Health System Authority – to oversee private health insurance to ensure policyholders were getting fair value for money through a mandated minimum amount that every insurer is required to return to patient care.

In reimagining healthcare across the entire patient journey, Health Industry HubTM is the ONLY one-stop-hub bringing the diversity of Pharma, MedTech, Diagnostics & Biotech sectors together to inspire meaningful change.

The exclusive leadership and influencer podcasts and vodcasts add huge value to our breaking news coverage. The content on Health Industry Hub is copyright protected and should only be accessed under individual user licenses. Please click here to subscribe and visit T&Cs here.


News & Trends - MedTech & Diagnostics

Government commissions review as 70% of private hospitals face financial crisis

Government commissions review as 70% of private hospitals face financial crisis

Health Industry Hub | June 14, 2024 |

MedTech & Diagnostics News: Despite playing a crucial role in providing acute care and surgical services, a staggering 70% of […]

More


News & Trends - Pharmaceuticals

Pharmacy Guild echoes ACCC red flags over Chemist Warehouse-Sigma deal

Pharmacy Guild echoes ACCC red flags over Chemist Warehouse-Sigma deal

Health Industry Hub | June 14, 2024 |

Pharma News: The Pharmacy Guild of Australia has echoed the significant concerns of the Australian Competition and Consumer Commission (ACCC) […]

More


News & Trends - MedTech & Diagnostics

Competition watchdog raises concerns over cancer care provider's expansion plans

Competition watchdog raises concerns over cancer care provider’s expansion plans

Health Industry Hub | June 14, 2024 |

MedTech & Diagnostics News: A leading provider of cancer care services in Australia, faces scrutiny from the Australian Competition and […]

More


News & Trends - Biotechnology

Aussie biotech secures first local CAR T patent

Aussie biotech secures first local CAR T patent

Health Industry Hub | June 13, 2024 |

Biotech News: A Melbourne-based biotechnology company which specialises in developing immune cell therapies for cancer treatment, has been granted its […]

More


This content is copyright protected. Please subscribe to gain access.