Health fund reform needed says ADA

1
1780
health fund reform

Copyright: 72soul / 123RF Stock Photo

The Australian Dental Association’s submission to the Senate Community Affairs Committee Private Health Insurance Inquiry, published on the Inquiry website last week, highlights the discriminatory, anti-competitive and at times unethical way some health funds are operating in the ‘extras’ insurance space, with negative consequences for many consumers and dental practitioners.

In its submission, the ADA makes 26 recommendations for reform designed to make ‘extras’ (aka general treatment) insurance and the operation of private health funds more transparent, more accountable, and fairer for all policy holders and healthcare providers.

ADA President Dr Hugo Sachs urged the Senate Committee to scrutinise the declining value for money extras cover offers consumers, and the real reasons for massive premium increases year after year.

“The health funds are blaming successive premium increases at two to three times the rate of inflation on the rising costs of healthcare,” Dr Sachs said. “But dental fees aren’t to blame for spiralling extras premiums—ABS figures show they’ve only increased in line with the overall CPI over the past five years or so.

“In the five years to the end of June 2016, the health fund industry as a whole retained a staggering $6.21 billion in extras premiums paid by consumers, instead of providing decent rebates for health services claimed. And it’s not just policy holders who deserve better”, Dr Sachs said, “but all taxpayers, who subsidise the health funds through the private health tax rebate.”

Chief among the reforms recommended by the ADA is the prohibition of a discriminatory system of “rebate inequality” operated by health funds with “contracted provider” networks.

“Rebate inequality means that patients who want to see their preferred independent dentist, rather than a dentist contracted to their health fund, are penalised for that choice with much lower rebates, even though they pay the same policy premiums” Dr Sachs said.

The evidence presented in the ADA’s submission is backed up by personal accounts given by over 100 dentists who have also made individual submissions to the Inquiry.

Based on a media release sourced from the ADA website.

Previous articleTools of the trade: The Wand STA System
Next articleEating vegetables good for teeth

1 COMMENT

  1. ”Rebate inequality means that patients who want to see their preferred independent dentist, rather than a dentist contracted to their health fund, are penalised for that choice with much lower rebates, even though they pay the same policy premiums”

    This at the end of the day was why ‘I HAD TO’ join HCF more for teeth program – even though the patients like you, if they can have no-out of pocket for their regular exam clean and bws – the patients will choose the no out of gap – a car wash is a car wash mentality.

    So finally this ‘discriminatory, anti-competitive and at times unethical’ is being addressed…..and the person that was pushing this in the senate….Nick Zenapon….has left……I think that we could have been abit more ‘nible’ about this and addressed this 5 years ago.

LEAVE A REPLY

Please enter your comment!
Please enter your name here