12 Million Reasons To Act Now On Private Health Insurance

A few days ago some private health insurance funds said they’d help consumers get more value for money out of their policies by giving  more information about out-of-pocket and other annoying extras.

Sharing our experiences of gap payments can be handy in choosing a specialist but there are steps we can take now to save ourselves, if not the healthcare system.

About 12 million Australians have some form of private health insurance, half are on incomes of less than $50,000 per year, and they play a crucial role in reducing pressure on public hospitals in terms of waiting lists and budgets.

But we have the unsustainable position of those who pay insurance facing higher costs each way above inflation.

So what’s to be done? The federal government says it’ll bring in more easily understood categories for health insurance, such as gold, silver or bronze to indicate was kind of coverage they really provide.

The reforms include simplified billing and standard definitions for medical procedures to allow easier comparisons.

But they only go so far. Here are some ideas to help in choosing and using health funds without shifting more costs or confusion onto consumers:

• Simpler information about out-of-pocket costs, available at the right time ie before the procedure:

Out of pocket costs are surcharges by any other name and are imposed on health services by specialists. Medicare will cover a certain level of your costs, your private health insurers some more, but in the end, some specialists can charge pretty as much as they like.

Requiring that all expected out-of-pocket costs are disclosed before a medical procedure would reduce so-called “bill shock”. It’s said transparency is the best disinfectant in which case we need a hospital grade variety to improve this area.

Choosing a policy: Rather than reducing our options government and industry should be making the choice easier for consumers. This doesn’t mean stifling competition by scrapping the lowest cost so-called  “junk policies”. For those, especially younger people, who want a cheap-as-chips policy to  keep the government levies and surcharges at bay and have little intention of actually using the cover, they are a valid and legal option. Yet both sides of politics have demonised these very basic policies and want to make customers pay more for cover they don’t chose to take out!

• Stop pressuring patients with private health insurance in public emergency departments to pay twice:

It’s solely up to the individual consumer to chose whether or not they elect to use their health fund cover in a public emergency department. The encouragement by hospital staff to go private instead of public, and then face higher costs instead of no cost for often little difference in treatment, may not be in the consumers best interests and is effectively double charging.

The consumers’ needs as opposed to the industrial and professional interests of hospitals, funds and specialists etc, must be paramount. Restricting choice, shifting costs onto already burdened personal budgets and being less than 100% open as to all the costs is testing all of our patience.