AMA opposes changes to private health insurance

The Australian Medical Association (AMA) says it will reject any government proposals that would limit a person’s ability to use private health insurance for treatment in a public hospital.

President Dr Michael Gannon warned that such a move would restrict patient choice and further disadvantage public hospitals. Responding to a Federal Government paper titled ‘Options to reduce pressure on private health insurance premiums by addressing the growth in private patients in public hospitals’, the AMA has now made a submission to reject all options proposed in the document.

“The options raised in this paper would simply reduce the level of funding available to public hospitals in favour of private health insurers, and significantly reduce the health care choices available to privately insured patients,” Dr Gannon said.

“Patient choice is a fundamental feature of our health system, which includes the option for patients to use their private health insurance in a public hospital.

“There are very good reasons why a patient may choose to use their private health insurance for treatment in a public hospital, and in regional and rural areas, there may be no other option available due to the lack of private sector services.

“Public hospitals are also equipped to handle the most complex of cases and, in many cases, may represent the most appropriate clinical setting for treatment.”

Dr Gannon said any change needed to be made in the context of broader health insurance reforms and funding arrangements for public hospitals.

“On the one hand, the industry is offering and promoting public hospital-only private insurance policies, but at the same time objecting to more and more of their members opting to use their insurance in a public hospital.

“Insurers and governments only have themselves to blame for patients increasingly choosing to be treated as a private patient in a public hospital.

“On top of this, public hospital funding has failed to keep up with community demand for services, with the Commonwealth and the states and territories guilty of under-delivering in this area for many years.

“If the government and the private health insurers want to see fewer patients opt to use their private health insurance in a public hospital, we will need to see significantly improved long-term funding for public hospitals, private health insurance policies that meet the common medical needs of consumers, and clear articulation of the different levels of coverage so that they are easily understood by consumers.

Dr Gannon said changes would also detract from current flow-on benefits to public hospitals.

“In a constrained funding environment, the supplementary revenue generated from private patients makes an important contribution towards the recruitment and retention of medical practitioners, improved staffing, teaching, training, and research, and the purchase of modern equipment,” he said.

“All these resources support and enhance the delivery of high quality care to public and private patients alike.

“The development of a durable solution to this issue needs to be proportionate, and considered in the context of broader private health insurance reforms and future public hospital funding arrangements.

“This will require extensive consultation, including with the states and territories which, in relation to private patients in public hospitals, appear to have had very limited input to date.”