Private Health Insurance

It can be a dangerous thing to raise ideas in Canberra. When it comes to health and doctors, and at certain phases of the political cycle such as when no election is imminent, a good idea can turn bad in a flash.

The AMA experienced this when an earlier President decided to pursue the issue of national registration. As is normal practice, we wrote a letter setting out our objective and our reasons which were to do with simplification, reduced costs and to make life easier for doctors who practise on a border such as Albury/Wodonga.

We could hardly believe it when this idea morphed into the most bureaucratic nightmare of meetings and committees involving governments (two levels), consumers, medical boards, medical profession, bureaucrats etc. All of a sudden, a simple idea became a very complex one and all sorts of conditions started to be attached. After a lot of work, the end result didn't do much damage but it didn't do much good either.

A few years earlier, I was involved in developing legislation to amend the National Health Act to provide for Gap Cover Schemes. I was wondering what all the fuss was about getting legislation through the Parliament because everything had gone relatively smoothly until the legislation got to the Senate.

I suddenly realised that amendments to the legislation which we had nurtured and ushered through the Parliament were trade-offs in a much bigger deal involving the environment, Tasmania and family values.

If it wasn't for a wily Secretary General who had been down this road many times before, we may not have been happy with the outcome at all. The strategy involved various AMA people being camped in the key offices in the Parliament to head off any undesirable outcomes and we didn't leave until the legislation was through.

So it was with considerable trepidation that I read over Christmas that the AHIA was pushing for legislation to be introduced into the Parliament to make informed financial consent compulsory. Their idea involves making any part of the doctor's bill above the MBS fee level an unenforceable debt if there has been no informed financial consent.

This has the potential to go horribly wrong and we have sought a meeting with the AHIA on this. The AMA is already involved in a group called the Promoting Private Health Group which is chaired by former President, Dr Bill Glasson. That Group is looking at ways to improve the level of informed financial consent.

Doctors are a lot better at talking to patients about their fees than they used to be. It is mainly an issue in private inpatient care where the gaps can be large. Overall, about 80 per cent of these services are provided at 'no gap' so complaints are unlikely. Of the rest, discussing fees is widely practised but there are some patchy areas.

We are hoping to get some good quality materials developed which can be used in a campaign to raise awareness of IFC as an issue. The Government gave the health funds millions to run an advertising campaign for gap cover schemes. I still remember the umbrellas. We won't need millions but a little bit of money will help solve this issue for the Government and eliminate the need for any nasty legislation.

John O'Dea is Director of the Medical Practice at the Federal AMA

[Australian Medicine, Volume 18, Number 2, February 6, 2006, page 6]

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