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16 Aug 2017


One of the health policy issues of interest to members is that of doctors’ fees and patient out-of-pocket costs. Both have come under scrutiny as part of a Senate inquiry into the value and affordability of private health insurance and out-of-pocket medical costs.

The AMA has made a submission to the inquiry that will be made public in due course by the Senate committee. The AMA’s submission emphasises the dual nature of the Australian health system with public and private sectors working together.

The private health sector is a significant contributor to health care delivery. In 2014-15, 42 per cent of all hospital separations were funded by private health insurance; 50 per cent of separations were public patients; and the remainder were self-funded. The AMA submission focuses on the reduction in value of private health insurance, through exclusions and other restrictions, which has been a factor in the increased contribution by patients to the cost of their treatment.

The AMA points out that while costs of service provision have continued to increase, benefits have remained unchanged since indexation was first frozen in 2013. While re-indexing commenced in July 2017, MBS items related to specialist procedures will not be indexed until 2019. This too has added strain on the cost of service provision by medical practitioners.

Notwithstanding this, 86.6 per cent of services for hospital treatment were provided with no gap, and 6.5 per cent of services with a known gap in the March quarter of 2017.

Medical expenses are a relatively small proportion of total outlays by private health insurers at around 16 per cent. While there have been calls for greater transparency of doctors’ fees, there is no evidence that additional information will impact on either the level of private health insurance premiums, or patient out-of-pocket costs.

The AMA strongly supports the giving of informed financial consent.

Members will have received information about the process for the 2018 nominations and elections to Federal Council. One of the important entitlements of a member is the right to nominate for, and vote for, representatives on Federal Council, which is the peak policy-making body of the AMA.

As a consequence of the changes to the AMA’s Constitution in 2016, a member may be part of as many practice groups as are relevant to their practice. The practice groups are: general practice, private specialist practice, rural doctors, public hospital doctors, and doctors in training.

The State and Territory AMAs appoint eight of the members of Federal Council. The President and Vice President are elected at National Conference. The representative of Australian Medical Students’ Association is appointed by that organisation. The remaining positions on Federal Council are elected by the membership – 16 specialist representatives; five practice group representatives; and five area representatives.

I urge you to review your Federal AMA profile to ensure you are listed appropriately in advance of the nomination and election process that will start early in 2018.

Published: 16 Aug 2017