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15 Aug 2018

The AMA has called for more consultation on proposed private health insurance reforms, arguing that the changes will need to work with the Medicare Benefits Schedule (MBS) Review, which is still underway.

AMA President, Dr Tony Bartone, told a Senate inquiry into the Gold, Silver, Bronze, and Basic system that the AMA supports standard clinical definitions, as coverage for a condition should not vary between insurers and policies.

“Standard clinical definitions are one policy lever to stop this,” Dr Bartone said.

“But to make them work, we need to engage with each specialty within the medical profession.

“Right now, the Government has released the private health insurance rules for comment. They have done this before the Senate has finished its deliberations, before this legislation is finalised.

“These rules outline what the Medicare Benefits Schedule (MBS) items are that ‘sit behind’ the definitions.

“More time is needed on this critical work. It would be wise for there to be more consultation and a better outline of how these reforms will work in tandem with the MBS Review, which is of course updating all these items and their descriptors.”

Dr Bartone said the AMA welcomed the decision not to allow restrictions in the Gold, Silver, and Bronze policies, and acknowledged the effort the Government is going to, in order to make private health insurance more affordable for younger Australians.

But he urged the Government to be careful.

“We don’t support dismantling community rating. This must be protected to maintain equity of access to private health treatment,” Dr Bartone said.

The AMA is disappointed that pregnancy cover has been limited to Gold policies, he said.

“It does not make sense to us, as clinicians, to have pregnancy cover in a higher level of insurance only,” he said.

“Many pregnancies are unplanned, meaning people are caught out underinsured when pregnancy is restricted to high-end policies.

“Pregnancy is a major reason that the younger population considers taking up private health insurance.

“They are less likely to be able to afford the higher-level policies. We need to make sure it is within reach.”

The Senate Committee was due to report on 13 August.

Maria Hawthorne

Published: 15 Aug 2018