Transcript - Medibank Private

MICHAEL BRISSENDEN: The Australian Medical Association has accused the health insurer Medibank Private of refusing to fund a number of key procedures at some hospitals.
Medibank has been negotiating a new agreement with Calvary hospitals in three states, which could see patients charged out-of-pocket costs for some hospital care.
But the health insurer insists it's trying to keep health care affordable. 
Bridget Brennan reports. 
BRIDGET BRENNAN: Calvary Health Care runs 15 public and private hospitals in the ACT, Tasmania, and South Australia.
But contract negotiations with the hospitals and the nation's largest health insurer, the newly privatised Medibank Private, have stalled.
The company's executive general manager is Dr Andrew Wilson.
ANDREW WILSON: At the moment we've been unable to agree terms for a continuation of our contract with Calvary. We're obviously very happy to continue talking to them about that and we would hope that agreement is still possible at this time.
It's up to Calvary to determine whether they wish to charge our members additional fees over and above the amount we pay them.
BRIDGET BRENNAN: Calvary says some patients won't be covered for a range of procedures - and in some cases re-admission to hospital - if they're insured by Medibank Private.
That's angered the AMA president Professor Brian Owler.
BRIAN OWLER: This is going to put an enormous strain on our hospital system - not just in terms of the private system but the public system as well. 
We know that there will be patients that won't be able to be readmitted should they develop problems with their wound or other complications, and that will have to go to the public hospitals.
There are other patients that won't be able to afford the out-of-pocket expenses that Calvary will have to charge. 
Now the AMA has nothing to gain in this argument except to say that we will not stand by and let Medibank Private continue to act in this manner.
BRIDGET BRENNAN: Medibank Private says it wants hospitals to take some of the cost of 165 so-called "highly preventable events".
Dr Andrew Wilson says that will reduce mistakes like bedsores, falls and surgical complications.
ANDREW WILSON: Medibank, we're really concerned to keep healthcare affordable and ensure the best possible outcomes for our members, and preventing unfortunate mistakes is part of that.
The key thing is keeping premiums affordable. Our members are telling us every day that premiums are becoming increasingly unaffordable. 
We are only interested in increasing, I guess, the accountability of hospitals - and many of Australia's leading hospital groups entirely agree with us on this and they've already agreed to these criteria - so, in fact, Dr Owler works in one of those hospitals.
What we want to do is increase the ability of organisations like Medibank and hospitals to work together to reduce these events, and where events occur that are clearly not preventable, then of course Medibank will be paying for those.
BRIDGET BRENNAN: The AMA president, Professor Brian Owler, wants the Federal Health Minister Sussan Ley to intervene. 
BRIAN OWLER: To say that the Government does not have a role in this dispute is ludicrous. 
First of all, this dispute is in part the creation of this Government. It was this Government's policy that actually put Medibank Private on the stock exchange, created the biggest private health insurer where the responsibility was now the shareholders and concentrating on returns to investors.
BRIDGET BRENNAN: In a statement, Calvary Health Care says Medibank's new measures would restrict hospital access for patients.
MICHAEL BRISSENDEN: Bridget Brennan.

20 August 2015

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