GPs demand more transparency from private health insurance industry

17 October, 2017

The Royal Australian College of General Practitioners (RACGP) says the shake-up of Australia’s private health insurance industry is a step in the right direction but far more needs to be done to improve policy transparency.

RACGP President Dr Bastian Seidel welcomed the changes announced by the Federal Government recently, particularly the introduction of more mental health services to be covered under private health insurance and commitment to fund only evidence–based treatments, but said Australians will still be caught out by their private health insurance policy unless further changes are made.

"Australian patients want transparency, not clever marketing," Dr Seidel said.

"Our private health insurance is currently too confusing, which means many people don’t understand what they’re signing up for.

"They think they’re covered for a procedure or treatment only to find out when they get to hospital that they’re not or, if they are, there is an enormous excess they must pay."

Dr Seidel said he was concerned the changes to the private health insurance industry may catch some patients out. 

"I am concerned Australians will get caught out by the initially cheaper policy," Dr Seidel said.

"What sounds affordable now could turn into a huge problem in the future when patients discover they have to pay an extremely high excess." 

Dr Seidel said the government must now step in to ensure private health insurance is based on a transparent value proposition, not branding.

"The private health industry is currently run completely inappropriately," Dr Seidel said.

"Patients aren’t sure how much they are meant to pay for treatment, so they’re avoiding it altogether.

"This completely defeats the purpose of having private health insurance in the first place.

"Patients must be able to clearly understand what they are paying for and the cost of their private health insurance excess."

Dr Seidel said he was pleased the changes would see the inclusion of more mental health services to be covered by private health insurance. 

"Quite often, mental health services are dramatically excluded from private health insurance," Dr Seidel said.

"Mental health issues dominate GPs’ time, so it does not make sense for them to be left off patients’ private health insurance.

"I am pleased this has been reviewed."

Dr Seidel said the government should also be praised for removing many non-evidence-based treatments from the list of treatments and services covered under private health insurance.

"Now there must be an absolute commitment to fund only evidence-based treatments," Dr Seidel said.

"Discontinued funding for quackery is a great thing for all patients."