Banking & Finance | Healthcare

2019 a key year for PHI reform

8 Mar 2019, by Amy Sarcevic

2019 looks set to be a key year for private health insurance with the Australian Government this week confirming it will fund the development of a nationally searchable website to promote the transparency of medical specialist fees; with a complementary education initiative for consumers, GPs and specialists.

The website will provide information on the costs of specialists services, in a bid to tackle excessive ‘out of pocket costs’ that have left many consumers questioning the value of their PHI policies.

Professor Brendan Murphy, who chaired the Ministerial Advisory Committee on Out of Pocket Costs is to present at the Health Insurance Summit – June 2019, where he’ll discuss key recommendations made to the Minister last year.

“The general public need to be aware that, when it comes to medical specialist services, there is very often no relationship between pricing and quality”, said Professor Murphy ahead of the Summit.

“A minority of specialists are charging disproportionate and unjustified fees that can cause financial harm to both the general population and, in turn, the PHI industry.

“These measures and other actions by the PHI industry itself can contribute to less skepticism toward PHI and have a positive impact on uptake in Australia.”

However, not all of the – actual and proposed – reforms are positive and the PHI industry may have to saddle up for its most important inquiry in years, depending on the outcome of the election.

This will be overlaid by the challenge of a 2×2 premium environment, which will need to be fully absorbed and managed.

Former PHIAC CEO Shaun Gath is also due to address the Summit and said, “Irrespective of how the politics plays out, the sector will have to build a new relationship with a regulator which has been bruised by the Banking Royal Commission.

“A strong regulatory response across the financial services sector has been promised; and PHI will be in the firing line too.

“PHI will continue to play a key role as a pillar of the health system, but must also adapt and change to meet the evolving health needs of a growing and ageing population”.

Leveraging his seven years’ experience as PHIAC CEO, Shaun will take a critical and candid look at proposed and existing PHI policies, outlining his key concerns and suggestions for a more effective PHI market.

You may download the full agenda here.

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