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Private Health Insurance – Paying for Value for Health Fund Members

5 Apr 2018, by Informa Insights

Much debate has taken place since News Corp’s publication of the AMA’s list of fees – in health insurance.

See AMA’s Private Insurance Report card for more details.


At Informa Insights, we did some research on what industry leaders have commented on this year’s controversial report.

National Seniors Chief Advocate Ian Henschke says in the News Corp report that the Australian Medical Association (AMA) was recommending specialists charge up to three times more than the Medicare fee for hospital, which showed “why many older people were struggling to pay health costs”. (Source)


Dr Rachel David, CEO of Private Healthcare Australia  – responds to report in News Corp Publications showing some specialists are charging 10-times more than the medicare fee.


“Health funds do their best to cover the gap for most surgical procedures, but they are unable to chase fees which continue to escalate above inflation, without causing premiums to go up for everyone. Transparency around fees and charges is critical for the sustainability of the private health system, which provides over two-thirds of elective surgery in Australia,” added Dr. David.



Dr David will be presenting a keynote address on ‘Private Health Insurance – Paying for Value for Health Fund Members’ at the upcoming Health Insurance Summit 2018.


The health care reform process is well underway – Changes should also be consumer driven. Consumers need more information, better tools for navigating medical specialist and out of pocket costs.


The 17th National Health Insurance Summit will provide discussion on legislative reform, regulatory changes, and the future direction of the Private Health Insurance (PHI) industry.

Register now to hear Dr. Rachel David’s keynote on how ‘Fraud, waste and low value care are costing the Australian health system more than $1 billion per year’.

In addition, Dr. Rachel David will also join a panel discussion regarding:

—— Accessibility to performance of surgeons and hospitals and post infection rates
—— What are the out-of-pocket costs prior to surgery?



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