AMA releases private health insurance scorecard

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The AMA has produced what it describes as a report card on Australia's private health insurers.

The report provides a range of information based on publicly available data. It is primarily focused on benefits paid by insurers to medical specialists for a limited number of procedures.

According to AMA national president Dr Michael Gannon, the report shows there are a lot of policies available that provide varying levels of benefits, cover, and gaps.

He used the report to double-down on criticism of the private health insurance industry, particularly Bupa following its recently announced changes to its Medical Gap Scheme.

The changes mean the scheme will no longer apply to the small number of private hospital beds not contracted by Bupa. It will require doctors to inform a Bupa insured patient whether they are going to be treated in a contracted hospital and what out-of-pocket costs they will face.

Releasing the report card, Dr Gannon said the changes were part of an attempt to introduced US-style managed care.

“Bupa’s new arrangements, which only provide maximum benefits for patients in hospitals with Bupa contracts, undermine the role of the doctor in providing and advising the most appropriate care - and could ultimately drive up out of pocket costs for patients

“Public confidence in private health insurance is already at an all-time low. These changes will further devalue policies, which are a major financial burden for Australian families, and will place dangerous pressure on the already stressed public hospital system.”

Bupa has previously described the claims as "scaremongering", arguing it simply requires doctors to inform patients of out-of-pocket costs that would likely happen before the change was announced.

Dr Gannon said the report card shows some insurers perform well overall, and some perform well only for certain conditions.

He again called for the abolition of basic cover policies, which he described as "junk". Department of Health officials recently said the abolition of basic cover policies would probably lead to an across-the-board 16 percent increase in private health insurance premiums.