Bupa says a new report by the Actuaries Institute calling for greater transparency in specialist fees and patient outcomes needs to be taken seriously.
The report, ‘How to make Private Health Insurance Healthier’, was released earlier this week and made a range of recommendations for reform of the sector.
The recommended reforms focus on enhanced transparency and measures to help address the affordability challenge, specifically focused on the 'supply side'. It says premiums reflect the combination of claims volume and cost.
"The best way to reduce the volume of claims would be to get everybody healthier, which obviously has broader benefits. Government and private organisations have a shared responsibility to continue to innovate and find new and better ways to drive health improvements. On the cost side, there are plenty of parts of the supply chain where inefficiencies may be targeted such as eliminating additional and hidden fees and continued prostheses reforms."
“The role private health insurers can play in reshaping their future is somewhat constrained by regulations that restrict their influence in large areas of the healthcare system,” says the report, pointing in particular to primary care.
The paper adds, "there are many inefficiencies in the supply side of private health ... including overly-expensive services being performed without supporting clinical evidence, over-priced prostheses items, and inefficiencies arising from the multitude of separately set prices relating to a single healthcare pathway.”
Bupa’s managing director of Health Insurance, Dr Dwayne Crombie, says the report should be taken seriously by all parties in the health system.
“These comments, by an independent organisation, show the value of Australia’s public/private health system to consumers,” said Dr Crombie.
“We have long maintained insurers are the canary in the coal mine, so to speak, when it comes to health system costs,” he added,