Everyone waiting for reform announcement

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All is quiet as the private health and medical device sectors anticipate a reform announcement from health minister Greg Hunt.

The announcement, which is considered imminent, follows months of discussions with the sectors aimed at constructing a package of reforms designed to ease rising concerns over the affordability of private health insurance.

Private health insurance premiums have risen in recent years at around the same annual average rate of total health spending. However, according to Dr Rachel David, CEO of Private Healthcare Australia, private health insurance differs from the public health system because there is a direct price signal every year.

"The only way you can put downward pressure on health insurance premiums is to address input costs. There is no magic to it...all of the discussion about the complexity of the system or how health funds are structured, whether they're for profit or not for profit, is all window dressing," she recently told HealthDispatch.

Much of the sectors' attention, and that of policy-makers, has been on reform to the pricing of prostheses and the Prostheses List.

Debate has raged over the extent of a price differential between what is paid for prostheses in the private system compared to what is paid in the public system, with heavily disputed figures ranging from $300 million to as much as $800 million ever year.

CEO of the Medical Technology Industry Association, Ian Burgess, acknowledged a differential in a recent interview with HealthDispatch, of around $300 million, but argued much of that related to the additional cost of choice and the services provided by medical device companies.

He cautioned that, if reform goes too far, in the form of price cuts, Australians with private health insurance might be left paying gap payments for prostheses.

Minister Hunt has said he expects his reform package will deliver "hundreds of millions of dollars" from prostheses and a strategic agreement with MTAA. However, it remains unclear whether it will also include changes to the Prostheses List.

hearts4heart CEO, Tanya Hall, urged Mr Greg Hunt not to forget patients in the reform process.

According to Ms Hall, whose organisation represents people living with atrial fibrillation, price cuts to prostheses might be required but the focus must remain on the needs of patients. 

She has been an outspoken advocate for the inclusion of catheter ablation on the Prostheses List. Catheter ablation involves the use of a non-implantable medical device that cost around $9,000. As a non-implantable device, with the catheter removed from the body after the procedure, it does not meet the criteria for inclusion on government's Prostheses List. 

"We want catheter ablation in the PL and something needs to be done urgently," said Ms Hall.

Mr Hunt's reforms are also expected to include major changes to the way private health insurers fund mental health services.