Private Healthcare Australia CEO Dr Rachel David says the AMA’s "scaremongering" about health funds accessing My Health Record data demonstrates an astonishing level of ignorance about how health insurance operates.
In an interview with ABC Radio National earlier this week about My Health Record, AMA president Dr Tony Bartone said, "We're very, very happy with the current robust requirements that prevent the access to that de-identified data to private health insurers. We fear that if they were given the opportunity to access that data, they could reverse-identify the data, and that would be a serious threat to the community rating principle that is the cornerstone of equitable policies in the community."
In response, Private Healthcare Australia said community rating could not be impacted by health insurers having access to My Health Record data.
"Private health insurance is based on the principle of ‘community rating’, which means consumers pay the same premium for the same policy regardless of their current or potential health status," said Dr David.
"It is illegal for health funds to exclude a member, or alter their premium based on their health status or potential health status. Private health insurance differs from general or life insurance in this respect, as these are risk-rated.
"Like Medicare, health funds are prevented from discriminating between people on the basis of their health or for any other reason. Therefore health insurance policies depend on the depth and breadth of cover sought but not the health background or age of the policy holder."
Dr David said health funds are only interested in accessing data at the secondary use level.
"This is population level data that has been de-identified, and is used for health systems research, that being how to improve the quality, safety and cost-effectiveness of health services and better co-ordinate patient care. This level of access has been granted to all other health system stakeholders, and health funds, most of which are also health service providers should also have access to it as well.
"Health funds have repeatedly confirmed that they are not interested in any form of data from the My Health Record whereby individuals or members could be identified."
Dr David highlighted the results of a recent survey conducted by Healthshare, and published in HealthDispatch today, that found 70 per ent of GPs surveyed were either unsure or believed that if a patient discussed their medical history with their health fund, it could impact their premium.
"This is completely incorrect," said Dr David.
"Community rating is a crucial part of our health system, both for Medicare and private health. It ensures that private cover is equally accessible to anyone who needs it and enables health funds to help take the burden off the public healthcare system."