Price cuts are fine but don't forget patients

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hearts4heart CEO, Tanya Hall, is urging health minister Greg Hunt not to forget patients as he prepares to announce reforms to private health insurance and the pricing of prostheses.

Mr Hunt has been negotiating a package of reforms with the sector designed to address rising concern over the affordability of private health insurance. The reforms are expected to include changes to the pricing of prostheses.

However, 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.

hearts4heart has been outspoken in calling for intervention from Mr Hunt on the inclusion of catheter ablation on the Prostheses List.

Catheter ablation is surgery that seeks to correct electrical short-circuits that make the heart beat irregularly. It 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. Inclusion would compel private health insurers to fund the procedure.

"We've been advocating on this issue for three years. Catheter ablation is our focus because it impacts so many people, who are either missing out, or waiting up to two years on public hospital waiting lists," said Ms Hall.

The completed Senate inquiry into the pricing regulation of the Prostheses List recommended the Prostheses List Advisory Committee (PLAC) investigate a mechanism for the reimbursement of medical devices not currently eligible for inclusion on the Prostheses List, including non-implantable devices such as catheter ablation.

In its response, government noted the recommendation and confirmed the PLAC was considering the criteria for inclusion on the Prostheses List (PL) and "other reimbursement options, such as theatre banding and case based payments."

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

She said patients are unsure but remain hopeful the minister will negotiate an outcome that provides a clear pathway for the consistent private funding of catheter ablation.

"It could go either way but I would be angry if our patients are being used as a negotiating chip. This simply needs to happen and both minister Hunt and his shadow, Catherine King, are aware of our position."

"This could take years, and we don't want that, we have already been advocating for three years," she said. "We can't afford to wait because people are dying and having strokes. This needs to happen now and while we back the pricing review any savings cannot be achieved at the expense of patients."