The Australian Society of Ophthalmologists (ASO) has welcomed legislation targeting private health insurance ‘product phoenixing’, while calling for care in how specialists’ fees are presented to patients.
Product phoenixing refers to the practice of closing a policy, then offering a near-identical one at a higher price.
The legislation, which passed federal Parliament in September, requires insurers to seek ministerial approval for premiums on new products and for certain changes that reduce the cover or value of existing products.
The ASO gave the move to outlaw product phoenixing its “strongest support”.
The legislation… requires insurers to seek ministerial approval for premiums on new products and for certain changes that reduce the cover or value of existing products.
“We continue to see disingenuous behaviour from private health insurers towards both patients and the healthcare providers who deliver care,” ASO Chief Executive Officer Katrina Ronne said.
“This is something the ASO has advocated on for many years, and we will continue to hold them to account.”
The reforms also allow the government to publish the fees individual specialists charge and likely out-of-pocket costs through the Medical Costs Finder (medicalcostsfinder.health.gov.au).
The ASO said it has always backed measures that genuinely help patients understand what they are paying for and why. However, ASO President Dr Peter Sumich cautioned that a fee published without context can mislead as easily as it informs.
“The fee for seeing a specialist reflects expertise, responsibility, and the cost of providing a medical service in an inflationary small business economy,” he said.
“With transparency comes attribution, and we believe patients will be shocked but not surprised when they see how little the private health insurers are contributing to specialist fees – it is absolutely appalling.
“For this to work for patients, the data must be accurate, current, and presented with proper context.”
The ASO is participating in a working group advising on how the fee information will be presented.
