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  • 5 months ago
If you're one of the more than 14 million Australians with private health insurance, you're being shortchanged by big insurers. That's the allegation by the peak private hospital body, in a dramatic escalation of a long-running conflict with its rival. It's now calling on the Prime Minister to step in and mandate a code of conduct, but insurers deny the allegations.

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00:00With many private hospitals under increasing strain, the peak body has written a letter
00:06to Prime Minister Anthony Albanese pointing the letter at insurers and calling for a voluntary
00:12code of conduct to be made mandatory.
00:15In the letter, the Australian Private Hospitals Association's Chief Executive Brett Heffernan
00:20argues that many private hospitals are on the brink of collapse, with the folding of
00:25health scope and about 70 other smaller operations nationally since 2020.
00:30And he leaves much of the blame at the feet of private health insurers, detailing a raft
00:36of allegations about their conduct, including that alleging that private insurers are misusing
00:42their market power by issuing contracts that leave no room for negotiation, and also saying
00:47that insurers effectively are delaying entering new contracts with hospitals, so they're
00:53forced to run on previously agreed lower prices.
00:57Take a listen to the Australian Private Hospitals Association's Chief Executive Brett Heffernan.
01:03People with private health insurance are getting less for their money year on, year out.
01:08They're getting less choice, less access, and quality is being compromised, and that means
01:14that your insurance dollars aren't going as far as they should.
01:18The industry's peak body, Private Healthcare Australia, says that there's already a voluntary
01:23code of conduct that's overseen by the ACCC and the Commonwealth Ombudsman, and when it
01:29comes to those allegations of anti-competitive contracting processes, Private Healthcare Australia
01:35CEO Rachel David says they're simply not true.
01:38Take a listen.
01:39And the contracting process puts a bit of friction in the sector to keep downward pressure on
01:47premiums and keep them affordable for consumers.
01:50That's not to say the contracting process is foolproof.
01:55So the federal government's actually reviewing it formally, and there's a collaborative group
02:00with private hospitals and private health insurers called the CEO Forum, which is currently
02:06reviewing the contracting process.
02:08It's been in place for a few decades now, and I think it is ripe for an overhaul, but
02:13I would utterly reject those comments about take it or leave it contracts.
02:17There's tough behaviour on both sides.
02:20With private hospitals declaring the multi-billion dollar sectors at a crunch point, the federal
02:25government last year took the unusual step of asking them to open up their books so it
02:30could try to see what's going on, what's leading to these issues.
02:34But getting to the bottom of the problem has been made more complicated by claims and blame
02:39on both sides that the other isn't being transparent.
02:44And I spoke to an expert, the Grattan Institute's health program director, Peter Brayden, who said
02:48that this relationship has turned toxic and unless something is done, this fighting will continue.
02:53In a statement, a spokesperson for Health Minister Mark Butler said a forum had been comprised
02:59of stakeholders and experts to try to get to the bottom of this issue, to try to improve
03:04the financial viability of the sector, and that as part of that they would look at whether
03:09regulation was fit for purpose.
03:11The spokesperson said while the Health Minister reserves the right to intervene in the regulatory
03:16process if he deems it necessary, his clear preference is for those who have a stake in this sector
03:23to come up with a workable solution themselves.
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