NSW government pushes for private insurance to cover GP visits

The NSW government will advocate to allow private health insurers to cover visits to general practitioners, in what would significantly extend the power and reach of the industry.

From the Sydney Morning Herald, by Harriet Alexander.

A submission to the federal government’s review of the private insurance industry advocates a greater role for private health insurance in primary care, particularly to manage people with chronic conditions and prevent them from going to hospital.

Critics have warned that allowing private health insurers into GP practices will create a “two-tier system”, because those with private cover will get longer consultations and preventative care, while those who cannot afford it will get more superficial treatment.

Opposition health spokesman Walt Secord, who obtained the submission under freedom of information laws, said it revealed the NSW government did not support a public health system.

“This submission is brutal in its honesty as it reveals the Baird government’s true intentions on health and hospitals,” Mr Secord said.

“It is now clear that they want a two-tier system: one for the well-off and another for everyone else.”

The submission says there is scope to expand the role of private health insurance to manage people who have or are at risk of complex health conditions, using the Netherlands and Germany as examples of where this occurs.

In the Netherlands, insurers pay a single fee to cover the primary care of patients suffering from certain conditions.

In Germany, patients can fully substitute their core coverage with private insurance.

The submission says subsidies for ancillary services that are not covered by Medicare, such as dental, should not be ceased as this may encourage members to drop their insurance cover, but recognises that some polices have so many exclusions they are rendered meaningless.

“The ‘fine print’ exclusions and restrictions that may apply can result in a meaningless product for consumers, creating confusion and frustration,” the submission says.

“It can also drive consumers to the taxpayer-funded public sector instead of accessing care in private hospitals using their private hospital insurance.”

The private health insurance industry is under pressure from consumer groups after the federal government announced it would approve a 5.59 per cent increase to insurance premiums next month.

The federal government is running consultations into how the private health insurance can provide better value for consumers, which will include ways to improve transparency around policies.

NSW Health deputy secretary of strategy and resources Elizabeth Koff said private health insurers were already heavily involved in the funding of primary care delivered in the community with treatments such as physiotherapy, optical and dental services.

The NSW submission reflected on the need for the public and private sector to co-ordinate their efforts in GP practices and hospitals to tackle chronic disease, she said. “NSW Health is not advocating a two-tiered system.”

Federal Health Minister Sussan Ley has said that the government will not allow private insurers into GP practices.

University of Sydney public health professor Lesley Russell said there was little evidence to support the statement that tax levers were an effective way to get people to take up private health insurance.

“There’s the apparent desire to see private health insurance enter the primary care sector and the delivery of comprehensive care, but there is no recognition given to the fact that funds have already tried this and for the most part scaled back their efforts,” Professor Russell said.

Health Minister Jillian Skinner said the government was investing record amounts in capital works to enhance the public health system.

“This is another example of Walt Secord playing politics with health,” Ms Skinner said.

“The record of this government speaks for itself.”


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