Australian patients missing out on innovations

Australian patients missing out on innovations as Health Fund Lobby drives a race to the Bottom Line

Susi Tegen of the Medical Technology Association of Australia (MTAA) today said Australian patients are missing out on innovative treatments because of an outdated system for approving new technologies, and the dishonest campaign being run by the Private Health Insurance lobby which appears more intent on slashing benefits than delivering better health outcomes for consumers.

“Patients in other countries have access to a world of new technologies that can be more effective, and often cheaper than what’s available to Australian patients,” Ms Tegen said.

“The MTAA welcomes reform of the Private Health Insurance industry, provided it achieves real outcomes for patients. Unfortunately the Private Health Insurance lobby appears to want an Americani sed system where patients and doctors lose control as insurance companies line their pockets.”

For privately insured patients to be able to access prostheses devices such as hip replacements or heart valves, that device must be listed on a ‘prostheses list,’ which struggles to keep up with improvements in technology. (see case studies overleaf)

“As we have seen many times over, newer, cheaper technologies not on the prostheses list are denied to patients on the whim of the health funds. Putting more power in the hands of massive private health insurers to choose how a patient is treated is a recipe for disaster for patients,” Ms Tegen said.

“Device manufacturers have seen no increase in benefits paid per device on the prostheses list in five years, while health insurance premiums have skyrocketed. The MTAA is pleased the Government is committed to reform which benefits consumers, but it must not be fooled by the smoke and mirrors of the powerful health insurance funds.”

According to a Galaxy Poll commissioned by health fund comparison website iSelect in March, 71 per cent of Australians with private health insurance will take some sort of action to change their cover when insurance premiums surge from April 1. Meanwhile Australia’s largest insurers have reported a 60% increase in profit after imposing above average premium rises.

Key statistics:

• Private health insurance premium increases have been more than 6% per annum, or 35% since 2010. 
• Growth in the average benefit paid per item on the Prostheses List between 2010 and 2015 was zero
• Prostheses benefits represent only 14% of hospital treatment outlays, compared to 16% for medical benefits and 70% for hospital accommodation benefit.