2GB The Steve Price Show program interview with Dr Rachel David on PHI membership and out-of-pocket medical costs

Station: 2GB
Program: The Steve Price Show
Date: 21/08/2019
Time: 1:11 PM
Compere: Steve Price
Interviewee: Dr Rachel David, CEO, Private Healthcare Australia


STEVE PRICE: Dr Rachel David is the CEO Private Healthcare Australia. They listened to what we were talking about yesterday and wanted to make a couple of points. She’s on the line. Thank you very much for your time doctor.
RACHEL DAVID: G’day Steve.
STEVE PRICE: Every time we raise this, we get good and bad references to private health insurance. I don’t think you could get a better reference than the guy who rang me yesterday, Rachel, who had had open heart surgery, $50,000 bill and didn’t pay a cent because Bupa looked after him. And yet on the other hand, we had people calling us yesterday who talk about being out of pocket by many thousands of dollars.
RACHEL DAVID: Well look, I am concerned about particularly, some of the high out of pocket costs that people raise. But taking a step back, some of the data that the Government and the regulators released yesterday, showed that health funds are actually paying record benefits this year on behalf of consumers, more than ever before. And- so that if people are in health insurance, like yourself for the long haul, they will actually get value for money and benefit from it, you know, once they actually claim. Because the cost of being in hospital, are far higher than people realise and if they do want to go to a private hospital and get their surgery when they want it, from a doctor that they’ve chosen who will provide- who’s fully trained and will provide them with continuity of care, it really is worth the trouble. Now you’ve mentioned dental and that’s a big cause of concern for everyone because it’s a service that occurs outside of hospital. Now health funds can’t pay the gap, they’re not allowed to pay the gap for services that occur outside of hospital. They can for some dental services, but basically they can’t continue to chase higher and higher costs because that would put premiums up for everyone.
STEVE PRICE: So there’s not much point then having extras cover, covering dental then, is there?
RACHEL DAVID: Well a lot of people actually get dental check-ups and preventive dental services for no additional cost at all through excess cover and that’s important in terms of preventing dental issues.
STEVE PRICE: $26 back from 195, for a 10-minute procedure.
RACHEL DAVID: Look, I do acknowledge that there’s probably more that we could do with dental. I mean, one thing that’s occurring at the moment is that there’s an oversupply of dentists in the community and that’s causing the costs of dental services to come down. But there needs to be a lot more transparency on how consumers can choose a lower cost dentist and also perhaps more involvement to actually intervene in that market and create some lower cost options for consumers. And I think health funds can probably do some more in that area.
STEVE PRICE: Last time we spoke and I really appreciate you giving me this knowledge and I’ve been able to share it with our listeners and our listeners who’ve done what you’ve suggested are now telling me it works. This is checking before you agree to a medical procedure that would be expensive as to whether the medical professionals involved have signed up to what’s known as the GAP agreement, and that seems to work for people. Is that your advice?
RACHEL DAVID: Yeah look, and particularly when you’re at the GP and you get the sense that, you know, the GP is going to refer you to a specialist, it’s really important to raise if you have any concerns about money at that point. The visits to the specialist in the community are much quicker than going to a public hospital but they often involve an out of pocket. But if you can get the GP to refer you to someone who they know is good but doesn’t tend to charge large gaps, that’s a really good first step. Because if you’re in front of that surgeon or that doctor and they suddenly tell you that there’s going to be a big gap, it could be pretty tricky to back out, particularly if you’ve already had a big discussion about your medical problems.
STEVE PRICE: Yes. Because you do feel like, you know, once you commit, once you sit down in that waiting room with the specialist and you go in and, you know, it could be some fancy specialist’s office in Macquarie Street or somewhere, that you are beholden to go ahead with it. You’re quite right. So the GP’s time is the time to ask. Look, I mean, the point about this from a Government and from a public’s point of view, the more people privately insured, the better. Because I mean, obviously that takes pressure off the public system. But these figures show we’re down at 44 per cent, the Government wants it back to 55. What’s the industry doing to encourage more people to go back in or not to back out?
RACHEL DAVID: Well this year we were able to deliver a much lower premium increase than was expected. Really by taking very tight control of management expenses and by actually passing back some of the money that had been saved from that activity and the greater controls on things like [indistinct] back to the customer. The Government’s also helped us by working with us on some of the very high prices that were being charged by regulated high prices that were being charged by some of the multinational medical device companies for implants like hips, knees, cataracts, commonly used in … Perhaps one of the disappointing things that we’ve seen from the latest data is that in response to that, the device companies have simply pushed harder and sold far more medical devices into providers so the costs have just gone up again. So we really need much greater control within that area to help make sure that consumers get the care that they need, but also at an affordable price.
STEVE PRICE: We’ll keep in touch, thanks for being available for us today.
RACHEL DAVID: Any time Steve.
STEVE PRICE: Dr Rachel David there, CEO of Private Healthcare Australia.
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