Private Health Insurance: What Consumers Want. Anna Greenwood. Deputy Chief Executive Officer. Presentation to the 2012 PHIO Industry Seminar

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1 Private Health Insurance: What Consumers Want Presentation to the 2012 PHIO Industry Seminar Anna Greenwood Deputy Chief Executive Officer

2 Consumers Health Forum Advocates for appropriate and equitable healthcare Undertakes consumer-based research Raises the health literacy of consumers, health professionals and stakeholders Provides a strong national voice for health consumers and supports consumer participation in health policy and program decision making.

3 Consumers and private health insurance Many of our members take out insurance because they, or a family member, experience a chronic condition that requires frequent treatment. Private health insurance is very important for these people they need access to the level of care available in the private system Similarly, in some locations in Australia some consumers believe private health insurance provides access to services not readily available in the public system.

4 Changes to the Private Health Insurance Rebate what do they mean for consumers? Uncertainty conflicting messages Cost implications short and long term Pre-payment risks and benefits Implications of changing the level of cover

5 Putting the rebate tiers in the broader health context PHI rebates represent a substantial investment in the health system by Government. In a context of rising health costs and health system inequality is this the most appropriate and effective use of these funds? We need to think about the overall sustainability of the health system.

6 Two speed health system Particular health challenges are faced by: the elderly (most likely to have low incomes) the 800,000 Australians on disability pensions (mental health accounts for over 30%) the long term unemployed people who are dependent on welfare (usually with compounding issues) those in the most marginalised communities, including rural and remote

7 Rising out-of-pocket costs individuals contributed 18% of total health funding through out of pocket costs Out of pocket costs are high when compared to other countries

8 Costs are a considerable barrier for some consumers 8.7% of consumers delayed or did not see a GP due to cost in % of consumers referred to a specialist delayed or didn t see the specialist 26.4% of consumers delayed or did not see a dentist

9 Those experiencing disadvantage are the most affected Source: COAG Reform Council Healthcare : Comparing performance across Australia

10 People with private health insurance experience fewer barriers Percentage of population 15 years and over who needed a health service but delayed using or did not use it due to cost - by health insurance status 40.2 Has PHI No PHI General practitioner Medical specialist Dental professional Prescription for medication Pathology test Imaging test Table based on figures from Australian Bureau of Statistics 2011 Patient Experiences in Australia: Summary of Findings , table 6

11 A system under pressure While the Australian health system has many strengths, it is a system under growing pressure, particularly as the health needs of our population change. We face significant challenges, including large increases in demand for and expenditure on health care, unacceptable inequities in health outcomes and access to services, growing concerns about safety and quality, workforce shortages, and inefficiency. - NHHRC, A Healthier Future for All Australians

12 Other strategies to consider Assessing the evidence base for health services eligible for benefits Expanding the range of health practitioners whose services are covered by private health insurance

13 Conclusion We need to think about how investment should be targeted to achieve the best possible health outcomes for all Australians. We have to monitor consumer experiences and health outcomes to ensure policy changes are delivering the desired outcomes and don t have unintended consequences.

14

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