ADA cautions senate enquiry examining the role of private health insurers in GP care

20 August 2014

A clear message was delivered by the Australian Dental Association (ADA) to Senators at the Inquiry into the Private Health Insurance Amendment (GP Services) Bill today in Sydney. Patient choice will be eroded and clinical autonomy of practitioners will be undermined if private health insurers are allowed to continue to enter into preferred provider arrangements that are more about the bottom line for PHIs than health outcomes for patients.

By providing some real world experience of the operation of the PHI industry in the oral health care sector, Mr Robert Boyd-Boland, ADA CEO, sought to give the Senators a snapshot of what general practice in Australia may come to look like if the private health insurance industry is allowed to fund the provision of GP services.

The Private Health Insurance Amendment (GP Services) Bill 2014, introduced by Senator Richard Di Natalie, seeks to close a potential loop hole in the law which may permit the opening up of Australia’s universal primary health care system to the private health insurance industry.

Mr Boyd-Boland said: “Our members routinely deal with the private health insurance industry, so the ADA is well placed to inform the Senate about the operational practices of the private health insurance industry. Our experience with the industry suggests that without better regulation by government, private health insurers will significantly impact on the delivery of optimal patient care in Australia.”

It was pointed out that in the desire for ever increasing profits, many private health insurers currently seek to:

a) limit choice for Australians to choose their own dentist;
b) limit access to dental care by Australians through restrictive business rules and policies which seek to dictate the nature of treatment allowed;
c) increase the out of pocket expenses for Australians by discriminatory rebate practices and poor annual increases in rebates;
d) artificially inflate the cost of dental consultations by non-preferred providers through their discriminatory rebate practices;
e) damage the nature of the dental care environment by damaging the family dentist whose primary goal is the health, welfare and safety of their patients; and
f) usher in a model of corporatised managed care in dentistry where profit is the sole motivator and the delivery of oral health care is strictly controlled by the industry rather than the dentist who is best placed to advise their patients.

All of this significantly compromises the delivery of quality care to patients.