Media release

AMA and private healthcare sector leaders agree on need for reform

Leaders from across the private health sector met in Canberra today at an Australian Medical Association workshop to discuss what reforms are needed to ensure the sustainability of the sector into the future.

Private health insurance building blocks

AMA President Professor Steve Robson brought together leaders from across the sector, where there was general agreement on the need for reform, including on out-of-hospital care models.

Addressing the workshop, Professor Robson said the private health system was an essential pillar of the health system, and the impact of a struggling or failing private system on the public system would be enormous.

“The private system continues to provide essential care alongside our public system, ensuring patient choice and access to the specialists, treatment and surgery many Australians need,” Professor Robson said.

“This is why so many Australians have chosen to invest in private health insurance. But we know there are issues that must be resolved to ensure the system remains sustainable.”

Professor Robson said the AMA’s recent research report on out-of-hospital care demonstrated the fragmented and complex nature of the system — a system in which some patients were disadvantaged and didn’t have the same access to new and effective models of care.

“Our report showed that while some hospitals and insurers provide out-of-hospital care, it is not universal, and therefore not available to all patients, and doesn’t always involve shared decision making. For those who do have access, their clinician isn’t always involved. One of the reasons for this is that regulation and legislation are complex, and don’t encourage or support these new models of care.

“From the patient perspective, this is not ideal. Regardless of who a patient is insured with, they should have access to these great models. But we don’t have consistency in product design, models, or financial arrangements.”

The workshop generated wide-ranging debate on the most pressing issues facing the system, the barriers to reform and opportunities for change.

Following the workshop, Professor Robson said the agreement on the need for reform was evident at the workshop and while there were differing views on what that reform might look like, the willingness of everyone to come together and discuss solutions was encouraging.

“Any discussion about reform needs to consider the views of all stakeholders in the system, and today we had some great debate on the issues in the system and possible solutions to those,” he said.

“We will be using the outcomes of the workshop to inform our ongoing advocacy to government on private health reform, including the need for a mechanism that can drive cohesive reform that benefits the sector and ensures the sustainability of this important part of the health system.”

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