Author: Team

[vc_row][vc_column][vc_column_text]The potential benefits remain and much of the policy to date is sound. Trust and confidence can be improved through consideration of the recommendations of the report and further legislative amendments to reflect key recommendations.

The CEO of the Consumers Health Forum, Leanne Wells, said she expects the Government to work collaboratively to pass legislation before the opt-out period ends. There has been enormous public investment in getting MHR to this point, and CHF would welcome bipartisanship around additional amendments that further strengthen the policy intent and protections.

Policy and implementation need to align before any records are created. To meet the intent of legislative amendments to address privacy concerns, it is CHF’s view that these must be passed before the end of the mid November opt-out period, and that ideally no records should be created following the opt-out period until the implementation of those amendments is complete.

“It is heartening to see much of the advice submitted to the inquiry by CHF included in the report. Realising the potential of MHR requires the Australian people to have confidence that their health information is used for their benefit, with their consent.”

“CHF welcomes the Report’s recommendations to provide more legislative clarity around the secondary uses of MHR data, and further education and communication campaigns to improve understanding and use of MHR.

“The ‘digital divide’ is real and, as the Committee has said, it is important that additional effort is made to identify, engage and provide targeted support to vulnerable groups to ensure they can make an informed choice about opt-out and, if they stay in, know how to adjust their controls.”

“Consumer access to their own health records through MHR is a key step in the shift from health consumers as passive patients, to consumers as active partners in their own care.

“Further communication and education should continue to include benefits and assurances about safeguards and risk mitigation strategies, but most importantly, must now begin to include more information about how to use MHR, both in terms of how to manage its access controls, and how to use it as a tool to improve health.

“Many Australians are already finding the system beneficial in their circumstances. Providing avenues for better understanding and use of MHR is the essential next step in its ongoing development,” Ms Wells said.[/vc_column_text][/vc_column][/vc_row]

[vc_row][vc_column][vc_column_text]AOA President Dr David Martin said the reform process to date does not appear to be consumer focused, “Rather than focus on the consumer, the real nuts and bolts of the reform is on exclusions, where it seems to be more about what insurers are prepared to provide within certain actuarial constraints, rather than what patients with private health cover require.

“Many private patients without “Gold” insurance will only discover they were inadequately insured when they reached the stage where surgery was the required treatment. AOA members frequently report experience of patients disappointed to learn their health insurance doesn’t cover treatment by joint replacement of their disabling arthritis (when all non-operative measures exhausted). The current system seems to be going to perpetuate this confusing situation.

Bizarrely the new system covers podiatry services at lower tiers including surgery and joint replacement and prostheses insertion even though these health providers are neither specialist surgeons nor have a system of monitoring outcomes like the National Joint Replacement Registry. The NJRR has already saved about AUD$600 million over last ten years by encouraging wise prosthesis choice.

“Insurance is meant to protect people against unaffordable financial risk, but with the present model the opposite is occurring. Patients with non-Gold insurance will only be covered for cheaper medical problems and be excluded from resource intensive problems like spinal fusion and joint replacement. Joint replacement surgery is potentially a very cost-effective intervention with good improvement in quality of life sustained over decades. Patients who can’t afford to increase their cover to Gold or pay for the surgery themselves, will be forced into the public system. The result will be an enormous cost shift from the private health system to the state-run public system.”

“This makes the decision about choosing policies that rely on exclusions a major gamble,” Dr Martin said.

AOA is calling on the Government to revisit its modelling of the traffic-light classification system by putting the Australian consumer first, rather than the profit levels of Australian private health insurance companies.

“We are urging the Federal Government not to rush, or rubber stamp these reforms. It warns changes to how orthopaedic surgery is covered requires urgent and careful collaboration with the specialists who work in the field, otherwise a sub-optimal reform will occur.

“The AOA actively supports efforts to reduce policy variation and make health insurance easier for patients to understand; however, the proposed reforms will continue to leave patients open to nasty surprises about their coverage when medical treatment is required,” said Dr Martin.[/vc_column_text][/vc_column][/vc_row]