Shepherd Takes on His “Anti Consumer” Critics – 25 May 1999

Dr Bruce Shepherd, chairman of the Australian Doctors Fund said today that attempts to paint him as anti-consumer for raising concerns about a scheme to eliminate gaps for private health insurance were uninformed and misleading.

“Patients are being misled in this debate,” said Dr Shepherd. “Some patients do blame medical gaps as the reason for them not taking out private health insurance,” said Dr Shepherd. “However, most cite higher premiums as the reason for their reluctance to either stay in or take out private cover.”

“But to put forward no gap health insurance as the panacea is a smokescreen hiding a failed health policy on private health insurance”, he said.

“The proposals being put forward at the moment would simply push up patients’ premiums and make interference in clinical practice inevitable, even if there were no contracts”, he said.

“The Australian public is not being told the truth in this debate,” said Dr Shepherd. “It is being presented as a simple equation with myself and a group of conservative specialists on the one side wanting the status quo and group of progressives led by Dr Wooldridge and his supporters on the other side getting rid of gaps and cutting health insurance costs.”

But it is not as simple as that.

He said “no gap” insurance products would be:

  • more expensive for patients
  • more expensive for hospitals
  • more expensive for health funds.

Already the health funds have been offering front end deductibles to counter rising premiums hence the health funds themselves have introduced “a health fund gap” of between $500 and $1,000 for around 40% of all people with private health insurance.

Further increases in costs will only see more health fund members taking out the maximum “deductible” health fund gaps.

This debate is really about the right of patients to get quality care from their doctor. It is about the right of choice and the right of affordable private health insurance.

Already Mr Russell Schneider of the Australian Health Insurance Association hasbeen publicly embarrassed by admitting when he thought no-one was listening that the health funds want to attract ‘yuppies’ ie, young couples with high incomes who don’t get sick.

As costs mount to health funds because they have taken on extra costs they will inevitably have to look to ways to cut back on these costs – either by restricting access to care, restricting the type of care or cutting length of stay, he said.

An AMA document on gaps without insurance suggests that the Health Minister would have the final say on any no gap schemes. “That has not worked with health fund premiums. Why would it work with gap insurance for doctors?” he asked.

Leading private hospitals in Sydney are already on the financial brink, he said. If they are negotiating individual case by case deals with doctors they will be forced to look at ways to save on doctors’ costs. Many of these savings will not benefit patient care – they will simply impose more and more restrictions.

Already three of Sydney’s leading private hospitals- the Sydney Adventist hospital St Vincent’s Private and the Mater have been forced to apply to the Australian Competition and Consumer Commission to jointly negotiate on contracts with health funds in order to survive.

“Funds have been squeezing hospitals,” said Dr Shepherd .”Length of stays are being cut. Patient care is being rationed. This process is already happening – it is not going to suddenly stop with no gap insurance deals which will introduce new cost pressures to an industry which is already hurting.”