MBF Must Come Clean On Hospital Cutbacks – 23 February 2001

Only 77 out of 150 private hospitals in NSW have been listed by health insurer MBF as preferred providers, according to the MBF website, the Australian Doctors’ Fund said today.

The MBF website strongly promotes the advantages of using a network hospital, including, out of pocket costs less likely, a single bill including drugs and physiotherapy, and more outpatient programs covered.

“But nearly half of NSW private hospitals have been left out of this list,” said ADF Executive Director, Mr Stephen Milgate. “The exclusion of many hospitals, particularly smaller private hospitals, should be of great concern to all those who believe that health fund members must have equality of access to all accredited private hospitals”, said Mr Milgate.

Some of the non-network hospitals include psychiatric hospitals, who were not required to tender, but the remainder include hospitals who have been told they are not preferred providers and must apply for “second tier default benefits”, or hospitals who simply cannot reach agreement with MBF. Most network hospitals were informed last December that they had successfully won a tender with the fund.

Non-network hospitals, to date, include leading teaching hospitals St Vincent’s Private, the Mater, the Sydney Adventist as well as a number of smaller hospitals in the city and country. The hospitals concerned have been asked to apply for “second tier default benefits” and patients using them may have to pay more for the privilege.

Mr Milgate said that situation meant many millions of newly insured members were not getting what they thought they were paying for – equal access to the hospital of their choice.

“For the last financial year health funds made $344 million in profits – 1.6 times the previous highest profit and next year experts are expecting profit levels to be three times as high as this year. Yet, rather than share the profits with hospitals and patients, health funds seem to be determined to control and squeeze private hospitals,” said Mr Milgate.

“Even if many of these hospitals do eventually reach agreement with the health fund it will be under terms that many of them find draconian and working against high quality care,” said Mr Milgate.

“The government has committed two billion dollars of taxpayers’ money to private health funds to relieve the pressure on public hospitals, and now we have a health fund making private health insurance harder to use,” said Mr Milgate.

“Instead of publishing a table of benefits for all hospitals accredited by the Australian Council on Healthcare Standards (ACHS), MBF is playing we love you, we love you not with members’ and taxpayers’ money.”