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Health insurance buyers beware: you could be getting what you pay for


Australia’s private health sector is losing sight of the principles on which it was founded, argues Health Partners CEO Byron Gregory.

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The noise in relation to private health insurance has reached a crescendo in recent months. Some of it has been useful and some of it downright confusing, particularly as the issue has been used as a political football.

Fortunately for consumers, there are some positives to emerge from the recent debate, if you can wade your way through the rhetoric, relating directly to increased transparency and the depth of information being provided.

As an example, for the first time that I can recall there’s been public discussion about the role of comparison sites which, to the surprise of many, has revealed they don’t represent all funds and they collect a commission from funds for every sign-up.  Essentially how it works is that funds determine how much they want to spend with comparison sites such as iSelect, Choosi or Compare the Market and that’s then reflected in referrals. Don’t get me wrong, these sites certainly have a role to play in terms of creating an easy go-to for consumers who aren’t inclined to do the research themselves, but people should know exactly what they’re getting.  It’s also worth noting they’re an expensive option for health funds to secure new members and that ultimately plays into overall costs.

Likewise, One Big Switch, which has trumpeted its own success, collects a commission from the selected fund that puts an offer to the private health insurance customers who choose to sign-up. The offer, which usually includes a one-year sweetener, leads to further churn in the market as people shop around for so-called ‘deals’, which costs the industry more money and inevitably increases cost pressures.

So, while consumers have probably learnt more about private health insurance in recent months than ever before, unfortunately it’s still a minefield and in many instances people are still only getting half the story.

After all your health isn’t a commodity. It’s your greatest asset, and is not one that should be bought and sold in the marketplace, without your needs being put front and centre.

Take, for example, the recent premium increases. The average overall increase for a fund is released publicly, and sent to the privately insured as written advice, without any further explanation.  If it’s a national fund, the increases can vary markedly state-by-state, so in South Australia you may actually be paying an increase that’s higher than that announced by the fund. And then there’s the question of how the increase impacts on your overall cost. For example, if a fund announces a 5% increase but it’s off a higher base than another fund which has say a 6.5% increase off a lower base, then you could still be paying more for a comparative product, without realising it.

My message is look beyond the marketing and don’t be afraid to ask questions. As the CEO of South Australia’s largest not-for-profit health insurer, I support any changes which make it easier for you, as a consumer, to determine the best option for you and your family, based on real information as opposed to spin.

After all your health isn’t a commodity. It’s your greatest asset, and is not one that should be bought and sold in the marketplace, without your needs being put front and centre.

Unfortunately the private health sector is becoming more commercialised and therefore commoditised.  The principles on which health insurance was born in Australia, which rested with member-owned not-for-profit funds, are being eroded in the drive towards profit.

The industry must listen to the very clear message from consumers and respond to the call for less hard sell and more ‘quality’ information, products and services.   That means it’s time to get rid of junk policies that offer little cover and are often sold through the enticement of unrelated incentives.  Instead, we need to arm consumers with the knowledge and information they need to make informed choices about the cover that is right for them.  To start, there are some basic questions you should ask your insurer if you have private health insurance already and certainly any prospective insurer, as a minimum.

While it’s understandable that people will shop around based on price, don’t make that your only measure, because the real question should be one of value. You can get a policy for a rock-bottom price but if it doesn’t really meet your needs then you’re wasting both your time and money.  And remember health insurance is exactly that – it’s there to protect and assist you when you need it most, and often that can be unexpected.  The worst time for you to find out you’re not covered is when you or a family member is facing a very real health challenge.

The Federal Government is currently finalising a review of the private health industry which calls for more transparency.  Being armed with the right questions and the right information will go a long way towards empowering you as a consumer and ensuring you can genuinely entrust your healthcare needs to the right partner.

Byron Gregory is chief executive of South Australian health fund, Health Partners.

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