Oct 2, 2012

Health Insurers Profit In Last Financial Year

Over the last 16 years rebates for physiotherapists, dentists and optometrists have dropped by 20% and now cover less than 50% of health costs. Health funds’ profits from ancillary cover, however, increased to $1.1-billion in the last financial year.

In 1996, health insurance covered 57% of fees for services like optometry and dentistry but by 2011 the figure had dwindled to 49%. Physio had a 60% rebate in 1996 but has now also dropped to 49%. Insurers also benefitted from $5.15-billion in subsidies from the government and now people over 30 and those considered to be high-earners are being forced into taking healthcare policies out. Despite rebates decreasing, insurers are topping their profits on an annual basis and consumers are being forced to pay more.

Since 2000 the industry’s for-profit health funds have increased from 12.5% to 70% and premiums are worth more than the premiums that are being paid out to cover ancillary services.

While the market becomes easier for health insurers to profit from, healthcare professionals are being reminded how it is much more challenging and ethically questionable for them to carve out avenues to drive business. The role of social media in the healthcare industry has also fallen under the spotlight recently, as the Australian Health Practitioner Regulation Agency (AHPRA) leaked a consultation paper on social media policy before the date of its highly publicised pubic launch. Contributors to the #hcsmanz twitter group, and Healthcare Communications and Social Media in Australia and New Zealand have voiced their disapproval at the content of the report, stating that it focuses too much on the negative aspects of the social media phenomenon.

AHPRA’s policy was drafted in response to demand from practitioners requesting guidelines on social media conduct from national boards. Unfortunately the report, which was apparently not the final draft, was released into Twitter prior to it being signed off and made publicly available. The focus of the report, that has got the social communities up in arms, is the focus of the report on social media’s potential to transgress laws pertaining to the health practitioner code of conduct and Advertising Guidelines.

AHPRA has been accused of neglecting the positives of the social media platforms and their potential for improving service delivery and involving the wider public in matters like health policy creation, research and service development.

The National Law for advertising health services is very restrictive and AHPRA has taken a conservative interpretation in light of the advertising opportunities on offer through social media. The laws pertain to any practitioners who are registered under National Law, their employers and anyone else who provides services through a registered health practitioner. Any person who advertises a health service on a social media platform is at risk of transgressing the Advertising Law.  Health practitioners who are found guilty of contravening the law could face losing their registration.

As a guideline practitioners must ensure that any content they post does not breach their professional mandate, does not transgress any privacy and confidentiality clauses, provides information that is informed and unbiased, ensure that no unsubstantiated claims are made and does not make use of any kind of testimonial. The laws prevent healthcare professionals from taking part in the reforms by advertising themselves as offering high levels of medical care. However, healthcare companies have been able to benefit directly from the competition that was generated in the market as people vied to make a health insurance comparison, before the means testing deadline. With insurance companies boasting exorbitant profits, it appears both the consumer and the practitioner are paying higher prices and the corporates are raking in the profits.

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