Health funds plot to dump cover for breast cancer from most policies
WOMEN will have to buy top health cover if they want to be insured for breast cancer treatment as men get prostate cover in the cheapest policies under controversial changes.
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EXCLUSIVE
WOMEN will have to buy top health cover if they want to be insured for breast cancer treatment but men will get prostate cover in the cheapest policies under controversial government changes.
Cancer groups are staging a revolt against the changes, which they claim are discriminatory and could force thousands of women back to the public hospital system for treatment.
A government committee has been working for almost two years on simplifying health funds products into Gold, Silver and Bronze products.
Initial stages of the reform planned to allow 12 of 32 key treatments to be excluded from bronze and silver cover including heart attacks, joint replacements, dialysis and cataract surgery.
Breast Cancer Network Australia and the Cancer Council have written to Dr Jeff Harmer, the chair of the Health Minister Greg Hunt’s Private Health Ministerial Advisory Committee, to say they are “deeply concerned” about the changes.
They believe changes that will see cancer categorised according to where it occurs in the biological system may mean women can only be covered for breast cancer in more expensive health fund policies.
Other types of cancer, however, will be covered in the cheapest policies.
Already many women are finding health insurance poor value for money, many are left with out of pocket bills of $20,000 to $38,000 for breast reconstruction surgery not covered by their fund.
Some women have to raid their superannuation to cover the bills.
Shadow Minister for Health and Medicare Catherine King said the development was concerning.
“Simplicity must not come at the expense of equity,” she said.
“Forcing women to pay for expensive Gold cover so they can access breast cancer treatment when many other oncology treatments are covered under cheaper Bronze cover would be unacceptable.
“Greg Hunt must immediately reassure Australian women that they will not be disadvantaged under his new scheme.”
Breast Cancer Network Australia chief Danielle Spence said her organisation was worried that as it currently stood, women with breast and ovarian cancer would have to have gold cover, the most expensive cover, to be able to access a private hospital for treatment.
It also looked as if women would be unable to get health fund coverage for comprehensive breast reconstruction after surgery in the private sector.
Health funds will cover only reconstruction of the cancer affected breast when generally women need to have work on both breasts to ensure they are of equal size after cancer surgery, she said.
There are also concerns the categorisation system used under the new gold, silver and bronze system would not cover modern lymph node treatment but require women to have all their lymph nodes removed.
This can leave women with lifelong painful and debilitating swelling of the arms.
“It’s good the government is wanting to make health insurance simpler, but we need a stand alone category for cancer,” she said.
A spokesman for Health Minister Greg Hunt said the details of minimum cover required under the gold, silver, bronze and basic reforms are continuing to be finalised by the private health ministerial advisory committee.
“Final decisions have not been made,” the spokesman said.
“The minister has indicated to the committee, in the strongest terms, that the reforms should aim for maximum cover for breast surgery including treatment of cancer, breast reconstruction and women’s reproductive surgery,” he said.
Private Healthcare Australia chief Rachel David said the exclusion of breast cancer was not what had been discussed with her organisation.