Pressure on Hunt after Federal Court’s health fund ruling
Health Minister Greg Hunt is under pressure to deliver on long-promised reforms to the private health insurance market.
Health Minister Greg Hunt is under pressure to deliver on long-promised reforms to the complex and confusing private health insurance market after a Federal Court judge found Medibank members were not entitled to better information about policy inclusions.
The Australian Competition & Consumer Commission had accused Medibank of making false, misleading or deceptive representations and engaging in unconscionable conduct. The case centred on the information given — or not given — to members after the fund decided to limit benefits payable for in-hospital pathology and radiology services.
But judge David O’Callaghan dismissed the case on Wednesday, giving a legal interpretation of common insurance terms, including that “the word ‘cover’ cannot be read to mean ‘entirely cover’ ”.
While the ACCC considers an appeal, the spotlight has turned to Mr Hunt and the Private Health Ministerial Advisory Committee charged with simplifying and categorising policies, developing standard clinical definitions and improving information provision.
Mr Hunt, who has not commented on the case, has yet to propose specific reforms but the government is understood to be negotiating directly with stakeholders.
ACCC chairman Rod Sims told The Australian yesterdaythat if the health insurance industry did not “clean up its act” the government should embark on a reform program to give members better protection. “It would have to be quite wide-ranging reform, I think, quite a big change on where we are now,” Mr Sims said.
Consumers Health Forum chief executive Leanne Wells said the judgement demonstrated that members seeking peace of mind needed to “regularly examine and re-examine their policy’s fine print to be assured of exactly what their health funds are covering”.
“The growing complexity of health insurance and the difficulties people face as they try to weigh up the value of the different products and keep on top of inclusions and exclusion changes places an unfair demand on consumers,” Ms Wells said. “It is a product where people should easily be able to make an informed choice.”
As premiums rise, coverage rates have fallen, and the number of policies with exclusions and restrictions, described by the Ombudsman as risky, has increased.
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