Catholic hospitals fight attempts to get them to pay for medical devices instead of health insurers

Australia’s Catholic-run hospitals are making a last-ditch bid to ensure $170m worth of medical technology on a government-run list is paid for by the nation’s private health insurers.

Health Minister Greg Hunt. Picture: Getty Images

Australia’s Catholic-run hospitals are making a last-ditch bid to ensure $170m worth of medical technology is paid for by the ­nation’s private health insurers, saying they will lose as much as $80m if they are forced to pay for devices themselves.

The Morrison government is considering changes to the Prostheses List, which includes prosthetic hips and knees, pace­makers, heart valves and ophthalmic lenses. The government-drawn up list dictates that insurers are required to pay for the items at set prices.

Catholic Health Australia fears if hundreds of medical items are taken off the government-decreed list on Tuesday and health insurers are no longer forced to cover the costs, patients will directly pay or member hospitals will have to cover the costs by making cuts.

CHA director of health policy James Kemp told The Australian that if Tuesday’s budget made hospitals pay for the medical tech, regional health and palliative care could be among the first services to be hit.

“If insurers successfully escape their current obligations to pay, it’s difficult to see where the money can come from.

“The funding of not-for-­profit Catholic hospitals is ­already stretched thin to sub­sidise low and negative-margin ser­vices like regional health and palliative care,” Mr Kemp said.

“If medical device companies are charging too much for ­individual devices, there are a range of sensible measures we can take to address that, like benchmarking against public hospitals.”

Health insurers say the list forces them to pay higher prices for routine medical items than public patients or any other insurer in the world would have to, and they are is willing to compensate private hospitals if items are removed and they no longer have to pay.

Medical groups have previously told The Australian they believe Australians paying thousands of dollars a year in health insurance could have their ­access to life-changing medical devices ­severely limited under any changes.

Private Healthcare Australia chief executive Rachel David, whose group is the peak body for health insurers, on Monday said any claims they were trying to control the prostheses list were “untrue”.

“The prices on the prostheses list are nearly 30 times as much as health insurers are paying for these devices in other countries … we can’t afford to lose that amount of money,” Ms David said.

“Our proposal calls for prices to be benchmarked and it’s categorically untrue to say hospitals would be unable to access medical devices under any reforms.

“If non-prosthetic items like sponges are removed, we are willing to compensate hospitals for those costs and any savings will go back into lower premiums for patients.”

A spokeswoman for Health Minister Greg Hunt acknowledged the government was pursuing reforms to drive down the price of medical devices.