Herald Sun

In­surer bul­ly­ing claims

- An­gus.thompson@news.com.au BELINDA MER­HAB

PRI­VATE hos­pi­tals are ac­cus­ing health in­surer Med­ibank of be­hav­ing like a bully and putting its share­hold­ers ahead of pa­tients.

Aus­tralian Pri­vate Hos­pi­tals As­so­ci­a­tion chief ex­ec­u­tive Michael Roff says Med­ibank risks be­com­ing an in­dus­try pariah, with hos­pi­tals con­cerned about the health fund’s “take it or leave it” ap­proach to ne­go­ti­a­tions.

He says the is­sue is more wide­spread than Med­ibank’s highly pub­li­cised dis­pute with hos­pi­tal op­er­a­tor Calvary.

The com­pany was now putting share­hold­ers ahead of mem­bers, Mr Roff said.

“Ul­ti­mately, that could be self-de­feat­ing if they end up los­ing mem­bers and there­fore pre­mium rev­enue, be­cause of the ap­proach that they’re tak­ing,” he said. “It’s clear from the ne­go­ti­a­tion with Calvary that there’s the pos­si­bil­ity that if pa­tients stay with Med­ibank, they’re not go­ing to be fully cov­ered at their hos­pi­tal of choice.”

Mr Roff said Med­ibank was try­ing to im­prove its prof­itabil­ity by re­fus­ing to pay hos­pi­tals, or pay a re­duced ben­e­fit, for a list of 165 so-called “highly pre­ventable ad­verse events”.

The list in­cluded in­fec­tions in can­cer pa­tients who were un­der­go­ing treat­ment that left them vul­ner­a­ble to in­fec­tion, as well as bleed­ing and haem­or­rhage in pa­tients with clot­ting dis­or­ders, Mr Roff said.

Newspapers in English

Newspapers from Australia