How to Make Private Health Insurance Healthier (Green Paper)

TRANSCRIPThttps://actuaries.logicaldoc.cloud/download-ticket?ticketId=2d1ed620-77a9-410b-8b0e-be4020d96694DESCRIPTIONIn this instalment of the Actuaries Institute podcast series, Practice Excellence Adviser at the Institute, Vanessa Beenders sat down with Bevan Damm and Matthew Crane, authors of the new Green Paper 'How To Make Private Health Insurance Healthier' to discuss their research and findings.The healthcare system in Australia is complex. It involves many funders and healthcare providers with competing interests, both from the public and private sectors. However, despite its complexity, the healthcare system in Australia is one of the best in the world and, for a long time, private health insurance has been a part of that system. So, without reducing or expanding the role of PHI in the healthcare system more broadly, how can the community get more from private health insurance?Discussion topics include:•The complexities surrounding the current structure of Private Health Insurance and the Public healthcare system including regulations, community rated products, Medicare rebates and risk equalization.•Different philosophical viewpoints on how to make private health insurance work better including the Medicare levy surcharge, priority in the current system for claiming and treatments and appropriate care in the public healthcare system.•Key issues in the current system that Bevan and Matt have addressed in their key paper including; •Limitations and lack of ability for a patient to choose the correct treatment and how to receive said treatment. •Confusion surrounding the policyholders benefits and claim entitlements. •The affordability of private health insurance as wage growth slows while the average premium continues to rise, year on year. • Convincing ‘healthier’ people to buy private health insurance products to further reduce premium costs. •The changing pathways of treatments that enable better access for less complex surgeries and treatments that the private health insurance sector hasn’t adjusted their coverage for.•Potential solutions for fixing private health insurance including; •Creating a new tool for GP’s and care coordinators to guide the patient though their choices including greater transparency, clear, easy-to-understand information on fee’s, waiting times, claims. •Incentivising insurers to reduce unnecessary claims costs. •Targeting inefficiencies in the supply side of private healthcare services e.g. tackling the cost of a specific service such as prosthetics, administration fees, add-on fees, hidden fees that may occur form specialists etc. •Focusing on increasing the health of policyholders with private health insurance to reduce the average costs of premiums and incentivising younger and healthier people to buy private health insurance cover. •Improving the perception of private health insurance via the whole private sector working together to reflect on how to create value as opposed to shifting the blame. The government should also do more to promote the value of having private health insuranceBevan and Matt will be discussing their research and key findings on Day 1 of the Actuaries Summit, held on June 3, 2019 at the ICC Sydney.ABOUT THE SPEAKERSBevan Damm is a Partner at EY and has fifteen years’ experience in the insurance industry, specialising in health insurance, general insurance and personal injury insurance, following sixteen years’ of service with the Australian Navy. He is the Appointed Actuary to two private health insurers and the Scheme Actuary to the NSW State Insurance Regulatory Authority. This unique...