The second largest private health insurance company in Australia has recently been in recent years. I started the proposal The members provide three free GP remote health counseling every year. This follows other insurers Nib We offer membership digital GP consulting for things like prescriptions and medical certificates.
But if you are searching the government Policy website comparison This helps people choose from a variety of personal health plans and will not find a plan to officially ensure GP visits.
Because this is because Current illegal It allows insurance companies to cover service costs outside of hospitals that are funded by Medicare, including GP and expert visits.
Insurers can solve this by operating a digital health platform as a separate business, not as part of a personal health plan that the government regulates. Another strategy Pay the overhead of the clinic Then we provide a “free” consultation to our members.
So why can private health insurers move to the primary care? Why wasn’t it allowed? And is it the danger of Medicare?
If you protect people in the hospital, money will save you.
Better approaching GP (primary) treatment can improve people’s health and reduce the possibility of improving people’s health and being admitted to people with chronic conditions. Heart disease, diabetes and asthma.
Sometimes people use emergency room services for minor problems. It can be solved by GP.
Therefore, providing free or cheap primary care with easy access can reduce the cost of downstream hospitals and save insurance companies in the long run.
There are other reasons for personal insurers dealing with primary care.
The first is the potential of “cherry picking”. In Australia, personal health insurance is A Community grade The premium is a system that does not based on individual health or age.
This means that insurers cannot exclude or claim higher rates for those who are at high risk of surgery or other hospital -based treatment (except) Lifetime health cover loadIf you are 31 years old and take out your personal health insurance for the first time, it will be applied).
However, insurance companies often have a strategy to attract healthier members. For example, you can also offer free sneakers to appeal to sharp runners. Age -based discount For new members under 30 years of age.
Customers for GP Remote Health Services, which are free or easy to access, are likely to be a work expert who lacks time or lacks young people. This group is generally healthier and less likely to be hospitalized every year.
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Another reason for insurance companies to deal with the primary care is to maintain a member who thinks that he feels real benefits and value from the insurance plan.
When Medibank received a trial to provide a free GP visit in 2014, members who benefited from the service It is highly likely to adhere to the insurer.
The Australian government is expanding throughout the health system. Team in remote health and multi -field (For example, GP, nurses, nutritionists, physical therapists and experts) manages chronic diseases.
According to these changes, the insurance company The future of health care delivery Create a large clinic that extends digital health and teams in various fields. Providing a free remote health GP service is a small step towards this great strategic change.
Why did the insurance company not provide primary care in the past?
When Medicare was introduced in 1984, medical professionals opposed the private health fund for the “GAP” between Medicare benefits (what the government paid to clinical) and commissions (clinical prosecution).
Australian Medical Association, Minister of Health, Neil Bleette conclusion If an insurance company can bridge the gap, it can increase the cost of service costs, especially those without insurance.
As a result, there was a ban on the first medical insurance. lawmaking.
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Over time, whenever a private insurer deals with the primary care, the main argument is 2 tier system. Under such a system, people without personal insurance will have low access to primary care.
for 45% There is a personal insurance of the population. And if the insurance company pays on the bill, the GP consultation price It will rise.
In addition, private funds will be more expensive than Medicare to encourage GPS to participate in GPS. This will leave disadvantageous people without personal health insurance.
This situation is currently being developed in the hospital division. Surgeon Public hospital. This determines the priority of working in a private hospital.
As a result, personal health insurance patients can access the selection process without delay. On the other hand, people without personal insurance have long waiting time.
Should the government allow private insurance companies to guarantee primary care?
The current evidence does not provide much support for the government that supports the private health insurance industry by paying individual premium subsidies.
Ours Research has been found Despite the government spent billions of dollars of subsidies to private health insurance, the sector had little pressure in the public hospital system.
At present, the ability to provide primary care companies is limited by legislation, and this is the case.
If private health insurance companies can expand to the primary care, the universality of Medicare can be damaged. It is risk of creating a second -tier first medical system, so it replicates this imbalance already in hospital treatment.
The primary care that insurance companies support funds also include large administrative costs, as can be seen in the medical system. AmericanHighly dependent on private funds and delivery.
However, the government must do other things to make the first care more cheaper to save the cost of downstream hospitals and emergency rooms. This includes:
- The increase in Medicare rebates offers free primary care, regardless of where the poor and children live.
- Provide primary care for rural and remote areas for free.
- Make the primary care cheaply to others.
The Australian government has the financial ability to make the primary care more cheaper and should prioritize it. Even private insurance companies recognize the benefits. But how to do this is not through personal health insurance, but more unequal and expensive.
