MEDIA RELEASE | ASO Back AMA Call for Stronger Regulation of Private Health Insurer Contracts

The Australian Society of Ophthalmologists (ASO) is backing the Australian Medical Association’s (AMA) newly released Position Statement on Principles for Private Health Insurer Contracting with Medical Practitioners.

The Position Statement aligns closely with the ASO’s stance against Private Health Insurers, ahead of reports that they will be hiking their premiums this year.

“This position statement addresses critical concerns that ophthalmologists across Australia have been raising for years,” said ASO President Dr Peter Sumich.

"The fox is in the hen house, and nobody seems to care. Private health insurers are laws unto themselves, wheeling and dealing and jumping through loopholes on their way to $2 billion profits a year.

“The lack of regulatory oversight in private health insurer contracting poses real risks to patient care and threatens the clinical independence that is essential for delivering optimal outcomes in eye health.”

Key concerns shared by the ASO include:

• The potential for insurer practices to interfere with clinical decision-making about treatments, procedures and prostheses
• Bundled contract arrangements that could compromise the independence of specialist care
• The use of confidentiality provisions that prevent appropriate scrutiny of contract terms
• Inadequate indexation of benefit rates that fails to keep pace with the true costs of delivering quality care
• ‘Take it or leave it’ contracts that exploit the power imbalance between insurers and individual practitioners

“Ophthalmology involves highly specialised surgical procedures where clinical judgement must remain paramount,” Dr Sumich said.

“Patients trust their ophthalmologists to recommend the best treatment options, and this decision-making must not be compromised by insurer-imposed restrictions.”

The ASO calls on the Federal Government to act on the AMA’s recommendations and implement meaningful regulatory reform to safeguard the integrity of Australia’s private health system for patients and practitioners alike.

 

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