GAP Australasian-Dentist-May June 2019

Category 114 AustrAlAsiAn Dentist r ecent news articles have revealed serious shortcomings in the conduct of some major health insurance funds. the Australian newspaper recently reported that Bupa was fined $150m for tax evasion via transfer pricing by inflating the interest rate of loans owed to their london head office. this was no accounting accident it was a clear intent to minimise tax payable on its profits in its Australian operations. this was followed up by a report that some Bupa aged care homes were not meeting the regulation standards- some by multiple defaults. the worst example being the news reports that a Bupa aged care patient was admitted to hospital with maggots in a head wound. then came another news report that another major health insurance fund has shifted its head office to the Cayman islands – a known tax haven where there is no taxation applied. Again, this is a deliberate move to minimise tax payable in Australia to a government that is supporting and encouraging the public to subscribe to health insurance. All this comes on top of the ACCC censure of some health insurance funds reducing the services of current policies without informing their policy holders the reports do not reflect well on corporations who profess to have high integrity standards and their members best interest as their high priority. Cost containment and cutting is a key factor in running large corporations that strive to maximise profits, but it comes as high cost to end services delivered. it’s a bit rough when health insurance funds making high profits take deliberate steps to hide their profit margin then go cap in hand to the government and cry poor when negotiating annual premium increases. labor is on the right track in stating it will limit annual premium increases to 2% PA. tV advertising by some major health insurance funds strives to convince people that they have care expertise and members and patients’ best interest at heart but when the spotlight is turned onto what is actually delivered it reveals a different picture. labor has stated that if it wins power it will hold a royal Commission into health insurance. this will follow the current royal Commission into Aged Care. i would like to see labor ask for a forensic audit of health insurance fund accounts. By the time the two inquiries are concluded a very clear picture will emerge on the conduct and service level shortcoming of some major health insurance funds. the Banking royal Commission was a real eye opener as to the conduct- motives and integrity level of the large corporations involved. We may well see something similar in the health insurance industry inquiry. A recent Government initiative in asking health insurance funds to revamp policies to make them simpler to understand gave the health insurance funds a great opportunity to revise all their policies and shift high cost services to higher premium policies and lower the available treatment cover in the lower cost policies. this meant they benefited both ways- reducing their payout and receiving a higher premium income. the loser was the fund members, yet the government is claiming credit for a major reform. i think there will be a sustained increase in the number of people who reduce their existing policies to basic hospital cover only and the number of people without any health insurance will steadily increase. it is time for major reform in this industry and i hope the proposed labor royal Commission come to pass and that new options to cover health costs emerge. u Merv Saultry, Managing Director Independent Dentist Network www.independentdentist.com.au The spotlight is on health insurance funds shortcoming By Merv Saultry ColuMnIsts Merv Saultry