Putting members’ health before profit

$862 million rip-off: People with private health still paying on average far more for medical devices such as artificial hips, knees and pacemakers

Members Health urges all sides of politics to enhance their efforts to eradicate profiteering in the medical devices market, as new data reveals people with private cover are still paying hundreds of millions dollars more for medically implantable devices, also known as prostheses.

The latest official data from the Independent Hospital Pricing Authority and Commonwealth Department of Health 2016/17 shows consumers paid about $862 million more for medically implantable devices in private hospitals than what they would have in a public setting.

“It is incomprehensible that private health consumers are forced to pay many times more for identical medical devices than those in the public hospital system,” Members Health CEO Matthew Koce said.

In 2018, the Coalition Government delivered some cuts to the price of prostheses totaling $188 million, but new data shows that was a drop in the ocean and much more needs to be done.

“We commend Greg Hunt for being the first Health Minister to tackle such entrenched and blatant profiteering, but the situation is far greater than initially thought.

“Minister Hunt has an exceptional record of delivering tangible outcomes in the health portfolio, chief among them being his determination to improve affordability for Australians by trying to combat inflated prices of medical devices.

“But clearly, much more needs to be done to make sure all Australians get a fair go. That $862 million is money that would contribute enormously to helping reduce private health insurance premiums for consumers.”

“The data shows the average cost of a pacemaker in the public system is $3,759 while in the private system it is $14,286 – three times more expensive. A hip replacement in a public setting costs an average of $6,169, but more than $10,100 in private. But the biggest offender of them all is the implanted heart defibrillator (AICD) pacemaker (DRGF01B), which costs $14,022 in the public system but $53,196 in the private system – an outrageous 280 per cent price increase.”

“While there have been some positive steps to reform prostheses pricing, all the data points to the need for more urgent reform of the regulation of medical devices.

“We need to immediately put an end to this appalling situation where consumers in a private hospital setting are being forced to pay outrageous prices for medical devices such as artificial hips, knees and pacemakers.

“Clearly the big multinational device companies see the regulatory environment in Australia as a license to print money. Australia is so profitable that they regularly describe it as ‘Treasure Island’.”

“The publically available data provides yet further proof that the current regulatory system is broken and being exploited to fatten the pockets of big multinational companies. This comes at the direct expense of consumers and Australian taxpayers who are being ripped off.”

“The 25 not-for-profit, member owned, community based and regional health funds represented by Members Health will pass on to policyholders all savings made through reform of the pricing of medical devices as they always put the consumer first, not profits.

“We cannot continue to put the profits of large multinational corporations above the health and wellbeing of everyday Australians. Members Health urges the Government to slash the regulated price set for prostheses in the private sector to bring is in line with the public hospital system.”

Members Health is the peak industry body for 25 private health insurers, which are member-owned and not-for-profit. In all, the Members Health funds provide private health insurance for over two million Australians.

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