Putting members’ health before profit

Over 14 million Australians with private health cover paying $956 million too much for medical devices

New data shows that outdated government regulation is forcing Australians to pay far too much for medically implantable devices or prostheses.

Data from the Independent Hospital Pricing Authority and Commonwealth Department of Health shows that for some devices in 2019/20, manufacturers charged patients with private health cover up to 85% more than those in public hospitals.

If the same average price for medical devices were applied in private hospitals as public, the more than 14 million Australians with private health insurance would have saved a staggering $956 million. This represents a massive increase of over $21 million on the preceding year.

The Government data reveals that a cardiac defibrillator (AICD) can cost $27,276 more for private patients. A spinal fusion can come in at over $15,000 more. A pacemaker can cost $7,651 more. Those paying for a hip replacement can be stung up for over $3,200 more than public patients.

“The data points to a regulatory system in total and absolute crisis and in need of urgent action,” said Matthew Koce, CEO of Members Health, the peak body for 26 of Australia’s not-for-profit or member-owned health insurers.

“The current system is a tragic long standing public policy embarrassment. It suggests brazen exploitation by big overseas dominated med-tech conglomerates out to fatten their bottom line.”

“There can be no legitimate justification for Australian families having to pay up to 85% more for some medical devices, just because they are a private patient. It is both unfair and it is discriminatory.”

“It is pleasing to see that there is some light at the end of the tunnel with the Albanese Government putting forward new draft legislation intended to help fix medical device regulation. As part of those legislative efforts, we call on the Government to mandate price disclosure, consistent with the highly successful Pharmaceutical Benefits Scheme (PBS).”

“A more transparent medical device industry would benefit everyone and go a long way towards restoring public confidence. In particular, mandated price disclosure would help put to bed any possible suggestion of secretive financial incentives being shared between medical device companies and hospitals.” Mr Koce said.

“Policyholders can be assured that any savings flowing from prostheses reform will be passed on by the 26 Members Health funds, who always put consumers first, not profits.”

Members Health is the peak industry body for an alliance of 26 health funds that are not-for-profit or part of a member-owned group, regional or community based. They all share the common ethic of putting their members’ health before profit. Our funds represent the interests of more than 5 million Australians.

Download media release and data.

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