Opinion
After an unfortunate experience regarding my private health cover recently, I was not surprised to read that the number of Australians covered by private health insurance had fallen to their lowest levels in over a decade.
Australia is undoubtedly the lucky country when it comes to health care. Our public system is, we are continually told, first rate and our private health network provides choice to those who have the means to pay for it. But something is lacking in that private health space.
It seems we have created a system that is only focused on getting you in the door. Once you have signed up, the system is structured so that the "fear" of falling ill will keep you there.
One issue that seems to continually raise its head, particularly in regional and rural areas, is the use of "preferred providers".
It was certainly a costly problem for me when, just a few weeks ago, our family of five visited the dentist for an annual checkup in our regional Queensland town.
No one in our family has ever had a filling or required major dental work so I was a little surprised to be out of pocket to the tune of about $700 after some pretty quick sessions in the chair. I was too embarrassed to ask any questions about the bill at the dental counter. So I handed over my card and left with a bad taste in my mouth that had nothing to do with the fluoride treatment I'd just enjoyed.
The experience prompted me to review our level of cover. I was surprised to read that we were each actually entitled to two free dental check-ups annually. Free! So why the gap?
Turns out I'd gone to the wrong dentist. There is a "preferred provider" in my town - just a street away - my private health insurer later told me. Had I just called them instead I'd be $700 better off.
Of course, much of the blame rests with me. If I'd done my due diligence, checked my cover, rung the dentist before...
But there's an equally good argument about why my insurer wouldn't make this information more accessible to me.
We are constantly bombarded by push notifications, email deals and google ads for services that we do not want. How great would it be if I got an annual text or email from my private health insurance to remind me who my preferred providers were?
That's the kind of customer service that would keep me paying for extras cover.
It seems I am not alone in my frustration about these preferred providers - especially in the bush.
Many smaller towns don't even have preferred providers for services such as dental or physiotherapy. That might mean a long car trip to access the preferred service - cancelling out any financial benefit of having the extras cover in the first place.
A part of my research, I posted a question in a closed Facebook group and received a significant number of responses from people who regularly find themselves unable to access their extras cover.
One lady, who lives in remote Queensland said: "I'd love to know how the preferred providers system works. We pay extra for our dentist because he is not an approved provider for our health fund. Considering we have been going to him for 20 plus years and there are no approved providers close by, I think this definitely needs to be looked at for regional, rural and remote areas".
Another private health insurance consumer responded to say she hated being out of pocket but appreciated the ability to chose her specialists when needed.
"I've just had surgery, and after Medicare and Private Health, we will still be out of pocket around $10,000. Worth it for the choice of surgeon and speed. As for disadvantages of living in the bush, I live nowhere even remotely close to one of the Preferred Dentists/Optometrist/Physio/Chiro for my fund, so always have to pay the higher gap just because of where I chose to live."
Melissa Fox, the CEO of Health Consumers Queensland, said many people did have a great experience in the private health system but she said there were many others who did not feel like they were getting value for money.
"The big issues that people consider about private health insurance include financial transparency, so people not understanding what out of pocket costs they might be up for, that whole preferred provider issue and also rising premium costs," she said.
"But the two-tier system is quite entrenched and many people do get great benefits and appreciate the private system for the choice it gives them, but then many do not feel like they are getting value and choice out of the system.
"We need to do what we can to rectify that because I understand it is having an impact on demand for our public system and it is obviously having an impact on insurance uptake rates."
Perhaps all that is missing here is good old fashioned customer service and value for money - either way it must be fixed because our "first class" health system is at stake.
