Patients Hit In Hip Pocket On Hip Device And Other Aids
The Age
Monday May 14, 2007
HUNDREDS of Australians implanted with a special hip prosthesis each year will be slapped with a new gap charge of more than $1000, after a Federal Government-appointed committee decided that private health insurers shouldn't have to pay the full cost of the device.
The hip device is one of dozens - including cardiac, ocular and other joint replacements - that are expected to attract hefty out-of-pocket fees when the new prosthetic prices list is released tomorrow. Introduced by the Government last year, the twice-yearly review of more than 9000 available devices is designed to curb the rising cost of prostheses and their consequent effect on insurance premiums. Under the changes, the committee must set a no-gap price for at least one device in every category. Makers of new and more costly prosthetics can either accept the lower price or risk losing sales by asking patients to fork out gap charges. The Medical Industry Association of Australia, which represents device makers, said the new rules would ultimately result in poorer results for patients as some device makers abandoned the Australian market. "The complex nature of surgical procedures does not allow a 'one size fits all' approach to prostheses," association chief executive Anne Trimmer said. "A variety of prostheses need to be available to patients in order to ensure the best possible outcome for the patient." She said the process was already "pushing products out of the Australian market and deterring investment in medical technology in Australia". But the Australian Health Insurance Association said the makers' arguments ignored the fact that they had enjoyed a 538 per cent increase in the money they received from private health companies over the past decade. Chief executive Dr Michael Armitage said recent research had also shown there was "not one new device that leads to an improved outcome that has been brought into Australia in the last five years. "In fact, a number of the new devices give you a worse outcome," he said. Against a general private health premium increase of about 4.5 per cent last year, the benefits paid to device makers by insurance companies went up by 7.5 per cent. That is significantly better than the 12 per cent and 20 per cent payout increases in the previous two years.
© 2007 The Age
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