SHORING UP: The alliance will enable funds to share knowledge and pool resources. Photo: iStockphoto

Experience you can bank on

Few people are better placed to understand the changes taking place in health insurance than HBF managing director Rob Bransby.


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One of the most pressing issues for members of health funds is the narrowing of the benefits provided by the insurer. Over the years we have seen a shift in the delivery of medical service that were once provided in public and private hospitals. Many services are now provided in the community by public and private providers. When services were provided in a hospital or are today provided in a hospital they are generally covered by private health insurance or the public provider. Today with more services being delivered in the community, health insurance funds draw the artificial line between services provided in a hospital and the community and do not cover a range of services provided in the community. This exposes users of those services to potential massive costs - costs that are not met by private insurers. Additionally, some private insurers have unilaterally changed the coverage provided. A case in point is skin disorders attended to by a private provider in a private hospital. Some insurers are now taking the view that if the procedure undertaken in the hospital (as an outpatient) reveals a major problem, the insurer will meet the costs involved in using the hospital facilities. However, if the procedure reveal no major problem, the use of the hospital facilities has be met by the patient. Essentially this means that patients with a suspected skin problem face the choice of having the procedure done in hospital (if required of course) and meeting the full costs for the use of the hospital facilities if the suspected problem does not on analysis prove to be major. Preventative health is not encouraged if patients face the prospect of massive costs for hospital services if a major problem is not found. Now medibank private is a publicly listed company required to act in the best interest of shareholder, can policy holders expect a further narrowing of the real coverage provided by their private health fund?

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WA Revenue

1st-CBH Group$4.19bn
2nd↑St John of God Health Care$1.80bn
69 not for profit businesses ranked by WA revenue most recent financial year

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12thCBH Group1,100
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15thYMCA WA865