The Royal Australian College of General Practitioners (RACGP) has called for a thorough investigation into the evidence base for expanding private health insurance to cover general practice.
The call forms part of the RACGP submission to the Private Health Insurance Consultations 2015-16, which details its concerns about extending private health insurance to broadly cover general practice.
RACGP President Dr Frank R Jones said the submission highlighted the RACGP’s concern a two-tiered health system could be created if private health insurers are allowed to cover GP appointments.
“Any changes to health funding and service provision must improve patient outcomes and be backed by a strong evidence base,” Dr Jones said.
However, with specific boundaries in place, Dr Jones said the RACGP did see potential for private health insurer involvement in preventative health care, evidence-based chronic disease prevention programs and targeted chronic disease management and hospital avoidance programs.
“If private health insurance cover was extended to include general practice, it must be a considered and coordinated implementation process where insurers provide support for access to evidence-based treatments only,” Dr Jones said.
“Any changes to the private health insurer role in general practice must also take place within the context of findings from the healthcare reviews currently underway, such as the MBS Review Taskforce and Primary Health Care Advisory Group.”
The key arguments of the RACGP submission include:
-
- changes to health funding and service provision should improve patient outcomes and be evidence based
- countries with strong public health insurance and adequately resourced primary healthcare systems have better health outcomes
- any involvement of private health insurers in general practice must be in accordance with three key principles:
- duplication or fragmentation of care is prevented
- the clinical independence of GPs is recognised and supported
- access to case is based on need, not private health insurance status.
The RACGP submission is largely based on its December 2014 position statement Private health insurance in general practice.