08/06/2023
To the Commonwealth Ombudsman
As a dentist dealing with a range of private health insurers on a daily basis, I am deeply unhappy about the way in which their behaviour is affecting the oral health of my patients.
It is increasingly apparent to me that the funds are playing a far more proscriptive role in the healthcare system than before, increasingly positioning themselves as the final decision makers on what is best for my patient's oral health. This excessive grab for decision-making power by a non-health provider should be of concern to the government, and anyone focused on the overall wellbeing of patients.
This trend is being accelerated by the growth of the insurers' own clinics. This increasingly means patients are being lured away from their long-term dentists, a development which disrupts the very valuable continuity of care that is integral to effective ongoing oral health care.
My patients are also being forced to shoulder a greater share of their treatment costs due to stagnant or decreasing rebates, despite consistent and significant increases to their premiums. Along with impractical annual limits and claiming restrictions, this is prompting many of my patients to put off vitally important treatment. The focus must always be on health over profit but the funds' policies and behaviour indicate that improvement to their bottom line is their prevailing motive.
Finally, while I appreciate that the federal government has undertaken a review of private health insurance, I am worried that it has underestimated the scope of the problem by narrowly focusing only on the lack of transparency in the private health insurance industry.
Unlike general medical services, which receive a significant amount of public funding via Medicare, dentistry is largely privately funded with patients bearing the major portion of treatment costs. I am not convinced the government is taking all the necessary steps to ensure that patients receive the assistance they need nor that dental care is properly funded.
I do not require any response to this complaint but I would like you to officially lodge and record it.
Regards,
Dr |FNAME| |LNAME|