Private Health Insurance – a Government Funded Fraud

Good morning readers,

Health insurance – maybe not what it is made out to be – what a surprise!

From: https://s.mainstreet.com/files/tsc/v2008/photos/contrib/uploads/healthinsurancezoom_600x400.jpg

A number of years ago, then Liberal Government, Led by PM John Howard, introduced policies that forced people to invest in private health insurance.

Financial penalties were created for those who chose not to join, and levies (in the form of increased Medicare Levies) were imposed on those who joined later than age 30.

At the time, it seemed fairly obvious to me that the Liberal Government were attempting to privatise the health system, and destroy our (largely) publicly funded system. A system that was one of the best in the world, and one that many countries envied.

It didn’t help that we had a few ministers suggesting that every Australian should have private health insurance. What appeared to be a clear indication of their intent!

The Government also decided to start funding private health insurance, by providing rebates to those who had, or took up, private health insurance.

Unfortunately this Liberal Government has also started to de-fund our public health system, to the tune of billions of dollars per year in cuts.

As time has gone by, private health insurance has become more lucrative – for investors that is. Premiums have continued to go up each year (above inflation), and the Government of the day has continued to prop up the industry by a rate of 30% of almost all premiums.

One could construe from this that, 30% of all dividends given to shareholders are from taxpayers! But perhaps that is too cynical.

Interestingly there have been some recent cases brought to the media, where insurance companies have denied claims, through deceptive clauses and complex examination of cases. Of course this was done through medicos appointed by the insurance company, and allegedly pressured to present examination reports in the insurance company’s favour.

The media have also found that there was generally harsh or deceptive treatment of claimants, so that the claimants would simply walk away – because it was just too difficult to fight. One media report can be seen below, but significant numbers of others have been noted.

http://www.abc.net.au/news/2016-03-07/comminsure-whistleblowersays-doctors-pressured-change-opinions/7226910

CommInsure, run by the Commonwealth Bank in Australia, was the main insurer focused on in this instance; but there are other insurers (and those who use CommInsure as an underwriter to their own policies).

This should come as no surprise, as insurers (and banks) are there to make money for shareholders – aren’t they? So denying as many claims as possible is in their best interest.

What is interesting about this, is that a review of my own Health Insurance Policy, provided by Defence Health, indicated quite clearly, that

…pre-existing conditions are not covered. That …a medico appointed by the insurer, may be used to examine all cases… The clauses also state that even if the condition wasn’t obvious previously… it could still be construed as pre-existing.

If I just reflect on my own situation, considering that I have significant pre-existing health problems, what do you think the chances are that my current insurer will suggest that some future claim is due to a pre-existing medical condition.

Sounds highly likely to me, particularly considering the media exposure of the CommInsure cases.

Reading between the lines of these clauses, and reading the cases presented by the media, it would appear that almost anything could be construed as pre-existing.

Unfortunately these insurers have been allowed to decide what they do or don’t cover.

If they aren’t going to cover all of the medical claims that are being presented to them, then what exactly is the point in having private health insurance.

Isn’t Private Health Insurance there to insure against ill health, regardless of the reasons?

Not only is private health insurance becoming ridiculously expensive, we now find that we may not be covered by them in many circumstances.

Combinded images from:
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vitamin-resource.com/wp-content/uploads/2012/09/private-health-insurance.jpg

So what is the point in being a part of this:

Government Funded Fraud!

 

Be wary of your insurer, check out your insurance policy in advance, you might be sadly surprised to find out that you aren’t actually covered for anything at all!

 

Food for thought,

Bye for now,

Greg

 

 

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#healthinsurance #comminsure #defencehealth #auspol