The Future of Private Obstetrics

It is common knowledge that in recent years, fewer Australian mothers have been giving birth in the private system. This is obviously having a significant impact on the work of many NASOG members and is a priority area for our advocacy.

Since mid February 2020, NASOG and a number of other stakeholders have been working with the Federal Department of Health on strategies to improve the rates of use of private obstetrics.

In the months since, the Department has developed a Discussion Paper which outlines their impression of current situations, provides an outline of relevant data, and raises some options for moving forward.

We believe that the future of private obstetrics is dependent on developing well founded policy options with three higher order objectives:

  • Make PHI for private births affordable.
  • Limit expansion and contraction of out of pocket costs caused by arbitrary decisions about benefit levels by government and private health insurers.
  • Help consumers to better understand and navigate private obstetric care, benefits and insurance arrangements.

To successfully achieve these objectives, some key aspects need to be more clearly articulated and understood. It is critical that there is cooperation to undertake a thorough review and analysis of all medical specialist fees charged in relation to obstetric care. This will objectively identify an appropriate policy outcome and show where efforts need to be focused.

Maintaining a consistent financial experience for patients will be key to increasing the uptake of private obstetric services. We suggest that a mechanism that benchmarks fees, MBS rebates, PHI benefits and appropriate indexation could be established to provide that consistency.

In terms of PHI, NASOG believes this particular discussion should focus on policies designed to increase the number of women holding policies that cover private obstetric care. Data analysis of the number of women who have held cover for obstetric services and how they have used it would inform development of policy and help provide incentives for women to hold PHI for obstetric services.

Any policy options around PHI need to be informed by data about which policies have been used to cover women for private obstetric care, and which have been dropped.

Finally, there is no doubt that women and their partners currently find it difficult to navigate private health insurance when planning a family. Many start with an assumption that the Out of Pocket costs will be prohibitive and go no further. A significant number start the process with a private obstetrician but do not progress past the first visit.

A specific communication package for patients should be developed that provides a guide to the current funding arrangements for private obstetrics and the reasons for choosing private care, how to make choices about doctors, hospitals and insurers, and what to expect along the way. This will help counteract the ‘urban myths’ around private obstetric care and is a starting point for improving patient engagement with private obstetrics.

I strongly encourage all Members to review NASOG’s full submission, discuss it with your colleagues and work with them and your hospitals to prepare your own submission supporting NASOG’s position.

This will guide the Future of Private Obstetrics.

Submissions are due with the Department by 30 August 2020 however, you can contact SurgicalServices@health.gov.au to request a later submission date.

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