Responding to the Shadow of Managed Care

Honeysuckle is a glorious and fragrant climbing plant. It is a traditional favourite of many cottage gardens, filling the early days of spring with its beautiful scent and seeming to herald long and happy summer days ahead….

It is also highly invasive and aggressive and now classified as an environmental weed throughout Australia. It spreads quickly, smothering trees and shrubs and pulling down the fences and buildings it scrambles over.

Honeysuckle Health is a joint venture between private health insurer nib and US Managed Care giant, Cigna.

The Australian Competition and Consumer Commission (ACCC) recently released a draft determination that would allow Honeysuckle Health and nib to form and operate a buying group to collectively negotiate and manage contracts with healthcare providers on behalf of health and medical insurance providers and other payers of healthcare services.

You can see the details of the case including all submissions made here

To believe that a corporate entity wouldn’t put profits ahead of best patient outcomes is naive. And when this entity plans to work on behalf of the majority of private health insurers in the country, the potential repercussions for our healthcare system are significant. The scope for quality private practice work is likely to diminish, limiting future career options for trainees and pricing many senior specialists out of practice altogether as they will be unable to compete with the prices of many of those on contracts.

Australia does not need another type of invasive honeysuckle that threatens to smother our healthcare system.

NASOG’s submission on the draft determination is below. If you would like to add your voice to this issue, you can email a letter, referring to case AA1000542, to exemptions@accc.gov.au by 11 June 2021.

SUBMISSION TO THE ACCC: HONEYSUCKLE HEALTH DRAFT DETERMINATION (21 MAY 2021)

The National Assocation of Specialist Obstetricians and Gynaecologists (NASOG) opposes the ACCC draft determination in relation to the proposed health services buying group, Honeysuckle Health.

Colleagues in other specialty groups have already emphasised the negative impact of the managed care model in the United States which this model approximates. Particularly in relation to a corporate entity placing profitability ahead of patient rights and preferences and clinician expertise.

Unlike the USA, Australia has a well established public health system, delivering a high standard of care. Australian patients expect that they are going to receive the best and most appropriate treatment, whether they are in the private or public sector.

Experience in Obstetrics tells us that if this model gains a foothold, there will be wider impacts on our health services. Over several years, Private Health Insurers have tried iterations of no-gap maternity programs. Despite locking hospitals and doctors into tight contracts, the anticipated uptake and profits have not been seen, so insurer investment in these programs is diminishing. Obstetric patients are increasingly turning to the public sector, which is not resourced to manage the volume, resulting in high-profile media stories about infant deaths and maternal damage.

In the ACCC’s final deliberation, it must be considered that Honeysuckle Health’s proposed model could result in patient dissatisfaction with the options for their care. Either through limitations on which doctors they can see, the treatment options available or which hospital to attend. Coupled with any restrictions placed on the doctor by their contract, the result will be increased numbers returning to an under-resourced public sector and significant cost burdens and pressure placed on the state and federal governments.

Finally, NASOG queries the value of adding another level of administration to our healthcare system. While Honeysuckle Health will draw an income from the contracting and management arrangements, it is challenging to see how adding an additional layer into government schemes, indemnity providers, hospitals, clinicians and patients will improve efficiencies in healthcare delivery and patient care.

We believe there is no justifiable reason to negatively impact the way Australians access their healthcare through the implementation of a foreign style, managed care structure.

Leave a Reply

%d bloggers like this: