The Australian Competition and Consumer Commission welcomes the Australian Health Insurance Association's announcement that health funds will provide their members with details of specialists who can be expected to treat them with no gap or a gap known in advance, ACCC Commissioner responsible for health matters, Mr Sitesh Bhojani, said today.
In general terms health fund contributors will now be able to get guidance on 'no/known gap' doctors either via a fund's website or its call centre.
"This decision by health funds will ensure that fund members have access to greater information regarding their choice of specialists who do not charge a gap.
"The ACCC has long been calling for better information about medical services and practitioners to be provided to consumers.
"To make informed choice about specialist medical services, consumers need reliable information about various specialists, including the fees they charge. Naturally, price is not the only element for choosing a specialist, but it is an important one. To ensure real choice, consumers need to have information about specialists' charging pattern before making an appointment to visit a particular specialist.
"The ACCC's recent reports to the Senate have highlighted the importance consumers place on price information in the medical sector and the actual amount they pay for particular services.1
"Consumers are entitled to know which specialists they can go to without incurring any extra expense.
"In both Senate reports, the ACCC urged health funds to set up databases of specialists' fees for their members to access, including those who take part in the funds' no/known gap arrangements.
"In the ACCC's view, the funds' initiatives will provide valuable information to fund members about the specialists participating in the fund's no/known gap arrangements and the extent of the members' exposure to out of pocket expenses".
1 The Commission's first Report to the Australian Senate on anti-competitive and other practices by health funds and providers in relation to private health insurance, was tabled in the Senate on 12 April 2000 and the Commission's second report was tabled on 8 November 2000.