Funds must level with their members and return what they save on the shutdown of elective surgery.
Health funds must level with their members and eventually return the funds they save as a result of the COVID-19 shutdown of elective surgery, urges the Consumers Health Forum.
“We welcome the commitment by health funds to reimburse windfall gains to members. Independent estimates put at billions of dollars the surpluses the funds are expected to generate in coming months,” said the forum’s chief, Leanne Wells.
“The bottom line is that, particularly, at this time of financial hardship for many consumers, it is members who should be the beneficiaries. It is, after all, their money, paid in ever-escalating premiums.
Ms Wells says the fund would already know roughly how much they will be in the black as a result of the shutdown.
“They have sophisticated business modelling and would already know the pattern of claiming in a normal year, so they should be able to come up now with a reasonable estimate of their expected profits.
She says funds need to do more than give unspecified promises of returning surplus funds sometime in the future, and that there needs to be some definitive undertaking to do so now.
“The industry would retrieve some credibility if it adopted a consistent and transparent approach. The ad hoc responses taken by the industry in response to the realities of COVID-19 show yet again a failure of funds to give priority to the best interests of their members,” said Ms Wells.
“If private health insurance in Australia was not previously under existential threat, it certainly is now.”
Would you expect your health fund to reimburse you for any savings it makes?
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