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Medibank saga remains unpreventable

Govt welcomes Medibank Calvary truce - Featured Image

The full page ads last week in some capital city papers may have heralded ‘peace in our time’ in the dispute between Medibank Private and Calvary Health, but the big insurer’s approach to safety and quality in our hospitals is still in question by hospitals, doctors, and patients.

While Medibank and Calvary may have finally signed a contract, the detail of the belated agreement remains top secret.

While the AMA agrees that any commercial details should remain private, it is in the public interest that any agreement over Medibank’s draconian list of 165 preventable events should be disclosed.

Calvary CEO, Mark Doran, told Adelaide radio that Medibank Private had agreed to engage with the Australian Commission on Safety and Quality in Health Care on what they believe are preventable events, and that they will act on the call for an independent clinical review process. But that’s about all we get to know at this stage.

Related: Medibank-Calvary contracts stand-off: what it means for doctors and patients

AMA Vice President Dr Stephen Parnis said that Medibank’s ‘trust us, we’ll do the right thing by you’ response is not good enough.

“I’m a doctor and I don’t say that sort of thing to patients anymore,” Dr Parnis said.

“I’ve got to give them the specifics. And I think Calvary and Medibank Private need to do the same here.

“We’d like to understand exactly what the arrangements are with regard to that long list of 165 complications, which Medibank was erroneously calling mistakes, to understand what is going on with those as a result of this new agreement.

“The concern, of course, is that if you’re insured it’s the detail that tells you what you’re covered for and what you’re not covered for.

“The treating doctors need to understand what their patients will be covered for so that they can treat them in the appropriate setting.

“Up to now it’s been hardball by Medibank.

“The AMA rarely intervenes in these sorts of disputes but, because it has such wide-reaching implications for the health system, both private and public, we have regarded this as essential that, one, it gets sorted out, and, two, that it is done in a transparent way.

“It is positive that the Commission for Safety and Quality in Health Care is now involved.

“The Commission does things the right way when these complications are being assessed to try and reduce risk, rather than what was happening with Medibank saying these are not complications, they’re mistakes, and if they occur we’re not funding them or we’re dramatically reducing our funding.

“So we need more detail here because it doesn’t just affect Calvary and it doesn’t just affect Medibank Private. Every other player in the health system is watching on here.

“If this sets a good precedent, wonderful. If it doesn’t, then it’s going to have repercussions for everyone.”

John Flannery

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