The report highlights that premiums have consistently risen, outpacing both inflation and wage growth. Concurrently, the scope of coverage has narrowed, with nearly 70% of policies now containing exclusions for specific treatments or conditions. This shift has led to a decline in the uptake of comprehensive gold-tier policies, as consumers opt for more affordable options with limited coverage.
AMA President Dr. Danielle McMullen has called for urgent reforms, including the establishment of an independent Private Health System Authority to oversee the sector. The AMA also advocates for a mandate requiring insurers to return at least 90% of premiums to consumers in the form of treatment benefits, aiming to enhance transparency and value for policyholders.
For health care professionals, these findings underscore the need to stay informed about changes in insurance policies and advocate for reforms that prioritize patient care and equitable access to services. Understanding the evolving insurance landscape is crucial for guiding patients in making informed decisions about their healthcare coverage.
