Backlash over Medibank’s dated cataract surgery comments

In a report in The Australian newspaper dated 8 August, Dr Andrew Wilson, Medibank’s executive general manager of provider networks and integrated care, implied Australian ophthalmologists were charging higher fees for cataract surgery than the US and Europe.The rarks were made as part of a broader commentary on the need for greater transparency within Australia’s health sector as a market failure was supposedly causing costs to rise. The increase in prices cannot be explained by increasing complexity of procedures alone when the cost of a procedure in Australia is more expensive than in other comparable countries, he told the newspaper, adding, [We] are not competitive compared to many other countries. Dr Wilson cited data from the International Federation of Health Plans’ (IFHP) 2013 Comparative Price Report, which stated that the average price of cataract surgery in Australia was US$3,841, higher than the US’ US$3,762 and more than double the Netherlands’ US$1,610.However, several ophthalmology and medical bodies were quick to point out that Dr Wilson had used out-of-date information. I and my RANZCO colleagues are extrely confused by Medibank Private’s statent about the cost of cataract surgery in Australia, especially given that it relies on 2013 data, rather than the updated 2015 data which is available and which shows that cataract surgery in Australia is cheaper than in either the US or the UK, Dr Bradley Horsburgh, president of the Royal Australian and New Zealand College of Ophthalmologists (RANZCO), said. Medibank Private is also very much aware that ophthalmologists’ fees account for less than a third of the cost of cataract surgery. The rest of the fees cover the costs of the intraocular lens, the anaesthetist and the hospital. {{image3-a:r-w:300}}Australian Private Hospitals Association chief executive officer Mr Michael Roff claimed Medibank deliberately chose to use the 2013 data because in that year, the Australian dollar had been extrely strong against the US dollar, causing distortions in the international comparisons. The 2015 report, which Medibank chose to ignore, shows Australia is indeed competitive based on the IFHP analysis and is not the most expensive country on any measure, he said.The 2015 data reportedly showed the average cost for cataract surgery in Australia was 16 per cent lower than the US and lower than the UK. Medibank have been caught out presenting meaningless and out-of-date data and misrepresenting the true picture in order to further their own cause, Mr Roff stated. Australians should certainly be asking questions about healthcare costs, not least of all why large insurers make such significant profits and continue to cry poor. Australian Society of Ophthalmologists (ASO) president Dr Michael Steiner agreed that the unfair attack on medical specialists and the fees they charged had cast doubt on the health fund’s credibility, adding that Medibank had been disingenuous in its attpt to tarnish the reputation of Australian surgeons . This is the insurer who is facing legal action from the ACCC [Australian Competition and Consumer Commission] over alleged misleading and unconscionable conduct, he said. It is also the insurer which, in 2010, decided to restrict cover for cataract surgery for 300,000 of its policy holders. Consumers deserve to have access to healthcare providers who are open and accountable; no doctor will have an argument with that. Medibank’s credibility in this area, however, must be seriously questioned. Australian Medical Association president Dr Michael Gannon denied doctors were forcing costs to increase and instead blamed insurers for forcing more of the expense onto patients and healthcare providers.He said that the real driver behind rising costs was a mix of factors, including the cost of prostheses, rising wages, technological advances, soaring drug prices and an ageing population, which meant that patients were increasingly presenting with a complexity of health probls.Sharing a similar view, Dr Horsburgh said, The increasingly ageing population in Australia means that patients present with more complicated conditions and greater co-morbidities than ever before. Despite that, the data shows that in 2015 the cost of cataract surgery in Australia is less than in the US or the UK.