Conference on Health insurers - 6/4/2005

link to The Times article

Need for education on health insurance
Cynthia Busuttil

The public needs to be given more information and education about health insurance, a national conference on the subject established yesterday.

This was evident from a vox pop carried out by Geoffrey Bezzina, the consumer complaints manager at the Malta Financial Services Authority, in which it emerged that a number of people did not know exactly what health insurance was about.

Consumer and Competition Division director general Marcel Pizzuto said the absence of clear information to potential consumers about the price, quality and conditions of different types of health insurance policies prevented them from making informed comparisons between different products and put them at a competitive disadvantage in the marketplace.

Competitiveness and Communications Minister Censu Galea also stressed the importance of information, saying that before the consumer bought an insurance policy he should have enough information and understand it so that he could make an informed decision.

Mr Bezzina said a very low percentage of the population was covered by health insurance. There was a considerable lack of financial literacy and some consumers had little or no knowledge as to how their insurance policy worked. Some people felt that policies were worded in a way that only insurers understand and when a claim is turned down they are not given enough information about the reason.

Mr Pizzuto said the provision of private or voluntary health insurance constitutes an important supplementary service that exists alongside the national health scheme funded by the government. It offers beneficiaries faster access to health care by ensuring more speedy medical intervention, as well as a wider choice of health care providers.

Private health insurance enhanced competition for the provision of private healthcare services in Malta by creating new demand for these services by consumers who would likely opt for public healthcare if they did not have a private insurance policy.

However, he said, both the health insurance industry as well as the private health care sector suffered from a number of market failures.

Medical Association of Malta representative Mario Zerafa said private health care had advantages both for the patient and the government because it offered the patient more comfortable health care, while taking the load off the national health service.

Replying to a comment that doctors charged a different fee to patients who had a health insurance and those who did not, Dr Zerafa said a doctor was free to charge the fee he deemed right. He said a doctor could argue that his fee was the one he charged insured patients and lowered his price for others.

He also said it took time, sometimes even hours, for a doctor to fill in a medical report that a patient needed to present to the insurance company.

Dr Zerafa said that although there was no official fee structure, and a doctor could charge whatever he wanted, this did not mean that the insurance would pay the full fee.

He said a benefit maximum for doctors has been set since 1997, adding that it was unacceptable that insurers seemed to refer to this maximum as the fee a doctor should charge. He insisted that a doctor's fee could be lower or higher than the benefit maximum.

Simon Camilleri, from the Malta Insurance Association, said healthcare costs were constantly on the rise. He explained that the cost of a cataract extraction went up from Lm450 in 2000 to Lm930 in 2005 and a tonsillectomy increased from Lm300 to Lm550. Health insurance for a 25-year-old went up from Lm60 in 2002 to Lm180 in 2005 while that for a 55-year-old rose from Lm110 to Lm240

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