The Australian Medical Association has called for urgent regulation to stop private health insurers offering doctors “take it or leave it” contracts.
The Australian Medical Association has warned private health insurers are abusing their market power by forcing doctors into inflexible contracts that limit patient choice and drive up out-of-pocket costs.
In a position statement released on Tuesday, the AMA said insurers should be banned from offering “take it or leave it” agreements, arguing the practice unfairly shifts costs onto patients.
About 97% of procedures in private hospitals are performed under “no gap” or “known gap” arrangements negotiated between doctors and insurers.
AMA federal president Danielle McMullen said doctors who refuse to sign contracts because fees are too low can trigger reduced insurer benefits for patients.
She said insurers then blame doctors’ fees, despite medical benefits remaining largely unindexed and the $500 “known gap” cap unchanged for years.
McMullen said the contracts no longer reflect the real cost of providing care and described the arrangements as deceptive and unfair.
The AMA argues stronger regulation is needed to prevent insurers using their dominance to dictate terms that ultimately increase patients’ out-of-pocket expenses.
