Private Health Insurance. Level Playing Field?

Dentists are often asked by their patients about private health insurance for dentistry, and which “fund” is best.

An interesting question.

What is the best answer?

Let me start by saying this:

Whenever there is a third-party intermediary between the provider of a service and the receiver of a service there will always be opportunity for compromise as well as extortion.

This will happen if the third party is an insurer, or if the third party is an employer, or if the third party is a government.

Let’s look outside of health. If your employer offers to pay your out of pocket expenses on car, or travel, would you tend to spend a little more than if you were paying your own way?

Even in the automobile repair industry down here years ago, a well-known insurer received fines when it was found out that they were using non-genuine parts in their company owned auto-repair shops where members of the insurer were taking their cars for repairs.

This was simply a case of extortion because of opportunity, where the insurer was the provider of the service as well as the entity paying for the service.

But the poor old consumer thought they were being “looked after” by their insurer….

Of course this would never happen in health care?

An article in last week’s news reported that the Australian Government is working to “dramatically reduce” annual premium hikes from insurers so that they will be as close as possible to the general inflation rate of two per cent currently.

This comes at a time where ten thousand Australians are ditching their policies every month, because they are confused about coverage, they are unsure about value, and they are angry at the cumulative premium increase of close to fifty five per cent since 2009.

And the premium increases by the insurers have been dramatically higher than the cost of living for as long as I can remember, going back to 2001 at least.

Each and every year the insurers go cap in hand to the Government with their “bleeding hearts” and come away from the meeting being granted permission to excessively increase premiums, despite the fact that rebates or refunds for health services are not being increased by the same percentages on a per item basis. And insurance membership numbers are declining.

It eats at my craw that insurers will attempt to deflect attention away from their own inadequacies.

Just last week one insurer, who is happy to spend hundreds of thousands of dollars sponsoring sport every summer, was crying poor and suggesting that comparator websites are adding significantly to the cost of healthcare by taking their cut for their service.

Isn’t that the pot calling the kettle black?

Even the Australian Dental Association has questioned the double standards and this insurer’s lack of transparency.

These insurers and big corporates that provide dental services are also renowned for drawing up “concocted agreements” with their employees to make those employees, who only provide labour really, appear to be contractors, thus avoiding their obligations as an employer, of paying holiday pay, sick pay, superannuation and long service leave, in what would be easily considered as an attempt to gain “an unfair competitive advantage in the market place”.

Frankly, if it walks like a duck and quacks like a duck then there’s a good chance that it is a duck.

Labour is labour. Exchanging time for dollars is employment, no matter how you dress it up.

Most “contractors” in dentistry are really labour providers only.


Contractors exist in other industries where work is seasonal, and employment is tied to a specific time agreement. Or where trades are engaged to complete a certain task in a set time frame, such as painting, or plastering, and the contractor is providing all of their own equipment and tools.

Employers of any sort in dentistry may be in for a rude shock when their “ducks” start asking for their unpaid entitlements that they have been hoodwinked out of.

You cannot write an agreement that contravenes the laws of the land.

And fair work entitlements are those. They are the laws of the land… just in the same way that bigamy is outlawed because of a law of the land and cannot be dismissed or ignored because of some “concocted agreement”.

It is time we took a really good look at the “business practices” of the bigger corporates…


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