**My health insurance provider has written, saying I will not be reimbursed for my procedures unless they are carried out by one of their “affiliated providers”. Obviously these will be specialists who cost less. What concerns me is I may end up having to use specialists with the least experience or skill level, just so my health insurer doesn’t have to pay so much.
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It’s worth keeping a close eye on, but I’ve not seen any evidence so far that affiliated providers are less than adequate specialists. If health insurance is to remain viable as procedures get more costly, it makes good sense to ensure that specialists used are not over-charging. And I think there’s plenty of evidence that some specialists make fortunes by charging far more than others for the same procedures.
This issue is very similar to when car insurance firms began insisting you take your damaged vehicle to one of their nominated panel beaters. Some people were outraged, saying the insurer’s panel beaters did cheap, shonky
jobs. But, after a couple of decades, I think most of us accept the logic of insurance companies nominating panel beaters. Firstly, they weed out those that overcharge, and can do deals with affiliated panel beaters to keep the costs down for everyone. I think the same will happen with health insurers nominating specialists. And it will help prevent health insurance premiums from going through the roof.
Do you have a consumer question for Kevin? Email [[email protected]], or post to Weekly Consumer, PO Box 90119, Victoria St West, Auckland 1142.
