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Friday, 12 September 1969


Mr Whitlam asked the Minister for Health, upon notice:

(1)   What payments were made to registered medical benefits organisations by:

(a)   their members and

(b)   the Commonwealth in 1968-69.

(2)   What payments of

(a)   organisation and

(b)   Commonwealth benefits were made to or in respect of their members by the organisations in 1968-69.

(3)   How many members

(a)   made payments to the organisations and

(b)   received payments from them in 1968-69.

(4)   How many claims qualified for

(a)   organisation and

(b)   Commonwealth benefits in 1968-69.

(5)   What was the average amount paid in

(a)   organisation and

(b)   Commonwealth benefits.

(6)   What were the principal reasons for refusing organisation benefits and in what percentage of claims did each of these reasons apply.

(7)   What are the

(a)   reserves and

(b)   operating expenses of the organisations and what percentage of members' contributions did the operating expenses represent.

(8)   How many medical benefits organisations were in operation during 1968-69.

(9)   What percentage of the population of each State and of the Commonwealth contributed to medical benefits organisations in 1968-69.

(10)   What percentage of contributors in each State and in the Commonwealth was enrolled in each medical benefit table in 1968-69.


Dr Forbes - The answer to the honourable member's question is as follows:

(1)   (a) Payments made to registered medical benefits organisations by their members during the financial year 1967-68 amounted to $68,018,974. Figures for 1968-69 are not yet available.

(b)   Payments made to registered medical benefits organisations by the Commonwealth during the financial year 1968-69 amounted to $49,556,134 (this figure includes payments of $1,145,623 towards Special Account deficits).

(2)   (a) Payments of Fund benefits (including ancillary benefits) to members during 1968-69 totalled $58,031,143, and

(b)   Commonwealth benefits paid amounted to $48,410,511.

(3)   (a) There were 3,635,426 members of registered medical benefits organisations as at 30 June 1969.

(b)   Details in respect of the number of members who received payment from registered medical benefits organisations are not available.

(4)   (a) Claims for Fund benefit were accepted in respect of 33,964,904 services during 1968-69.

(b)   Commonwealth benefit was paid in respect of 32,927,642 professional services during 1968-69.

(5)   (a) The average amount of Fund benefit paid per service during 1968-69 was $1.71.

(b)   The average amount of Commonwealth benefit paid per service during 1968-69 was $1.47.

(6)   The principal reasons for refusing payment of Fund benefits were:

(a)   the service was not rendered by a doctor in private practice,

(b)   the service was rendered during an ordinary waiting period or a maternity waiting period,

(c)   the member contributed to a Fund table which did not provide a Fund benefit for the particular service,

(d)   (he claim was not submitted within 12 months of the date of service, and

(e)   ineligibility due to provisions concerning non-payment where there is a claim to compensation or damages.

Information to permit a calculation of the percentage of claims refused for each of the reasons mentioned is not available. However, during 1968- 69 the number of individual services for which no Fund benefit was paid represented 1.23 per cent of the total individual insured services.

(7)   (a) The aggregate reserves of registered medical benefits organisations, including provisions for outstanding claims, were $43,938,511 as at 30 June 1968. The figure as at 30 June 1969 is not yet available.

(b)   The operating expenses of registered medical benefits organisations amounted to $10,278,277 in 1967-68 and represented 15.1 per cent of contribution income. The figures for 1968-69 are not yet available.

(8)   There were seventy-eight registered medical benefits organisations operating throughout Australia as at 30 June 1969.

(9)   The estimated number of contributors and their dependants and that number, expressed as a percentage of the total population* by States as at 30 June 1969 is set out hereunder:

 

(10)   The percentage of members enrolled in the various medical benefit tables as at 30 June 1969 was as follows:

 







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