Monday, August 19, 2013

Notes from the Southern Cross Road Show 2013 (Part One)

Recently one of our team attended the Southern Cross Health Insurance Roadshow. Here is her experience from the event, and what the experts are saying about the current state of Southern Cross, health insurance in New Zealand, the private health care system and several forthcoming changes.

Lars Bojsen-Moller (Chief Operating Officer - Marketing and Distribution) took to the floor first up, a really interesting, knowledgeable man, who has been around the world several times comparing the world's public health and health insurance systems. I have broken down as best as I can his hour long presentation.

·         Southern Cross has 61% of the NZ market share.
·         Grew by only .08% last year.
·         Processing 2000 claims a day at $2.8 million.
·          Southern Cross has had an A+ Claim rate for 9 years in a row.
·         Southern Cross had 12% fewer cancellations last year.
·         They have the biggest Adviser Group and were happy to report that Group Schemes were on the rise.

However, on the negative side:

Unfortunately, NZ Health Insurance overall is in decline and has been for the past 3-4 years. This is a direct result of people’s disposable income being increasingly under pressure and the amount of redundancy increases. Also, confidence in Insurance Companies is at an all time low across the board.

Lack of disposable income among Kiwis is hurting the Health Insurance Industry.

Lars spoke with much passion and at great length about a significant problem we are having with specialists/surgeons overcharging and the perception from members and the public that the more the surgeons/specialists charge, the more it must mean they are “the best”. From the statistics, this is not entirely the case. Private practitioners have made sure they have greater demand than supply and have been able to apply this for a long time, by setting their price structure high, and this is not about to change in the foreseeable future. I guess what this means for Southern Cross and the Health Insurance industry is they are being effectively caught in the middle of paying too much and keeping up with meeting member expectations. This will take a long time to remedy, the surgeons and specialists are happy, very happy actually, and the members don’t care about cost as long as they can claim 100% of their procedure, Southern Cross unfortunately are left paying as necessary for procedures that are boosted in price by surgeons and private health care providers. You can understand Southern Cross’s frustration.

The cost being charged by private surgeons is doing damage to the health insurance business, according to Lars Bojsen-Moller.

A recent survey showed most Aucklanders refused to receive private treatment outside of Auckland. North Shore people refused to even receive treatment over the Harbour Bridge. Auckland is by far the most expensive city in NZ for any private procedure and that’s because quite simply, they just can be. For example:  A knee replacement would cost $17,990 in Marlborough and a whooping $26,029 for the exact same procedure in Auckland. The interesting fact is that if anything was to go wrong in Private Surgery/Hospital you end up in the Public hospital!

A lot of Auckland Private surgeons/specialist aren’t willing to contract with Southern Cross, they are price setting and getting away with it. However Southern Cross has contracts with some affiliated providers and this is when you swipe your card and the specialist involved sorts out your prior approval etc which has been the case for quite sometime and which they are hoping to spread further throughout the health care system. If this goes the way Southern Cross wants it to, they believe it will end up helping the public and make a positive impact on mitigating the stresses involved with health insurance prior approvals.

In the next part: We'll see what other initiatives and changes Southern Cross are looking at implementing, some statistics on claims, and how these changes will affect you as insurance clients.

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