No Gaps Health Insurance: a Gain for Consumers or a Windfall for Specialists?

Abstract

Attempts to introduce contracts between the purchasers and providers of Australian health services in the 1990s in order to reduce the gaps, or 'copayments', that patients pay have met with limited success. However, the Harradine requirement that health funds introduce 'no gap' or 'known gap' policies by the middle of the year 2000 has raised a political storm within the AMA and set the funds and doctors in an adversarial position. This paper traces the history of 'gaps' and gap insurance, provides an interpretation of the present situation and speculates about likely outcomes.