A national obstetricians group is calling on the Human Rights Commission to stop private health companies from charging "gold-level" rates if members want to be covered for pregnancy and birth care.
Private health companies charge a higher level of cover if members want to include pregnancy and birth-related services, which is often accompanied by a 12-month waiting period before they become eligible to use it.
The National Association of Specialist Obstetricians and Gynaecologists (NASOG) claims it is a form of discrimination when many men's reproductive issues are covered at a lower level.
"Conditions specifically related to male reproductive health, such as testicular torsion or cancer and prostate issues, are covered in cheaper entry-level insurance policies, but pregnancy is only covered in the top level of cover," NASOG president Gino Pecoraro said.
Dr Pecoraro said NASOG wrote to the Human Rights Commission a year ago but was yet to hear whether the issue had been looked into.
The commission has told the ABC it does not release information about individual complaints.
NASOG also started a petition and wrote to "almost every" federal MP about the issue but had yet to see any progress.
"The federal government allows the health funds to get away with saying only women who have gold insurance policies will be covered for pregnancy and that's just not fair," Dr Pecoraro said.
"It goes totally against the principles of community ratings for insurance.
"The government lets the health insurance industry, which is making record billion-dollar profits, get away with this."
Women are being charged hundreds more per year
When Samantha Burazin from the Melbourne suburb of Attwood had her first child two years ago, she suffered from cholestasis — a liver disease that can spontaneously develop during pregnancy.
It can lead to life-threatening complications for the mother and baby, including premature birth.
"The only way to get rid of cholestasis is to have the baby. So I asked the public health system if I'll be able to have extra blood tests next time around for extra monitoring," she said.
"But I was told no, only if I was showing symptoms."
Ms Burazin is now weeks away from giving birth to her second child and wanted to be closely monitored because there was a high probability of again suffering from cholestasis and it could be worse this time.
"The issues were not going to be as closely monitored as I wanted in the public system, so I felt I needed to go private this time," she said.
In late 2020, Ms Burazin decided to plan early and add pregnancy cover to her private health insurance.
But it came at a cost for her young family.
"We had to up the private health to the highest level, the price difference was an extra $50 a month and then it increased again by $20. So we're now paying an extra $70 a month," Ms Burazin said.
"The fact you have to have it as well for 12 months before the pregnancy and birth cover kicks in is annoying.
"And you put the obstetric charge on top of that, which for me is around $3,000, so it costs quite a bit extra than going public."
Public health system under pressure
Dr Pecoraro said unaffordable private health was forcing women to go through the public hospital system.
"The public sector was never designed to support everyone having a baby. We need both systems to work together," he said.
"Already overstretched and under-resourced public health units are now under more pressure.
"We are hearing women are being ushered out of hospital quickly after having a baby in the public sector — as early as two to four hours after a vaginal delivery, 24 hours after an elective caesarean section, and two days after an emergency caesarean section.
"The care is now being offloaded to the local GP who is already overstretched."
Out-of-pocket costs also cause pain
Private Healthcare Australia (PHA) chief executive Rachel David agreed the increasing cost of private health was putting pressure on the public system.
But she said the issue that needed to be better addressed was the out-of-pocket costs for women who went through a private specialist.
Obstetricians usually charge between $3,000 and $5,000 depending on how much they elect to charge above the Medicare scheduled fee.
"Health funds are not allowed by law to cover those costs … there is a significant gap fee, which puts most patients off," Dr David said.
Dr David said the gold, silver and bronze-tier system needed to be changed.
Currently, government regulation requires pregnancy and birth to be included in top-level cover, but it is a commercial decision by private health companies to include them at a lower level.
"It's made top hospital coverage very expensive," Dr David said.
"Freeing the system up so that health funds can make their own choices about what treatments are in each tier is going to be important.
"If private health can guarantee that consumers are better informed about what they're covered for then the strict tiering system becomes less important."
