Have your say on private health insurance

Health Minister Sussan Ley announced late last month that the Federal Government would undertake consumer consultations as part of its review of Private Health Insurance. She advised that there would be a focus on value for consumers and the long-term sustainability of private health insurance in Australia. Consultations will also be held with insurers, hospitals and doctors to discuss structural reform to the system to draw out better value for consumers.

As at 30 June 2015, 11.3 million Australians were covered by hospital treatment cover (47.4% of the population) and 13.3 million Australians had some form of general treatment cover (55.8% of the population). Last financial year the Australian Government spent almost $6 billion on the Private Health Insurance Rebate. Around 500,000 ‘all-inclusive’ policies were dropped last year in favour of cheaper premiums that apply exclusions or excesses. Consumers are clearly unhappy with both rising premiums and the overall value of their private health insurance.

The sustainability of private health insurance is being impacted by factors such as:

• the growth in chronic diseases, including of course chronic pain affected more than 3.2 million Australians;
• increasing patient expectations about access to services;
• the number and range of health services provided;
• the increasing cost of those services; and
• an ageing population.

Currently, private health insurance premiums in Australia are not risk rated like other forms of insurance. This means that all consumers pay the same premiums as others for the same policy, regardless of their age or health status. To ensure that everybody who chooses has access to health insurance, the principle of community rating prevents private health insurers from discriminating between people of the basis of their health or for any other reason. There have been suggestions, as evident in the Government’s consumer survey, that moving away from community rating to a tailored premium system based on lifestyle risk factors could be considered.

Consumers Health Forum (CHF) has welcomed the Health Minister’s announcement of consultation on health insurance, but has cautioned that “sufficient time and analysis needs to be given to identifying issues and shortcomings in the current arrangements, to identifying solutions, and underlying circumstances that mitigate against a good value deal for health fund members as well as uninsured Australians”. The role of private health insurance in our health system needs to be carefully considered, with a number of regulatory incentives and penalties in place alongside shrinking coverage and increased expenses for consumers. Despite the Government’s Private Health Information Statements for every policy available, there is so much variation that it is almost impossible for consumers to compare private health insurance products in order to be able to make an informed decision. As consumers we need to ensure that the Government’s significant investment in private health insurance supports equitable access to quality health care for all Australians.

It’s time to get involved and have your say – find out more and let the Government know what you think on this critical issue which will have wide-ranging implications for our health system in Australia. The Government’s only direct consumer outreach is via an on-line survey, which is available through the review’s consultation portal here.

The CHF as part of its submission development has created and publicised its own consumer survey. The results of this survey will be a crucial component of CHF’s submission, and will also help organisation’s such as APMA prepare our own submissions.


The Australian Pain Management Association Ltd. (APMA) is a health promotion charity providing advocacy, information and practical support for people living with chronic (persistent) pain and their families. APMA is the consumer health organisation for all Australians who live with pain. APMA is your voice.


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Australian Pain Management Association Ltd. (APMA)
Level 1, Gabba Towers, 411 Vulture St, Woolloongabba QLD 4102
GPO Box 2104, Brisbane 4001