Health Reform Patients


More and more Aussie families are choosing to downgrade or cancel their private health insurance – you may even be one of them. The cost of private health insurance in Australia has been continuing to rise, making it increasingly more difficult to justify its costs for thousands of Australian families. And with the Commonwealth Government’s new health insurance categorisation reforms, families will end up paying more for health insurance, while receiving less.

  • Here’s the gist: Industry association, Private Healthcare Australia (PHA), has proposed a number of key reforms it believes will “address the rising costs of healthcare and stem the movement of members to an already overburdened public health system”.
    PHA wants to:

    • cut the number of items listed on the Medicare Benefits Schedule (MBS);
    • permit health insurers to fund specific out-patient services;
    • increase home-care and community-based treatments – removing people from hospitals; and
    • implement international reference pricing and price disclosures, and assessments of new health products to further cut the prices of medical devices in Australia.

As of June 2018, 54% of Australians had private health insurance. But without further reforms, PHA believes this number could plummet to 30% by 2030/35.

  • Why do this? Like any industry association group, PHA’s primary goal is to represent and defend the interests of its member health insurance companies. Ensuring a viable private health insurance sector in Australia is a core goal for PHA, but so too is ensuring their members don’t face adverse financial impacts due to public policy decisions and reform.

PHA CEO, Rachel David, said “wasteful costs in the health system are not unique to the private sector… Often this is down to health system design and regulations, which are not fit-for-purpose”.

KEY INSIGHT: An agreement, struck between the Commonwealth Government and the medical technology industry in 2017, to cut prices on the Prostheses List was a major contributor to last year’s health insurance premium increase being the lowest in 18 years.

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