Private Healthcare Australia

The NSW Government and private hospital groups, including one owned by a foreign private equity firm, have tried to raid health funds this year to fix their own budget problems. In a cost-of-living crisis, even small increases in fees will force people to downgrade or drop their health insurance, which will push more people onto the public system.    Health funds have done the hard work to respond to what consumers want and to financially manage their money prudently and efficiently. It is those who have failed to balance their budgets who are now trying to make consumers pay for their failures.    Our CEO Rachel David has shared suggestions for how the next Federal Government could make private healthcare more sustainable in The Australian Financial Review: https://lnkd.in/etgg22pZ

The Minns Labor Government has backed down on a health tax that would result in an immediate rise to the cost of health insurance for four million NSW residents.   The government passed legislation so it could increase the levy from $1.77 to $3.27 per adult per policy from early next year. It claimed this was necessary because several funds were not paying the government’s preferred rate for privately insured patient accommodation in single rooms in public hospitals. This is despite all funds paying the legally required rate set by the Commonwealth.    The NSW Government has now informed health funds that, in return for them agreeing to pay the state’s preferred rate, it will not raise the Health Insurance Levy.   Although this latest resolution is the least harmful option, NSW citizens are still likely to face an increase in health insurance next year, due to the Minns Government’s decision to raise $140 million annually from privately insured patients who receive a single room in a public hospital. Health insurance premiums in the state are expected to rise by about 2.5% as a consequence, on top of any other increases due to inflation and the rising cost of delivering healthcare.   Health funds have tried to negotiate the best deal for consumers because every additional cost drives up the price of health insurance. Our modelling shows that every time costs are added for health funds, and they push up premiums 1%, about 75,000 people drop out of health insurance because they can’t afford it.    Health funds will continue to fight as necessary to protect consumers.   Read our full statement here: https://lnkd.in/ebQ7AuSY   #NSW #HealthInsurance #HealthFunds

45% of Australia's population now has private hospital cover, according to the latest data from Australian Prudential Regulation Authority. Young people aged under 30 turbocharged growth in the last year, with a 5% increase in people in their 20s opting for hospital cover. The increasing number of Australians taking out private health insurance reflects a desire for rapid access to treatment with a doctor of choice.   The data also shows health funds paid 7.5% more to hospitals for medical treatment in the year to September 2024, suggesting that private hospitals are continuing to recover after a period of lower activity.    The ACCC has also confirmed that health funds are on track to exceed their promise not to profit from the pandemic, returning a total of $4.73 billion to consumers. This is more than health funds saved during the pandemic from lower claims.    Read more here: https://lnkd.in/gtXHEgAp

Healthscope has announced it is ripping up legally binding agreements and will start charging patients who use its hospitals from early next year. Owned by North American private equity group Brookfield, Healthscope runs 38 private hospitals across Australia. This is another unethical tactic by Healthscope, which is trying to bully health funds into paying them more so they can increase their profits.    In a cost-of-living crisis, it's disheartening to see that Australian patients, doctors, nurses and hospitals will be negatively impacted by Healthscope's decision. Health funds are doing everything possible to protect consumers against big foreign-owned companies like this. Federal data shows we now have more private hospitals in Australia than we did 5 years ago. There are more ethical hospital operators who are happy to talk to medical practitioners about switching patients, or doctors entire practices to alternate facilities.    Ripping up contracts and charging patients might be an American way of doing business, but there is no place in Australian healthcare for these unethical private equity bully boy tactics. https://lnkd.in/gxRaU5rM

Private health insurers financed $19.35 billion of Australia's total health spending in 2022-2023, according to Australian Institute of Health and Welfare (AIHW)'s recent Health Expenditure Report. More than half of health spending by private health insurers was for hospital services last year, with private hospitals receiving 50.2% of this spending ($9.72 billion).   The data also highlighted that public hospital services spending by private health insurers increased by 10.5% in 2022-23 with a total of $879 million spent.    This was a year still impacted by the effects of the pandemic, and claims have surged even further in 2024. Currently health funds return 88c to customers for every dollar of premium income received. The highest rate of return of any insurance type.   Health funds remain committed to ensuring Australian's can access efficient and top-quality care. Read the full report here: https://lnkd.in/gdsmw6My

We are deeply concerned by Melissa Cunningham story about allegations specialist doctors are defrauding patients, health funds and #Medicare for personal financial gain. These claims must be thoroughly investigated and, if proven, those responsible should face serious sanctions and have to pay the money back. Our CEO Rachel David said “Medicare needs to urgently investigate these allegations to ensure taxpayers are not footing the bill for wide-scale fraud in our private health system.” Consumers concerned they may have been a target of these alleged practices are urged to examine their medical bills to see if they have been charged a fee while being bulk-billed or treated under a “no gap fee” arrangement with their health insurer. #healthsystem #privatehealthinsurance #healthcare https://lnkd.in/gKhXkfGJ

Nurse practitioners should be given more responsibilities in private hospitals under Medicare to ease a shortage of medical specialists. The Albanese Government has recently made the necessary changes for nurse practitioners to operate more effectively in the community with Medicare rebates and referral powers. The next stage is to allow nurse practitioners to do the same in private hospitals.    We look forward to working with nurse practitioners to promote the next stage of workforce development – unleashing the potential of nurse practitioners in the private sector.   Read more here: https://lnkd.in/gVqD2iT2 Ben Harris

We applaud Professor Mark Cormack's "Unleashing the Potential of our Health Workforce Review Report" published this week. PHA supports the recommendation to introduce a new bundled payment for maternity care in the private health system. This will go a long way to encouraging more affordable and contemporary models of care for people having babies, including midwife-led models of care and those involving shared care with a GP. If adopted, this recommendation will create more options to boost the viability and affordability of private hospital maternity services in Australia. https://lnkd.in/gUzbS4zq Mark Butler Ged Kearney Australian Government Department of Health and Aged Care

Health funds remain committed to helping private hospitals in a way that does not unnecessarily push up the cost of health insurance for 15 million Australians. The Federal Government's "health check" found private hospitals experienced healthy profit margins in 2022-23, and that health insurance premium increases closely matched rising health fund payments to hospitals. This shows that what Australians pay for health insurance typically goes straight back out to hospitals to cover the cost of their care.    While the sector has had a difficult time, Australia has more private hospitals today than it did 6 years ago. Health funds will continue to work with the Federal Government, private hospitals and other stakeholders on ways to ensure our private health system can meet the needs of the 12 million Australians with hospital cover.

Suggestions in the media today that health funds will not pay for fibrin sealant medicines from 1 November in private hospitals are completely false. All health funds will be supporting the use of these medicines in future. There is no need for patients to be concerned about accessing these medicines if they require them in future. Fibrin sealants are medicines used to stop bleeding and help wounds heal.   In October, the Department of Health and Aged Care changed how these medicines will be funded from November 1 as part of its reforms to the Prescribed List of Medical Devices and Human Tissue Products. During the Department of Health and Aged Care’s consultation about this change, health funds made it clear they would support access to these valuable medicines for their members receiving healthcare in hospitals.   You can read about DHAC's decision here: https://lnkd.in/e8K_f_Ed