Fix private health insurance

Our health system should empower and support us to live happy and healthy lives. :ambulance:

But increasingly, thousands of us are feeling frustrated by high-cost, low-value and overly complex health insurance policies.

Today CHOICE joined forces with 17 consumer and public health groups to call for #privatehealth insurance to be fixed in Australia.

Join our calls for this industry to be examined:


Have joined the call!


Expansion of public health insurance would probably be more cost-effective. Perhaps much of the “fix” for the private sector lies in reducing its scope.


The whole ‘lifetime health cover’ thing was just another attempt by the Liberals to damage Medicare. They are still doing it - paying 30% of private health insurance, adding in a ‘Medicare Levy’, and ticking the boxes every year when the insurers say “we need to charge more!”.

I have signed on - we need to get rid of the ridiculous health system that is held together with bits of sticking plaster in some cases, and have a national Medicare scheme that includes hospitals and all the other things the states currently control but cannot fund.


It will be great if the government of the day does respond to this initative. I’ve added my support.

There is currently minimal transparency in the sector which makes informed debate impossible.

It makes little sense to live a healthier life and need to pay ever increasing premiums for a longer period of time. When for a car you get a no claim bonus reduction in premiums over time.

Health insurance could also reward healthy choices and sensibly, after X-years of paying for private cover with no major medical claims the rest of life should be free or a minimal nominal fee?

The same could apply to public as well as private cover.


Good on ya, hopefully something positive and decisive action by the government will result from this. I joined the call as well.
Like with all other major institutions it’s a never ending blame game. Here the health fund providers blame the ever increasing cost in treatment options, the government blames the health funds for price gouging and us consumers cop it in the end.
I wonder if the situation can be fixed step by step or otherwise maybe we need another Royal Commission?


A recent call by NIB CEO to scrap Medicare and put us all on Private Health insurance. He suggests that those who can’t afford it have their policies paid for by the Govt. Better idea in my opinion would be scrap Private Health Insurance (no profit taking then nor the inefficiency of many companies paying for CEOs etc) and only have Medicare fully funded to give everyone proper universal care.

One for CHOICE to perhaps weigh in on @BrendanMays/@ajohnson

Link to the article in the AFR:

Sorry it is behind a paywall for many.


Thanks for the heads up @grahroll :+1:


A Very American Republican outlook. It appears he attended Harvard Business School and rubbed shoulders with the monied there. It superficially reads like Obamacare. That is step 1. When the profits are not high enough he will move on to propose step 2, destroy all public and universal healthcare, ban policies for preexisting conditions, and may the healthy wealthy who can afford it be treated.

We should be afraid considering the track record of our parties, and especially the coalition.


Assume the broader community is also familiar with the not for profit advocacy organisation, the Consumers Health Forum of Australia.

The body received a recommendation to be one of the three participants in future Community Pharmacy Agreements, along side the Pharmacy Guild of Australia and the Pharmacy Society of Australia.

And the,
Australian Health Care Reform Alliance

It has some significant member organisations and policy objectives. One relates to the deregulation of pharmacy services. It’s internal policy document was largely reproduced as the ABC news item at the head of The Pharmacy Monopoly Racket Choice Community Topic.

Is this where Choice should also be, it’s a busy table?


Paywalled, so I can’t read the article.

The Totalitarian Capitalist way is one approach. I prefer the Social Democratic way.

Some things just shouldn’t be left to market forces. Health is one of them. Perhaps the private sector should be banned from health insurance. It certainly seems not to work - and the longer we try, the worse it gets. But then, I’ve never had much time for private sector insurance in general.


Relevant to the discussion, an alternative approach from Grattan:


What it fails to recognise is some of the positive benefits of the private health industry (a double edged sword), namely direct research and development or foundations established to support R&D. If the private health industry collapses, the weight of such would be placed on the public sector.

With cost pressures on the public sector, it is likely that R&D would be the first area hit when cost pressures are imposed by the health department bureaucrats.

It is worth noting that much of this R&D (both public and private) has lead to many of the medical and scientific breakthroughs which have improved the success of medical treatments, leading to longer and ‘healthier’ lives.

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That depends if government is business as usual. Once upon a time the CSIRO was one of the pre-eminent national labs that hit far above its weight and funding. Then a government decided it should pay its own way, some (arguably) feel it became politicised, politically guided ( censored ) and is forced to follow the (private enterprise) money to sustain its (politically) approved activities.

Funding R&D is as much ideological as anything. A reset could change the status quo, noting once upon a time there was a lot of public support to fund the CSIRO, as well as the ABC. Fund R&D, put the patents in the governments name, and apply any revenue to more R&D and supporting education, health, and welfare, not individual dividends.


That comes as something of a surprise.

Bupa has made grants totalling $31M since 2005. Hopefully that is not all?

Perhaps with only $22,500M of income last year (AU + NZ) it helps to explain their profit downturn?


Another article on what the NIB CEO said about using only Private Health Insurance and scrapping Medicare. The link follows:

Some parts from the article that perhaps point to why the NIB CEO & probably (most likely) the LNP Federal Govt would like Medicare to go away:

"Realising that “doctor of your choice” means nothing when you land in hospital as an emergency patient, the young are voting with their wallets. As the second graph shows, there’s not much interest in those expensive premiums, in subsidising the Boomers, below 30. "

"Only 41 per cent of Victorians and Queenslanders are privately insured, while 54 per cent of West Australians and Canberrans pay the premiums. "

"With a universal health care system, taxpayers across the board pick up the tab.

And, unlike the private health insurance industry, 14 per cent of what goes in is not eaten up by profits, tax, marketing and the cost of running the recirculation of money from premiums to hospitals and specialists."

“Meanwhile, Mr Fitzgibbon’s company is doing quite nicely. When announcing an 18 per cent lift in its interim results in February, NIB upgraded market guidance for the full year’s result due next month. Underlying operating profit is expected to be at least $195 million.”

Finally after this part about the profits of NIB the article asks the question (which should loom large in our minds) “Imagine what it might be if everyone was forced to take out private insurance”.


I found his comments laughable, given that the majority of NIB health cover relies on medicare funded doctors somewhere along the line, because some things are too expensive to insure.


A bit of history from Mungo MacCallum:

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And what then do you get that is any better for private health cover? A Mercedes branded ambulance, elective cosmetic surgery, a free annual OS clinic retreat?

How much of the government positioning is about the budget bottom line?
And how likely are any suggested changes to improve national health and well being?

A bottom line to health debate is whether healthcare is a human right, a right of citizenship, or a privilege.

While it could be seen as an idealistic human right, that is impractical because the global population would inundate any health infrastructure to the point of collapse.

As a right of citizenship those receiving care are paying for it through taxation, and the level of taxation to fund health care is a discussion, especially as our collective needs rise. Lower taxes and potentially a shorter lifetime due to lesser care makes sense to some but not to others. What is the value, price, and cost of prolonging life - an ethical and for some a religious issue.

Healthcare as a privilege? Those with sufficient wealth are able to buy whatever healthcare they need when they need it, and it has been so virtually forever and is not going to change. Eliminate the private system and the wealthy will go to another country for treatment if they want or need to. Complicating some of privileged treatment is the reality our system has put emergency care into the public trauma centres and the private system has very few emergency capabilities. That can be changed by legislation but should that happen by stealth, at all, or eventually by public support. If that happened we could learn about the US system where everything is user pays or charity.

Fall off a ladder and break your back in the US, or have a heart attack, or ruptured appendix, or [pick anything] - ambulance $$$ and when carried into the to ER, first questions are about one’s insurance or ability to pay, often with a credit card guarantee put on file. A late rellie in the US was a ‘sick puppy’ for many years and often spent 3-5 days in hospital at a time, and each episode was billed around $100,000. Two obvious questions, one being how 3-5 days of anything can cost $100,000, and how the business model for health insurance has to operate to pay such exorbitant amounts. In reality they negotiate with specific providers who take FAR LESS than the billed amount as full payment in return for the volume the insurance companies send their way. It is primarily about accountants and contracts. Our health funds with ‘network providers’ already operate under that business model.

The US system that the NIB CEO aspires to emulate puts accountants in charge, and the historic charitable system in the US requires hospitals to stabilise emergency patients but then allows private facilities to essentially dump uninsured/charity onto the streets to fend for themselves or literally dump them onto the few public hospitals, who likewise do their best to discharge them…

Since we have a coalition government, it pays to read the Liberal platform about Medicare. It reads well but the underlying message seems more about $$$$ than healthcare. The PM has reiterated this government is behind Medicare, but does not detail what that means in a long term practical sense. The Liberal party is seems to be a right-libertarian party in practice, and the left-libertarians (aka small ‘l’ Liberals) have seemingly been marginalised, to make the point. For balance a faction in the ALP seems to reflect left-libertarian ideals that creates tensions with liberal (progressive) ideals so little is clear at the political level.

Depending on how one perceives healthcare the ‘fix’ for private health insurance will vary dramatically, and often be tainted by political spin as well as point scoring. Each of us needs to read and understand what the words mean behind the claims, including what is unsaid as well as what is put in our faces by the vested interests and ‘their pollies’.