Private Healthcare Australia

03/09/2025

ACT residents with health insurance are being charged excessive out-of-pocket costs for using their insurance in a public hospital. Our analysis reveals at least 30% of ‘private patients’ treated in ACT public hospitals in 2022-23 received bills ranging from $50 to over $9000.

When someone opts to use their health insurance in a public hospital, doctors can legally charge as a private specialist. Patients can also be charged for diagnostic services by doctors they have never seen, never met and did not choose.

Patients often receive the same services they would as a public patient without health insurance but find themselves hundreds or thousands of dollars out-of-pocket because they ticked a box to use their health insurance. Patients are often signing these documents when they’re very ill, raising ethical concerns about their ability to consent.

Read our release here: https://privatehealthcareaustralia.org.au/people-with-health-insurance-are-receiving-shock-bills-from-act-public-hospitals/

01/09/2025

From January 2026, the ACT “Ambulance Levy” will rise by 10%, forcing more than 318,000 Canberrans with health cover to pay higher bills:

$180 a year for singles
$360 a year for families

This is the wrong policy at the wrong time. Canberrans already face the highest GP and specialist fees in the country, and many households are struggling with cost-of-living pressures.

More than half of those with private cover in the ACT earn under $90,000 a year and 26% earn under $50,000 a year.

Instead of supporting people who take pressure off the ACT’s busy public hospitals, this tax risks driving them out of health cover, making ambulance waits, ED queues and surgery delays even worse.

Read more via our website: https://privatehealthcareaustralia.org.au/act-health-insurance-tax/

29/08/2025

Australians seeking healthcare in the private system have been slugged with a 9% surge in hospital out-of-pocket fees over the past year, driven largely by increased charges from medical specialists, new APRA data shows.

The sharpest rise is in orthopaedic surgery, including common procedures like hip and knee replacements. When orthopaedic surgeons charge a gap fee, the average is now $1531 on top of what Medicare and health insurers already pay – the highest among all specialists. The average gap fee for orthopaedic surgeons was up 8.7% from the previous year.

https://privatehealthcareaustralia.org.au/specialist-doctors-hit-australians-with-soaring-out-of-pocket-bills/

27/08/2025

The rising cost to see specialist doctors in the community is causing too many people to skip or delay healthcare. The number of first appointments with specialist doctors has dropped 10% in the past five years despite our population growing 7%. This is reducing demand for private hospitals and putting more pressure on our busy public hospitals.

Our CEO Rachel David spoke with ABC News Radio National Breakfast about some of the potential solutions.

Listen to the discussion here: https://www.abc.net.au/listen/programs/radionational-breakfast/specialist-fees/105691672 https://privatehealthcareaustralia.org.au/dr-rachel-david-spoke-to-abc-radio-sydney-about-the-rising-cost-to-specialist-doctors-in-some-parts-of-australia-and-what-can-be-done-to-improve-access/

21/08/2025

A new virtual rehabilitation program for people hospitalised for heart problems is improving health and slashing the risk of return visits to hospital for ongoing illness. This is a great example of the innovative, convenient care health funds are offering for Australians all over the country. It’s helping people access care from home regardless of where they live, improving their health, quality of life and productivity.

Research found Medibank’s virtual cardiac rehab program:

- Doubled participant’s physical activity
- Improved diet, weight, and blood pressure
- Reduced depression and anxiety
Increased quality of life and confidence to manage risk factors
- Slashed return visits to hospital by 71% in the three months after hospitalisation.


Health funds are investing in more connected, convenient services to help their members stay well and out of expensive hospital care.

Find out more about Medibank's program here:

Medibank’s Heart Health at Home a game-changer in cardiovascular care

06/08/2025

Knee replacements are booming in Australia - but is it always the right choice? As Stephanie Wood writes in the SMH today:

• Some patients still struggle with pain and mobility after surgery.
High expectations sometimes go unmet - surgery isn’t a ticket back to running marathons.

• Less invasive options like physio, weight reduction and other lifestyle changes are overlooked, despite strong evidence of benefit and more options being available.

• Talk to your GP or physio before jumping into surgery. There might be less invasive, safer treatments available for you.

You can read the full article here:

Knee replacement operations are booming – and restoring mobility for millions. But many are questioning whether the scalpel is always the best option.

30/07/2025

Adding GST to private health insurance is a dangerous move that would cost Australians and our health system.

This is one of the ideas being put forward ahead of next month's Economic Reform Roundtable. Not only would this policy impose an unnecessary cost on 15 million Australians, it would also undermine the stability of our mixed public-private health model, which is internationally recognised for delivering efficient, high-quality care.

For households, the impact would be immediate and painful. A GST on health insurance premiums would add up to $600 a year for families with common silver-tier policies and more for those investing in top level gold cover.

Nearly two thirds of the 15 million Australians who choose to have a private health cover earn under $90,000. One-third earn under $50,000.

The Government is rightly pursuing reforms to secure a more sustainable future and boost productivity in our health system. Imposing the GST on health insurance would undermine this agenda. It would weaken Australia's public and private health sectors, and impose a significant financial burden on consumers, and state and territory governments in Australia who are already grappling with rising healthcare costs.

Read our CEO Rachel David's thoughts on The Australian Financial Review:

A 10 per cent increase in premiums would be a self-defeating policy that would hurt households, destabilise the health system, and increase pressure on public hospitals.

17/07/2025

Did you know that increased thirst, frequent urination, excessive hunger, fatigue, blurred vision, slow-healing sores, and numb or tingling hands or feet can be signs of type 2 diabetes?

If you’re worried about any of these things, talk to your GP. Early diagnosis of pre-diabetes and type 2 diabetes can prevent complications and give you a chance of remission.

By answering the Australian Government’s diabetes risk assessment survey below, you can calculate your risk of type 2 diabetes in the next 5 years.

The best cure for type 2 diabetes is prevention. Know your risk factors, know the signs, and take action to protect yourself.

https://www.health.gov.au/resources/apps-and-tools/the-australian-type-2-diabetes-risk-assessment-tool-ausdrisk/tool

09/07/2025

After breaking his neck in an unexpected fall, health policy expert Bill Bowtell tells The Australian what it was like to go from strategist to patient.

Following several months of inpatient and home-based treatment, Bill shares his experienced of Australia’s mixed health system, which he found excellent.

Bill was particularly impressed by the ‘hospital in the home’ service provided by his health insurer and he maintains it’s time to re-think how healthcare is delivered in Australia, so more out-of-hospital options are rolled out.

Read Bill's insights, here:

In the emergency room at Christchurch Hospital, the doctor stitched up the deep gash on my forehead, sent me for a CAT scan and delivered the results: “You’ve broken your neck.”

08/07/2025

Cancer rates in Australians under 50 are rising, as evidenced by a new study by ABC Australia Four Corners. Australians aged in their 30s and 40s are experiencing unprecedented rates of at least 10 different types of cancer, including prostate cancer, pancreatic cancer, liver cancer, uterine cancer and kidney cancer.

Especially alarming is the growth rates of bowel cancer in Australia - since the year 2000, rates of bowel cancer in 30 to 39-year-olds has increased by 173%.

It's important for young Australians to understand the risk factors for cancer and make sure they do not ignore any warning signs given we know the earlier the cancer is detected, the better the outcomes are likely to be.

Read more via the ABC piece here: https://www.abc.net.au/news/2025-07-07/cancer-diagnosis-rates-under-50s-rising-causes-four-corners/105495620

08/07/2025

Did you know that Australia has the highest rate of ACL surgical reconstruction in the world? 🦵🩺

The Australian writer Virginia Tapscott shares her experience following an injury which caused her ACL to tear. Instead of opting for a traditional surgery, she made the decision to heal her injury using a knee brace and rehabilitation - a tactic that has seen great results in different medical trials. She has now made full recovery.

Surgery can be costly, time intensive and carry other medical risks. When faced with an injury, it's always worth asking your doctor whether proven non-surgical alternatives are available.

Read the full piece here:

‘Part robocop, part woman limping around in bikini’: braced for a gamble

07/07/2025

According to the ATO more than 768,000 individuals currently pay the Medicare Levy Surcharge (MLS) each year. At the start of this financial year, here's 5 things to know about the MLS and why it's likely better to take out hospital cover and avoid paying the MLS. Swipe through below 👇