Private Healthcare Australia

26/09/2025

The rising cost of specialist medical fees is resulting in Australians delaying appointments. The number of first appointments with specialist doctors has dropped 10% in the last 5 years, with costs to see specialists such as psychiatrists rising to as much as $1000 in some cases. This is simply unaffordable for most Australians and causing reduced demand for private hospitals.

This morning, our CEO Rachel David appeared on ABC Radio Hobart to address the closure of the Hobart Clinic and soaring medical specialist fees. Read the full interview here: https://privatehealthcareaustralia.org.au/dr-rachel-david-spoke-with-abc-radio-hobart-about-the-closure-of-hobart-clinic-and-the-issue-of-soaring-medical-specialist-fees/

22/09/2025

New data suggests a rising proportion of Australians are experiencing pain that interferes with their ability to work for an income and engage in housework at home.

According to the latest data from the Household, Income and Labour Dynamics in Australia (HILDA) annual survey, pain is becoming more common for people in active jobs, such as labourers, technicians, machinery operators, drivers and trades workers compared to professionals and managers who work in offices. Other factors contributing to this trend across our population include chronic disease, obesity and more sedentary lifestyles.

Given the debilitating impacts of chronic pain and the costs for our health-care system and economy, slowing down this trend is imperative.

Health insurance funds are helping people prevent pain and manage pain through exercise, dietary advice and access to care in the community such as dental, physiotherapy and other allied health care. If you are experiencing pain, talk to your GP and act early to give yourself the best chance of recovery.

Click here to read more: https://theconversation.com/australians-are-in-more-pain-and-our-new-data-shows-its-not-just-due-to-ageing-265294

15/09/2025

No Australian should have to risk their financial security to afford dental care.

As Victoria Devine explains in The Age, a rising number of Australians are skipping dental treatment or tapping into their superannuation early to fund it.

This is causing dental fees to soar and should be subject to much tighter regulation.

On behalf of 15 million Australians investing in health insurance to access dental care among other healthcare, we want the Australian Government to address this.

Allowing people to access superannuation early for dentistry has driven up the cost of many dental treatments. It means all consumers of the private dental system are facing steeper costs for dentistry.

Read the full article here: https://www.theage.com.au/money/planning-and-budgeting/dental-care-is-too-expensive-and-it-s-our-super-that-s-suffering-20250912-p5muj7.html

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.”