Doctors and federal MPs are calling for an independent national authority to oversee Australia’s private health system, arguing that greater transparency and accountability are needed to protect patients and improve value for money.
At a press conference in Canberra, Australian Medical Association president-elect Dr Michael Bonning, Australian Society of Ophthalmologists president Dr Peter Sumich, and federal MPs Dr Monique Ryan and Andrew Wilkie backed the proposal, which the AMA says it has been developing since 2020.
The proposed authority would oversee the sector and help balance the interests of patients, doctors, private hospitals and health insurers. Supporters say the current system lacks an effective mechanism to resolve disputes and address problems affecting patients and providers.
Wilkie said private healthcare was a critical part of Australia’s health system, but financial pressures, hospital closures and growing consumer dissatisfaction were raising concerns about its long-term viability.
He said a national regulator could help ensure the private system operated effectively for patients and the wider health sector.
Dr Bonning said Australia’s combination of public and private healthcare offered patients access and choice, but warned that the system was coming under pressure.
He argued that the cost of private health insurance premiums was not consistently reflected in patients’ experiences, and said voluntary commitments from industry participants had not delivered the necessary improvements.
“We want that choice and patient care to be defended and protected,” Dr Bonning said, calling for an authority that could balance the needs of patients, doctors, hospitals and insurers.
Dr Sumich said the private health sector represented an estimated $30 billion of the economy but remained difficult for many consumers to understand. He argued that an independent watchdog could provide a forum for resolving disputes and improving fairness and value for people holding private health insurance.
Ryan said Australians had contributed about $100 billion to the private health industry through the private health insurance rebate since it was introduced under former prime minister John Howard. She questioned whether consumers were receiving adequate value for the money they paid in premiums.
She also raised concerns about the financial pressures facing private hospitals, claiming that 80 hospitals across the country were expected to close within five years because of financial difficulties in the industry.
The figures and forecast cited by the MPs were not independently verified during the press conference.
The call for stronger oversight comes amid a separate debate over proposed changes to the private health insurance rebate for people aged over 65.
Ryan said figures she had obtained indicated that 44,000 older Australians were expected to drop their private health insurance in the first year of the proposed changes, rising to as many as 78,000 in subsequent years. She said the government’s modelling and the potential effects on state health systems should be made public.
Wilkie also opposed the proposed rebate changes, arguing that some older Australians on limited incomes could struggle to maintain their cover. He warned that people leaving private insurance could place additional pressure on public hospitals.
Dr Bonning said some Australians had maintained private health cover for decades because they wanted access to treatment as they grew older. If they dropped their policies, he said, they could face longer waits for some forms of care in the public system.
Dr Sumich said patients could also be frustrated when their policies did not cover the procedures they believed were included, reinforcing the need for clearer information about insurance products.
Ryan called on the government to abandon the proposed rebate changes, while saying she was working with the Greens to oppose the legislation.
The proposed regulator and the dispute over the rebate raise separate questions about how the private health system should be funded and overseen. While the doctors and MPs argued that greater transparency and accountability were needed, the press conference did not set out the proposed authority’s precise powers, funding arrangements or enforcement mechanisms.
Any new regulator would also need to clarify how its responsibilities would interact with existing oversight of private health insurance and hospital services.
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