Private Health Insurance Consultations 2015-16

Page last updated: 18 October 2016


Australia has a mixed public and private model of health care funding and service delivery. Private health insurance offers members greater choice in the provision of treatment, coverage for some services not included under Medicare arrangements, and may offer shorter waiting times for some services.

As at 30 June 2015, 11.3 million Australians were covered by hospital treatment cover (47.4% of the population) and 13.3 million Australians had some form of general treatment cover (55.8% of the population). In 2014-15 the Australian Government spent $5.8 billion on the Private Health Insurance Rebate.

In common with public health funding, private health insurance sustainability is being impacted by:
  • the growth in chronic disease
  • increasing patient expectations about access to services
  • the number and range of health services provided
  • the increasing cost of those services
  • an ageing population.
The Australian Government is undertaking a number of reviews aimed at ensuring that consumers can access affordable, quality and timely health services into the future.

Private health insurance has important links to these reviews. As such, on 28 October 2015 the Minister for Health, the Hon Sussan Ley MP, announced consultations focused on the value of private health insurance for consumers and its long term sustainability. View the Scope of the Consultations here.

Announcement of Consultations

Minister Ley announced consultations on 28 October 2015 during her address to the National Press Club. View her address on the Department's website.

Information for Consumers

Private health insurance is complex. View the Consumer Fact Sheet.

For more information about private health insurance, visit the Private Health website (

Overview of Consultations

An online consumer survey opened 8 November 2015 and closed on 7 December 2015. There was a large public response to the survey with over 40,000 Australians taking the opportunity to have their say on private health insurance.

The results from the consumer survey showed that the cost of private health insurance was of greatest concern to consumers overall. Expense, affordability and lack of value for money were issues common to people both with and without private health insurance.

Targeted industry roundtables were held in the week of 16 November 2015. Eight roundtables were held in Canberra, Melbourne and Sydney with over 100 organisations represented.

Interested stakeholders were able to provide submissions to the Department of Health by 4 December 2015.

An issues paper was developed to guide the roundtables and submissions.

The written submissions indicated that stakeholders held a wide range of views on key issues and reform options. A summary of the written submissions identified the following six themes:

  • community rating;
  • consumer issues;
  • coverage;
  • deregulation;
  • efficiency; and
  • the future of private health insurance.
Thank you to all who participated in the consultations.

Prostheses reform

Minister Ley announced on 5 February 2016 the establishment of an industry working group to examine opportunities for reform of the arrangements governing prostheses and devices access and pricing in the private health insurance sector.

Next Steps

The Department of Health will be consolidating the input from the consultation process and will report back to Government in the first half of 2016.

More information

Enquiries: email PHI Consultations 2015-16
Media enquiries: News or contact 0412 132 585