Summary of the first meeting of the Private Health Ministerial Advisory Committee, 29 September 2016, Department of Health offices (Scarborough House), Canberra

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Page last updated: 07 October 2016

Printable version of the Meeting Summary 29 September 2016 (PDF 126 KB)


MembersProxies and Secretariat
Dr Jeffrey Harmer, ChairAlex White, Australian Medical Association (AMA)
Matthew Koce, hirmaaAndrea Kunca, Medical Technology Association of Australia (MTAA)
Ian Yates, COTA AustraliaJo Root, Consumers Health Forum (CHF)
Michael Roff, Australian Private Hospitals AssociationMark Booth, Department of Health (ex officio)
Jane Griffiths, Day Hospitals AustraliaCharles Maskell-Knight, Secretariat
Dr Rachel David, Private Healthcare Australia (PHA)Susan Azmi, Secretariat
Toby Hall, Catholic Health AustraliaCarla Roots, Secretariat
Marcus Dripps, Allied Health Professions AustraliaJosh Shanahan, Secretariat
Kristy Domitrovic, Minister Ley’s office


Garry Richardson, Expert member
Philip Truskett, Royal Australian College of Surgeons (RACS)
Tony Lawson, CHF
Anne Trimmer, AMA
Mark Cormack, Department of Health (ex officio)

1. Welcome, apologies and introductions
The Chair opened the meeting and provided members and proxies an opportunity to introduce themselves to the Committee. It was acknowledged that proxies were in attendance for the AMA, MTAA and CHF. The Chair noted apologies for this meeting.

2. Opening statement

  • The Chair discussed the culture of the Committee. He asked members to be respectful of each other and to share their views in a productive way.
  • The Chair reminded members that they have all signed confidentiality agreements. He noted that members will be required to discuss issues with their own organisation’s members, but asked that members be mindful of the balance between appropriate consultation and respecting confidentiality. The Chair asked members not to attribute statements or positions to other Committee members when undertaking consultations.
  • The Chair advised that the Secretariat will provide a meeting summary for each meeting, which members can use as the basis for their consultations. In addition, the Chair will provide advice to the Minister after each meeting, and this advice will reflect where there was or was not agreement among the members.
  • The Chair noted that this Committee has been selected as a consultative body and he does not expect to be undertaking a wide range of other consultations. Other organisations can channel their views through their peak bodies on the Committee.
3. Declaration of Conflict
Members confirmed they had no new conflicts of interests to declare.

4. Functions and Work Plan
The Committee discussed a draft work plan and agreed a Work Plan through to the end of 2017, including the establishment of Working Groups.

5. Product design

  • Mr Maskell-Knight provided an overview of a product design issues paper circulated to members prior to the meeting.
  • The paper outlined key issues for consumers regarding the complexity of private health insurance and difficulties consumers face when trying to understand and compare different products. The paper also explored potential approaches that could be taken to categorise private health insurance products.
  • The Committee discussed the paper and considered ‘pros’ and ‘cons’ associated with each of the potential approaches for categorising products. The discussion also examined issues including: scope of coverage and exclusions; restricted cover; minimum product standards; excesses; contracting arrangements; out-of-pocket charges and gaps; general treatment cover; impacts of changes on premiums and transition issues.
  • The Committee agreed that the use of inconsistent terminology by insurers to describe what is covered (or excluded) from private health insurance policies is a major factor contributing to the complexity of private health insurance for consumers.
  • The Committee agreed that any solution to improve the design of private health insurance will require the development of standard definitions and terminology for medical procedures across all insurers to enable consumers to compare policies more easily.
  • The Committee also agreed that a major issue related to product design is out-of-pocket charges and gaps. Members expressed a desire to pursue changes that deliver greater transparency in this area.
  • Dr Rachel David delivered a presentation outlining PHA’s early thinking and views on product design, common clinical terminology and a potential ‘Gold/Silver/Bronze’ product classification model. Dr David also identified findings of private health insurance consumer research and noted challenges for the sector including affordability issues for consumers.
  • Mr Matthew Koce, delivered a presentation outlining hirmaa’s ‘MyHealthCover’ proposal for improving private health insurance products. Mr Koce also noted the key challenges for developing a new classification system.
  • Acknowledging the complexities that will be involved in developing a new product classification scheme, the Committee discussed whether Hospital cover should be its priority focus, with consideration of General Treatment (Extras) cover to occur at a later stage.
  • The Committee discussed the range of approaches that could be used to categorise products and considered that some options would not be viable or practical. The Committee agreed it would examine in more detail approaches based around product criteria and exclusions, restrictions, excesses and co-payments. The Committee re-iterated that any reform must focus on delivering improvements for consumers.
  • The Committee agreed that the Secretariat would prepare an updated product design issues paper for consideration at its next meeting (November). The updated issues paper would incorporate the discussions and views discussed by the Committee.

Business and papers for next meeting

The Committee agreed that for its next meeting, scheduled for Wednesday 9 November 2016 (9:30am – 5pm, Canberra), it would consider the following items:
  1. Product design;
  2. Improved value for rural consumers;
  3. Contracting, minimum and second tier default benefits; and
  4. Private patients in public hospitals.
Please direct any enquiries to PHMAC Secretariat

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