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Private health insurance review provides opportunities

Phil Calvert

As promised in the lead up to the last federal election, Commonwealth Health Minister Sussan Ley has convened a group of experts to review private health insurance (PHI) arrangements in Australia and provide advice around its future.


Chaired by Dr Jeffrey Harmer AO, the group will spend the next few years providing advice on structure, regulatory and legislative issues, sustainability and the value of PHI. I have been nominated by Allied Health Professions Australia to join the committee.


Among OECD countries, Australia is unique in the structure of the shape and funding of our health system. Complexities relating to the balance between state and federal funding streams and service delivery responsibility make it difficult to understand.


Many physiotherapists are directly or indirectly affected by PHI coverage rates, benefits and regulations, and being part of this review is a great opportunity to share our views on opportunities and challenges in the current system.


So, what principles should underpin this type of review?


The minister has correctly identified that there is currently a problem with the value of PHI policies.

This manifests as both confusion about inclusions and exclusions and the uptake of PHI in different areas of Australia. She has also emphasised issues of access to services subsidised by PHI, particularly in rural Australia.


Other important elements are, of course, the safety and quality aspects of the system, service and practitioner, and the way in which innovation is either encouraged or inhibited by the system.


I am hopeful that we can come to the point where Australians both value PHI and have improved outcomes resulting from their care. This must be done in a way that ensures the sustainability of both service providers and the PHI industry itself.


Through the course of this process, there will be many opportunities for members to share your views. I encourage you to keep an eye out for chances to provide input into submissions, as well as having discussions with your patients, colleagues and APA office bearers.


Marcus Dripps, APAM


APA National President


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