Ahead of the annual rise in private health insurance premiums on April 1 we stepped up our calls for meaningful reform in the private health insurance system to protect patients and ensure the sustainability of the system.
To drive a national conversation about the need for reform we also releasedThe gaps that create gaps, an online resource that explains the policy failures and inconsistencies that drive up out-of-pocket costs. This resource makes it clear that blaming individual providers — whether insurers, doctors or hospitals — does nothing to fix the underlying problems in the sector.
AMA President Dr Danielle McMullen highlighted the challenges facing the sector in an address to health leaders at the Australian Financial Review Health Summit, warning that the system is no longer keeping pace with the needs of patients or the realities facing doctors.
“Our public hospitals are already overwhelmed, and governments cannot keep up with demand for public specialist appointments and essential surgery,” she said.
“Patients are being squeezed from every direction, and the system simply isn’t keeping up. We need to stop patching around the edges and start addressing the structural issues that are driving up costs and limiting access.”
The federal AMA has outlined several immediate opportunities for government action, including increasing the long-frozen known-gap limit, fixing the ‘no-gap’ cliff, reducing confusing rebates, and establishing a Private Health System Authority to drive long-term reform and transparency. These sit alongside broader recommendations in the AMA’s Prescription for Private Health , such as expanding hospital-in-the home and reviewing private health incentives and product tiers.
Dr McMullen also reiterated the need to address the widening gap created by the long Medicare freeze and called for the new National Health Reform Agreement to tackle excessive public hospital outpatient wait times.
“Without action, Medicare becomes a promise unfulfilled,” she said. “In this economy, it is clear health costs are not going down. Sustainability for providers and access for patients are both at risk unless government acts.”
The AMA will continue to advocate strongly for reforms that restore balance between the public and private systems, protect patient access, and support the viability of medical practice.
