Ali France (Dickson, Australian Labor Party) Share this | Hansard source

I rise to speak on the Health Legislation Amendment (Improving Choice and Transparency for Private Health Consumers) Bill 2026. No-one here is surprised that many Aussies with private health insurance are paying more out-of-pocket costs and rising premiums and that many are considering dumping their private health cover as a result. For public or private patients seeing a private specialist, we know that the gap fees are equally daunting, with many having to pay hundreds in out-of-pocket fees for a single appointment. This translates to pressure on our public health system and longer waiting times to see a specialist for elective surgery and non-urgent procedures.

This bill is a step towards greater transparency of gap fees. It also puts a stop to phoenixing, where insurance companies suddenly shut down a policy and move consumers onto a new but almost identical policy at a higher cost or with less coverage. We know consumers are quite often shocked by the increase in their private health premiums at the start of a new financial year. That shock has eroded confidence in our private healthcare system. This bill is part of the Albanese Labor government's mission to strengthen our healthcare system and protect Medicare.

For the people I represent in Dickson and for families right across Australia, the cost of specialists and private health insurance have been growing issues discussed around kitchen tables around the country. They are line items in the family budget that, under those opposite, became harder and harder to predict and manage. When you need a timely specialist medical appointment or a procedure, it's only fair and reasonable that you also know the out-of-pocket costs of that treatment—how much you're going to pay when you wake up from that surgery. Patients want to be able to access care without experiencing bill shock, and many across the country have experienced that shock. This bill makes changes that will give patients the power to scrutinise the cost of specialist fees and make informed decisions about their health care and private health insurance. It is about ensuring that, when an Australian family chooses a specialist or a private health product, they can do so with their eyes wide open. This bill will do two incredibly important things: make cost transparency the default, not an option, and crack down on sneaky private health insurance product phoenixing.

To understand why this legislation is so vital, we should have a look at the mess we inherited. For nearly a decade, the previous government sat on its hands while out-of-pocket medical costs spiralled, particularly to see a specialist. Their solution was the Medical Costs Finder website, a project that became a textbook example of a taxpayer funded big, fat fail. The Morrison government spent $24 million setting up the Medical Costs Finder website. They said this website would display the cost of common medical services alongside the fees that individual specialists charge, and those specialists would voluntarily share their fees to the website—effectively asking them to dob themselves in. It was, of course, a truly epic fail. Out of 6,300 eligible specialists, how many do you think uploaded their fees in 2022? Six—not six per cent; six individual doctors. Three years later, that number had slowly crawled to 88 out of 6,300. Without mandatory reporting, this tool is effectively a multimillion dollar suggestion box that has failed to gain any real traction.

I'm pleased to see those opposite supporting these much-needed changes tonight, because, for a family in Dickson trying to budget for a knee reconstruction or a hip replacement or to see a psychiatrist to get an ADHD diagnosis, that website was useless. It left them walking into specialists' offices with no idea how much they would be charged. This is not choice; it is being blindsided.

According to the Australian Bureau of Statistics, medical and hospital costs are a primary strain on the family budget. We are seeing massive variations in specialist fees, where patients are charged wildly different amounts for exactly the same procedure. Private Healthcare Australia released new data recently that is truly shocking. It showed some specialists are charging between $500 and $1,000 in out-of-pocket upfront fees for a first appointment. It also showed that the median specialist gap fee for in-hospital care has risen 22 per cent since 2022, which has meant thousands of dollars in out-of-pocket costs for procedures. One in two patients did not know their specialist fee before attending, 38 per cent received an unexpected bill, 55 per cent paid more than expected and nearly one in three reported being charged illegal booking or admin fees.

Patients deserve to know the price tag before they receive the service. This bill transforms the Medical Costs Finder website from a failed experiment into a meaningful platform. By integrating data from Medicare, hospitals and insurers, we are providing individual specialists' fees and out-of-pocket costs without adding any new administrative burden on our hardworking doctors. Consumers will be able to compare the costs of individual medical practitioners, helping them make informed decisions about their own health care. We know that surprise out-of-pocket bills for specialist services have been a household stress for way too long, and we are taking action to fix this.

Another important part to this bill is the outlawing of product phoenixing. To put it simply, some private health insurers have been closing down existing insurance products only to reopen almost identical ones under a different name and at a higher premium or reduced value. This means a consumer, who may have paid fees monthly for decades for health insurance, expecting a certain level of coverage, can suddenly have their insurance cancelled and replaced by a new product that costs them more or has less coverage. They do this to avoid government regulated caps on annual premium increases. For example, the government cap on premium increase in the 2025 financial year was about 3.7 per cent. We know of one insurer that offered a 'premium gold' product in February 2025, only to close it and launch an 'optimum gold' product that was almost identical but priced 35 per cent higher.

CHOICE research found that, while average health insurance premiums rose by 11.9 per cent over a four-year period, health insurers use phoenixing to close older, cheaper policies and replace them with more expensive, near-identical products to increase the average price of gold-level hospital cover by up to 45 per cent. This disgraceful practice forces customers into more expensive, often similar coverage, making it difficult to find, compare and maintain better value policies. By doing this, insurers have been able to sidestep scrutiny and quietly reduce the quality of care while hiking up the cost for families. It is a sneaky practice that destroys consumer confidence. The Australian Private Hospitals Association called them 'insurance cowboys', and the Australian Medical Association president said it well when she said:

The widespread practice of phoenixing is a major factor in consumers struggling to access the level of cover that meets their needs …

If you've been paying into a policy for years, you shouldn't wake up to find your benefits have been gutted through a technicality. This bill stops this quite mercenary practice. In my community of Dickson, I talk to families every day, who work hard and choose to pay for private health insurance because they want choice, security, or they want to help take pressure off the public system, but they feel like the system is not working for them. They see their premiums go up while transparency is just not there. This bill is for them. It demonstrates that the government is actually watching insurers and holding them to account. Under these reforms, insurers must seek ministerial approval for all new products, and any reduction in coverage, benefits or terms of existing products will require explicit oversight. This is a big, big change. We are drawing a line in the sand—no more shifting goalposts, no more phoenixing away the value of a family's hard-earned insurance policy.

By closing the loopholes that allowed insurers to avoid oversight, we are restoring accountability to the private health sector. This isn't about being anti insurer; it's about being pro consumer. It's about ensuring that our government-subsidised private health system complements our Medicare system in a way that is fair, sustainable and transparent.

This bill is part of the Albanese government's commitment to strengthen Medicare and build a stronger, fairer healthcare system. We've delivered more bulk-billing GPs by significantly increasing the bulk-billing incentive, supporting more practices to bulk-bill and making it cheaper to see a doctor. We're opening more Medicare Urgent Care Clinics so families can get urgent, non-life threatening care without having to go to the emergency department and without the bill. We've made medicines cheaper by reducing the maximum cost of PBS medicines to just $25. We're investing more than $790 million in women's health, and we're opening endometriosis and pelvic pain clinics right across the country. We are delivering more free mental health services, with walk in Medicare Mental Health Clinics popping up right across the country, including one in my electorate of Dickson in Strathpine—no appointment necessary.

This bill delivers on our promise to strengthen Medicare and to make private health insurance work better for those Australians who can afford to pay for it. It delivers real transparency in specialist fees, real protection against unfair premium hikes and real power for patients to make the best decisions for their families. We are fixing the $24 million—wishy washy, self-reporting, if you can be bothered—website that those opposite set up to track specialist fees. We are creating a system to ensure all healthcare providers and insurers are held accountable and act in the best interests of patients. We want to remove bill shock when it comes to health care. We want the light to shine in; the cost of health care should not be a mystery. We also need to ensure that our private and public health systems work together to continue to deliver the best health care in the world. I love this bill and I commend this bill to the House.

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