Kate Chaney (Curtin, Independent) Share this | Hansard source

The cost of accessing specialist care is now a deciding factor in whether many Australians get the treatment they need when they need it—if they can get an appointment. Now, that's not a sign of a fair health system; it's a warning light. The Health Legislation Amendment (Improving Choice and Transparency for Private Health Consumers) Bill takes a necessary first step by making fees and out-of-pocket costs visible to patients. But transparency on its own is not a cure. If we're serious about a health system that's genuinely fair, we must pair transparency with reforms that tackle affordability, access, quality and accountability while closely monitoring unintended consequences.

So what does this bill do well? First, it enables government-held data to be used to populate the Medical Costs Finder with GP and specialist fees and out-of-pocket costs. This ends an ineffective voluntary approach that saw only one to two per cent uptake by specialists and insurers. For the patient who's been quoted three different prices for the same procedure, a clear picture of typical charges is empowering. For the more than 800,000 people who in 2024-25 did not proceed from GP referrals to specialist care due to cost, shedding light on fees may reduce some of the fear and confusion that keeps them from treatment.

Second, the bill strengthens ministerial oversight of private health premiums to combat product churn that quietly ratchets up costs for consumers. We've seen examples where premiums rose far faster than the average across products, aided by product phoenixing, where like-for-like products close and then reappear at higher prices. These are almost impossible for consumers to track. Transparent approval processes and scrutiny of new and changed products are essential to stop this shell game.

These are sensible measures, and I'll support them, but they must be seen as the beginning, not the end, of the work that needs to be done. The government's argument for the bill is that informed consumers make better decisions. That's true, but information alone can cut both ways. When price information is published without context, we know that some providers simply increase their fees to match the market rate, and there's a persistent perception among some patients that a higher fee must mean higher quality care. Unless people can access better information about clinical outcomes, complication rates, readmission and wait times, we risk reinforcing this false choice. That's the last thing households facing cost-of-living pressures need. We must monitor, in real time, what happens after this information goes live. Are median fees rising? Are prices clustering at the top of the range? Are patients gravitating to higher priced practitioners without any evidence of better care? If so, the government must be ready to act, whether through enhanced quality reporting or targeted intervention.

There are also technical issues to resolve. The department's plan to publish a single fee figure for each practitioner must be transparent, accurate and fair. An internal review mechanism may not be sufficient when errors can damage a reputation or mislead consumers. We need a clear and timely correction process backed by a methodology that's publicly understood and independently reviewed. But the bigger point is this. Even the best transparency will not by itself make specialist care affordable and accessible. To achieve that, we must address the economic settings that sit underneath specialist pricing and availability.

That's why I've seconded the second reading amendment moved by the member for Kooyong. I agree with the honourable member that Medicare rebates must reflect the real costs of delivering care and must be indexed so they don't erode each year. We need to explore broader rebate coverage across specialities and consider gap-fee settings that rein in excessive out-of-pocket costs. These are structural levers, levers that deal directly with affordability rather than simply shining a light on unaffordable prices.

I've also seconded the second reading amendment proposed by the member for Wentworth, and that amendment relates to Schedule 2 of the bill and calls on the government to establish and enforce clear timeframes for decisions on new product applications by insurers, including automatic approval where those timeframes are not met. I've spoken at length in recent weeks about the government's ongoing failure to respond within timeframes to more than 50 parliamentary committee reports. Like the member for Wentworth, I have concerns, given this record, that decisions under this framework may not be made in a timely manner unless timing requirements are embedded in legislation. It's only fair that if insurers are expected to meet new and expanded obligations, they're also provided certainty about how long they'll wait for a decision.

I urge the government to ensure that three safeguards are baked in as this bill is enacted and implemented. First, active fee monitoring to guard against unintended consequences. The department should publish periodic analyses showing whether median fees are rising post-publication, whether fee dispersion is narrowing around higher price points and whether patients are shifting toward higher priced providers without corresponding quality gains. If we see these patterns emerging, governments should be ready with corrective measures such as enhanced quality disclosure or targeted interventions.

The second safeguard is transparency about the methodology for calculating published fees. This should be public, comprehensible and independently reviewed. There should be a time-bound process to correct errors, with clear thresholds for when changes are made and how practitioners can seek review.

The third action that needs to be taken is a parallel affordability reform agenda. We should progress work on Medicare rebate adequacy and indexation and consider gap-fee settings that protect patients from extreme outliers. Price transparency must be a beginning, not an endpoint. Australians accept that health care is complex, but they, rightly, expect it to be fair. Publishing fees and out-of-pocket costs are a necessary start, and one I support, but we cannot mistake transparency for structural reform.

Access to specialists is an issue which is raised a lot with me by Curtin constituents. For example, I heard from a parent of a four-year-old child who waited 12 months for an autism diagnosis from a child psychologist, which then needed to be verified by a paediatrician in order to access an NDIS plan. This parent contacted more than 20 paediatricians, only to be told that their books were closed for 12 months. And this is in the private system. In the public system there was a two-year wait for services, which is a long time in a child's life, when early intervention is critical. Sadly, stories like these are too common.

A truly fair health system ensures that people can afford to make informed decisions to act on the medical information they're given and get access to the specialists they need when they need them. This bill should be the first chapter of a reform story that restores confidence in specialist care so patients can get the treatments they need and aren't choosing between their health and their household budget. I commend this bill to the House.

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