Tracey Roberts (Pearce, Australian Labor Party) Share this | Hansard source

The incorporated speech read as follows—

I would like to speak in strong support of the Health Legislation Amendment (Improving Choice and Transparency for Private Health Consumers) Bill 2026.

This bill goes to the heart of what I hear in my electorate of Pearce. People are worried about the cost of seeing a specialist. They are confused about what their private health insurance actually covers. They are unsure who to trust when making big decisions about surgery or treatment, especially when they are already anxious or unwell.

Every week, constituents tell me similar stories. Their premiums keep rising, but the exclusions and gaps quietly expand. They receive referrals from their GP but do not act on them, because they fear a big, unknown bill at the end. Some tell me they sit at the kitchen table and call their insurer, only to be left without a clear answer. When a parent decides not to take a child to a specialist because no-one can give them a straight price, something in our health system is not working as it should.

This bill is about restoring confidence and fairness to that system. It aims to give patients clearer information and a fairer deal when they use private health care. It does that in two main ways: by fixing how specialist fees and out-of-pocket costs are published, and by tightening oversight of private health insurance premiums so insurers cannot dodge scrutiny through 'product phoenixing'.

We know that cost is already a major barrier to care. In 2024-25, 8.6 per cent of people—more than 800,000 Australians—delayed or missed specialist care because of cost. The biggest cause of those out-of-pocket costs is specialist fees, not hospital charges. It is wrong to expect patients to commit to a treatment plan without knowing what it will cost them and their family. People should not have to choose between their health and their household budget.

Under the previous government, about $24 million was spent on the Medical Costs Finder website. It was meant to give people clarity about specialist fees and help them compare costs, but it relied on voluntary disclosure from specialists. The result was embarrassing. Out of around 6,300 eligible specialists, at the end of 2022 only six had displayed their fees—six! Three years later, only about 88 specialists had done so—to clarify: that is 88 doctors, not 88 per cent. That is not transparency; that is failure. It did not deliver for patients or for taxpayers.

Meanwhile, private health insurance premiums are adding to cost-of-living pressures. Insurers must get ministerial approval to raise premiums on existing products, usually through the annual premium round. They can, however, launch new products at any time, at any price, without approval. Some insurers close an existing product and reopen a very similar one at a higher price or with reduced benefits. This practice, known as product phoenixing, leaves new customers paying more, undermines trust and defeats the purpose of ministerial premium scrutiny.

Schedule 1 of this bill fixes the failed Medical Costs Finder model and turns it into a tool patients can actually use. Instead of relying on a handful of specialists to upload their fees, the bill allows government to publish information on typical fees and out-of-pocket costs using Medicare, hospital and insurer billing data that is already collected. The initial focus will be on non-GP specialists, with the capacity to add GPs later. Patients will be able to see what different specialists usually charge for particular services and what that has meant, on average, for the gaps they might face.

This is a commonsense change. We already collect this data, and it is patients who pay the bills. They should be able to see clear ranges of what doctors actually charge, in one place, and compare those charges with other practitioners in their area. That will take some of the guesswork out of healthcare decisions and allow people to weigh cost alongside other factors, such as quality, location and waiting times.

Clinicians and professional bodies see the value of these reforms. The Australian Society of Anaesthetists has welcomed the bill as an important step to improve clarity in a confusing system. They point out that private health insurance premiums are a major cost-of-living pressure and that patients deserve clear, accurate information about what their insurance covers and how to get value from it. Their survey work shows that informed financial consent is already routine in anaesthetic practice, especially for planned admissions.

Many anaesthetists already give patients detailed information about likely fees and potential out-of-pocket costs, yet many patients still do not fully understand what their policy covers. This legislation supports that ethical practice by making consistent fee and coverage information easier to find and understand.

Stakeholders in aged care and hospital administration have also recognised the significance of this reform. Older Australians and their families can be blindsided by unexpected specialist or procedural fees as they move between residential care and hospital. By requiring health cost transparency, this bill helps ensure older people and their carers are not surprised by large out-of-pocket costs at a stressful time.

In the hospital sector, commentators note that publishing billing data on Medical Costs Finder will help patients 'find the best value' when they need specialist advice and treatment, rather than leaving them to navigate an opaque market.

Schedule 2 deals with the other piece of the puzzle—how private health insurance premiums are set and how consumers are protected when insurers change or launch products. At present, insurers must apply to the minister if they wish to change the premium on an existing product, but they do not need approval for premiums on new products. Some have used this loophole to close an old product and relaunch a similar one with higher premiums or fewer benefits, avoiding proper scrutiny.

Product phoenixing does real harm. It hurts new customers, who pay more for less. It hurts existing members, who see the value of their cover erode and lose confidence that ministerial approval means anything. It undermines the 15.3 million Australians with private health insurance, who deserve to know that products on the market are subject to consistent scrutiny and that premiums reflect fair value, not creative rebadging.

The bill amends the Private Health Insurance Act 2007 so that insurers must seek the Minister for Health and Ageing's approval not only when they change premiums on existing products but also when they set premiums for new products. They will also have to seek approval before making certain changes that reduce cover, benefits or other key terms and conditions. In short, if an insurer wants to charge more or deliver less, it must go through a transparent process and justify that decision to government. This gives effect to the wider scrutiny of premiums that the Minister for Health and Ageing has signalled and gives consumers greater confidence in the value of private health insurance.

The Office of Impact Analysis estimates a modest regulatory burden—around $480,000 a year in compliance costs across all 28 insurers—and notes there is no impact on individuals or community organisations. For consumers, the benefit is confidence that premium changes and new products are properly scrutinised and that commitments to address phoenixing are being honoured. For the system, it restores coherence and fairness—similar products, whether new or existing, will face the same oversight and consumer-protection expectations.

Underlying both schedules is a simple principle—patients and consumers must be at the centre of the private health system. For too long, opaque pricing, complex policy wording and practices that make sense on a balance sheet but not at the kitchen table have dominated. This bill shifts the balance back towards transparency, accountability and informed choice. It supports doctors who already practise informed financial consent, insurers who compete on value rather than confusion, and patients who simply want to know what they are signing up for.

The Albanese Labor government made an election commitment to tackle product phoenixing and to fix the broken approach to price transparency, and this bill delivers on that promise. It does so while working with the medical profession and good-faith insurers, including bodies like the Australian Society of Anaesthetists and peak hospital groups, that are ready to partner with government to make the system accurate, meaningful and fair. It also sends a clear message to those who have not done the right thing: the era of gaming the system through nondisclosure or phoenixing is over.

For my constituents—families, older Australians, and young people taking out private health insurance for the first time—these changes mean more than a line in a statute book. They mean being able to go online before a procedure, see what different specialists typically charge, compare those costs and have an honest conversation about fees and gaps. They mean greater confidence that the premium increase letter has been properly scrutinised and that similar products are subject to the same rules. Most importantly, they mean fewer unpleasant financial surprises when people are at their most vulnerable, and more Australians getting the care they need when they need it.

I commend the Health Legislation Amendment (Improving Choice and Transparency for Private Health Consumers) Bill 2026 to the House.

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