Renee Coffey (Griffith, Australian Labor Party) | Hansard source

Thank you, Deputy Speaker. I rise to speak on the Health Legislation Amendment (Improving Choice and Transparency for Private Health Consumers) Bill 2026. It's fitting to speak on a health bill with you in the Chair, given your 37 years as a paediatrician in Campbelltown and your lifelong work helping children and families get the care that they need. I thank you for your contribution to paediatrics and also to the many, many thousands of patients that you have cared for over the years.

When Australians make decisions about their health care, they should be able to understand the costs before them, not discover them after the bill arrives. This legislation is about making the private health system clearer, fairer and easier to navigate by improving the information available to patients about specialist fees and out-of-pocket costs and by closing a loophole that has allowed some private health insurance products to be repackaged in ways that undermine consumer trust. For people in my community of Griffith, these issues are felt in the everyday pressures families are managing—paying the mortgage or rent, keeping up with groceries or school costs, caring for children or ageing parents and trying to make sure that, when someone they love needs care, they can make an informed decision with confidence. Across Griffith, more than half of my constituents are covered by private health insurance because they want an additional measure of security and certainty.

Medicare is a cornerstone of fairness, providing universal access to essential care and forming the foundation of our healthcare system. Many Australians choose to complement that strong base with private insurance to provide additional options and reassurance, particularly for specialist care and elective procedures. When doing so, they want to know that if they need treatment, if their child needs a specialist referral, if their partner needs surgery or if a parent needs support, they will have choices available to them. Too often, people's experience with the private health system falls short of that standard. We hear the same story from colleagues, friends and family members. Someone trying to navigate the next step in their care, whether choosing a specialist, arranging tests, considering treatment options or preparing for a procedure, find themselves dealing with a system that feels complicated, opaque and just too hard to compare.

At the very moment when people should be focused on their health, they are also left trying to work out what Medicare will cover, what the fund will pay and whether there will be an out-of-pocket cost. All the while, they are frustrated by the fact that it's so difficult to get a straight answer before the bill arrives. This uncertainty is not just an inconvenience; it can have serious repercussions. It causes real stress, can lead to delayed treatment and may contribute to poorer health outcomes. It can leave families putting off care while they reshuffle the household budget or worrying that, at the end of a difficult health journey, they may be hit with costs that they simply did not anticipate. No-one should have to make a medical decision in the dark or only discover the price of their care after the fact. People should be able to ask a plain question and get a plain answer, and that is the context behind this bill.

This bill is about helping Australians make informed decisions when they need specialist advice or treatment. It's about strengthening confidence in private health insurance by improving transparency, and it's about closing loopholes that have undermined trust. My electorate of Griffith is young, diverse and a growing community. It is home to young families, older residents, renters, students, health workers, carers and small business owners. We are also home to some of Queensland's most important health institutions, including the Princess Alexandra Hospital, the Mater precinct and the Queensland Children's Hospital. Our community understands the value of good care, but we also understand the pressure that comes when people cannot clearly see what that care might cost.

Griffith is one of the nation's youngest electorates, with a median age of 34, and, with 48 per cent of private dwellings rented, there is not much room in household budgets for a surprise invoice. If someone in Griffith is referred to a specialist, they should not have to spend hours sifting through bits and pieces of information on top of the stress of a diagnosis or procedure. They should be able to make that decision with confidence.

At a national level, around 12.6 million Australians have some form of hospital cover, equal to 45.6 per cent of the population, according to the Australian Prudential Regulation Authority. In the December quarter of 2025, the average out-of-pocket cost for hospital admission was $471.29, with an average medical gap of $277.36. For many households, that's the difference between going ahead with the care or putting it off. In Queensland alone, nearly half of the state is covered by private health insurance. Within the Brisbane City Council region, including my community of Griffith, the ABS recorded 499,000 people with private health insurance in 2022. So, when we speak about transparency and fair value for people footing the bill, we are talking about millions of Australians and thousands of families in places like Griffith who need to plan for the cost of their care with the right information in front of them.

Schedule 1 of this bill is aimed at giving consumers clearer information about those medical fees that they can expect to be charged and the likely out-of-pocket costs associated with their private health care. In 2024-25, 8.6 per cent of Australians delayed or went without specialist care because of cost, which equates to more than 800,000 Australians each year delaying or forgoing the care that they need. One of the most common sources of out-of-pocket healthcare costs is specialist fees, and that is why transparency is so important. When someone is referred to a specialist, they should not be left trying to piece together what Medicare will cover, what their private health insurer will contribute and how much they may be expected to pay out of their own pocket and nor should they have to wait until after an appointment, test or procedure to find out that the cost is much higher than they had expected.

The Medical Costs Finder launched under the Morrison government was intended to give patients a way to compare costs, understand likely out-of-pocket expenses and make more informed choices about their care. In all fairness, the intent behind the Medical Costs Finder was a good one. The problem was not the intention; the problem was in the design. The model was built entirely on voluntary disclosure, relying on specialists and insurers choosing to come forward and provide the data needed to make that website useful. That approach by the former Morrison government was destined to fail in delivering meaningful transparency, and the results are proof of this. By the end of 2022, across some 6,300 eligible specialists and the 11 specialties listed on the site, just six individual doctors had listed their fees on that website. Even now, only around 88 have done so, because the website those opposite created was based entirely on voluntary disclosure. This is not simply a case of $24 million being spent on a website that failed to meet expectations. It means patients were left without the clear, practical information they need to understand likely costs, compare their options and make informed decisions about their care. It offers no help to a parent trying to find out the cost of an ENT appointment for their child or for a young person seeking clarity on what they might pay to see a psychiatrist for an ADHD diagnosis.

Rather than relying on voluntary disclosure, this amendment will allow the Medical Costs Finder to use Medicare, hospital and private health insurer billing data already collected by the government, making it more practical, more comprehensive and far more likely to produce a tool ordinary Australians can actually use. The principle is straightforward: transparency should be the norm. Patients should be able to see typical fees, likely out-of-pocket costs, Medicare rebates and relevant insurer contributions. Clearer information gives people the confidence to ask better questions, helps GPs and referrers have better conversations with patients, supports informed financial consent and reduces the risk of bill shock at that very moment when people should be focused on their health.

We also know that fees can vary significantly, even for the same procedure in the same city, and that variation is exactly why transparency is needed. If one patient may face a very low out-of-pocket cost and another may face hundreds of dollars for a similar service, people deserve to know that before they commit, not after. This amendment will help make that information easier to find.

The second major part of this bill goes to fairness in private health insurance by tackling a practice known as product phoenixing, a practice that has been eroding trust in this area. Product phoenixing occurs when a private health insurer closes a product and reopens an identical or very similar product at a higher price or reduces the value of the product without the usual scrutiny or oversight. Consumers who pay for private health insurance expect the system to be fair. They expect a policy to deliver what it promises, and they should not be sold a supposedly new product that is little more than the same old cover repackaged at a higher price, nor should they be left wondering whether the complexity of the system is being used to their disadvantage.

The Commonwealth Ombudsman has examined the impact of product phoenixing, including on top-tier gold products. The issue is that new customers or existing customers trying to upgrade may be pushed onto a more expensive product while very similar, older products remain closed to them. That cuts across the purpose of the standard annual premium review process, which exists to provide scrutiny of premium increases and ensure changes are assessed in the public interest. If insurers can avoid that scrutiny by closing one product and opening another that is substantially the same, then the system is not working as it should. This bill closes that loophole by requiring insurers to seek ministerial approval not just for premium changes to existing products but also for premiums charged for proposed new products and for certain changes that reduce cover, benefits, terms or conditions.

This reform has been welcomed by consumer advocates and health sector voices who understand that the status quo has not served patients well enough. The AMA has supported action to stop product phoenixing while also making it clear that the Medical Costs Finder must be implemented carefully so information is accurate, meaningful and fair. The Royal Australasian College of Surgeons has also supported reforms that improve transparency and inform financial consent while making the point that transparency should apply across the whole patient cost pathway, including practitioner fees, insurer rebates and benefit design.

The patient experience through the health system can be seen as a pathway—a GP appointment, a referral, a specialist consultation, a scan, a procedure, an anaesthetist, a hospital stay, a bill from one provider, a bill from another, until finally a gap they did not expect or a far greater one than that which they had budgeted for. If we want people to navigate that pathway with confidence, we need transparency at every point where cost can affect choice, and that's what this legislation is targeted to address.

This bill forms part of the Albanese government's wider efforts to improve affordability, accessibility and clarity within the health system. We have strengthened Medicare because we believe every Australian should be able to see a doctor when they need one, not just when they can afford one. The government has invested to support more bulk-billing, including expanding bulk-billing incentives to all Australians and supporting fully bulk-billing practices through the Bulk Billing Practice Incentive Program. In Griffith, that work is already making a difference. Bulk-billing rates increased to 63.5 per cent in March 2026, up from 58.7 per cent in October 2025, meaning more people in my community can get the care they need without having to worry about the cost. We have also expanded access to Medicare urgent care clinics so people with urgent but non-life-threatening conditions can get the care they need without having to wait in a hospital emergency department. In Griffith, our three Medicare urgent care clinics, South Brisbane, Coorparoo and Carina, have now seen more than 43,000 presentations, taking pressure off hospitals and helping families access timely bulk-billed care closer to home.

We've also continued to make medicines cheaper. The maximum PBS co-payment for Medicare cardholders was reduced from $31.60 to just $25 at the start of this year, while the concessional co-payment remains frozen to $7.70 until 2030. These changes are making a real difference in communities like Griffith. They help the parent filling a script for their child, the older resident managing a chronic illness, the student or renter weighing up every dollar at the pharmacy counter and the person who might otherwise delay filling a prescription because the cost is too high. Since July 2022, Griffith residents have saved more than $18.2 million on more than 2.1 million scripts. That is more money staying in household budgets, money that can go towards groceries, rent, school costs, transport and all the other everyday expenses that families are facing. Most importantly, it means people are less likely to delay or skip the medicines they need because of the cost.

Strengthening Medicare is not just about bulk-billing, urgent care and cheaper medicines, as important as all of those are; it's also about what happens when people move into specialist care, private treatment and surgery. It is about whether people can understand the costs in front of them, whether insurance products are fair and whether the system treats people with the respect that they deserve. Health reform should make the system easier to understand at every point, not just at one part of it. We know an increasing number of Australians are not taking up referrals from their GP to see a specialist due to concerns about cost. This legislation will give hardworking Australians the clarity they deserve about costs and more choice in their health care.

This bill legislates wider scrutiny of premiums so consumers can be more confident in the value of their private health insurance. This bill begins to put that right by giving patients better information when making decisions about specialist care, strengthening informed financial consent, closing a loophole that has undermined confidence in private health insurance and providing stronger safeguards against unregulated charging behaviour. It builds on the Albanese Labor government's broader work to strengthen Medicare, lower health costs and make our health system fairer for all Australians to navigate. For families across Griffith, that means better information, stronger protections and even more confidence in the choices before them.

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