Madonna Jarrett (Brisbane, Australian Labor Party) | Hansard source

We all know that it's Labor that's the party that delivers better, affordable and quality healthcare to Australians. We established Medicare in 1984, and, under the Albanese Labor government, we've delivered expansions to the Pharmaceutical Benefits Scheme, including $25 scripts. We've rolled out urgent care clinics across the country, including one in my electorate of Kelvin Grove. We've delivered a landmark women's health package, which means more choice, lower costs and better healthcare for women.

Australians know that they can always trust the Labor government to deliver accessible and affordable healthcare. There is no doubt that our system is one of the best in the world, but its trajectory has waxed and waned, reflecting the values of the party in power. Going back to 1972, Labor was elected and promised a universal, compulsory national health insurance scheme, and that was to replace voluntary arrangements. Despite this being met with fierce opposition from the coalition, the AMA and private health insurers, the policy was eventually legislated and Medibank was born. In 1975, the newly elected coalition government gradually dismantled the scheme until it was eventually abolished in 1981. This was despite an election commitment to maintain Medibank.

Various reports show that the Fraser years reduced people's access to the universal scheme and encouraged private health insurance membership, promoting the role of private care as a substitute for a public system for those who could afford to pay. The ideology was to support private funding and the provision of health care and that the government's role was to provide a safety net reserved for the disadvantaged, which saw means testing reintroduced and rebates payable for medical services reduced. After the 1984 election, the re-elected Labor government restored the publicly funded universal scheme under its new name, Medicare—the green and gold card that we all know so well. It was to provide free access to all public hospitals without means testing.

Medicare is a proud Labor legacy. Access to affordable healthcare was not just the right thing to do; it was the fair thing to do, and it was an investment in Australians and in Australia. For decades, private health insurance has continued to operate alongside Medicare as a complement, providing additional cover for services and amenities not covered or reimbursed by Medicare. That's because this Labor government and many Labor governments before us have recognised the importance of a strong and accessible public healthcare system, but Medicare can't do it all.

Private health insurance aims to fill gaps, and, for many, it's about minimising the time you have to sit on a public hospital waiting list. There are two types of private health insurance: hospital cover for things like accommodation and theatre fees, and general treatment for services like maybe dental, maybe physio. Many insurers often combine hospital and general cover, but most private health insurers let you know you can choose your own surgeon or other specialists and have treatment in a private hospital or as a private patient in a public hospital. Insurers can tell you what they'll pay for and how much you'll pay. This will help Australians choose a level of cover that suits their needs and their budget. But often costs can be hidden, leaving us consumers vulnerable to exorbitant specialist fees. So the Health Legislation Amendment (Improving Choice and Transparency for Private Health Consumers) Bill will help transparency in the private insurance area. It will enable Australians to make informed decisions about their health care and their private health insurance. It will also provide clarity on individual medical practitioner fees and out-of-pocket costs.

This bill also protects consumers by prohibiting phoenixing, closing a loophole that allowed private health insurers to discontinue a product and reintroduce an identical one at a higher price or with reduced value without ministerial oversight. Schedule 1 of the bill aims to enhance consumer transparency by requiring clearer information on expected medical fees and likely out-of-pocket costs for private health. An increasing number of Australians are not taking up referrals from their general practitioner to see a specialist due to cost. In fact, data says that in 2024 almost nine per cent of people delayed or missed specialist care. That's over 800,000 people, and the decision was made because of costs. That's simply not good enough. It leads to poorer health outcomes for Australia and higher costs in the long run.

The most common cause of out-of-pocket costs is medical specialist fees. It's unreasonable to require patients to commit to a course of medical treatment without clear, upfront information about the associated costs. Patients should be able to understand what they will be charged and have the opportunity to compare those costs with fees offered by other providers, enabling them to make informed and financially-sound decisions about their care. Understanding the level of support that is provided by their private health insurer is also vital in determining their likely out-of-pocket costs. This bill will provide consumers with the opportunity to plan for upfront costs.

Since 2022, specialists and insurers have been able to participate in the Medicare Costs Finder by voluntarily publishing their fees and their out-of-pocket information. This platform was created to provide transparency for patients seeking clearer information about medical expenses. But guess what? Uptake has been too low, with only one to two per cent of specialists and 10 per cent of insurers participating on the website as of December 2025. That's simply not good enough. There is a product there; there is a system there to provide transparency for patients and it's not being utilised. People deserve to know what their costs will be right from the start. So this legislation will allow for the publication of relevant data on the Medical Costs Finder without the need for input from specialists, as it will be drawn from Medicare, hospital and insurer billing data already collected by the government. While the focus is on the charging practices of non-GP specialists, general practitioners and their billing could also be published on the website in future.

Schedule 1 will amend the Health Insurance Act of 1973 and the Private Health Insurance Act of 2007 to do a few things. The first allows for the publication of information about medical practitioners and their billings, including their names, their locations, their fees charged by location and the utilisation of gap cover arrangements with insurers where insurers pay a medical practitioner more if they agree to charge no, or fixed, out pocket costs. The second allows for the publication of information about hospitals, including medical practitioners who provide services at the hospital and insurers that have gap cover or contracting arrangements with that hospital. The third allows for the publication of information about insurers, including the proportion of policyholders who experienced different gap cover arrangements and the out-of-pocket costs. The forth includes an immunity from civil proceedings, and the fifth modernises the secrecy regimes that make it consistent with the amendments to secrecy provisions in portfolio legislations made by the Regulatory Reform Omnibus Act 2025.

Importantly, the amendments will continue to protect the privacy of consumers. No patient information will be published. The Department of Health, Disability and Ageing is establishing an internal review process for medical practitioners to inquire about, or to request that the department review, the fee information that is published about them. Without passage of this schedule, Australians will continue to have uncertainty about the potential costs of their treatment, and that's just not fair. Patients will continue to be unable to compare private healthcare providers and unable to seek better value for their health care. Frankly, they'll make more-informed decisions with the passing of this legislation.

Currently, private health insurers are required to apply to the minister if they wish to change the premium of an existing product. This has typically occurred once a year through the annual premium review round process. Schedule 2 of the bill relates to changes to strengthen ministerial oversight of private health insurance premiums to better protect consumers. Insurers are not required to seek approval for the premium charge for new products. Some insurers have avoided the intent of the premium round by shutting down an existing product to new customers and introducing a new, nearly identical product priced higher than the minister had approved for the original one. This process is known as phoenixing. This hurts not just new entrants to private health insurance, who are directly impacted, but the 15.3 million people who hold private health insurance, who are left unprotected from unscrutinised changes.

To address this issue, amendments to the Private Health Insurance Act 2007 will require insurance companies to apply to the minister for approval of the premiums for new and existing products. In addition to requiring ministerial approval for proposed premium changes, insurers will have to apply if they open a new product or if they reduce the cover, a benefit or other term of condition of an existing product.

Additional changes are being made to formalise and enhance existing practices that also occur under the annual premium round process. These include specifying the premium round submission date in the legislation while allowing the minister to make a legislative instrument to vary those dates, encouraging submissions to be made through the premium round by introducing a more stringent public interest test to be applied to the applications made outside of the premium round submissions, and allowing delegation of the minister's premium approval power but not the power to refuse an application. This could enable a reduced process for certain categories of applications outside the premium round. A delegation would likely be for relatively straightforward applications where they're more clearly in the public interest, and details will be worked through with the industry. There are more changes in that schedule.

These reforms are an important step in holding private health insurers to account and empowering consumers to make informed decisions about the cost of their health care. The government will always pursue reforms that ensure that private health insurers deliver genuine value for money and greater transparency for consumers and that put consumers rights at the centre of healthcare decisions.

Australia has one of the best healthcare systems in the world, and many of us are really proud that everyone can get access to quality health care. I've lived through the flip side. While living in the US—another developed country, by the way—I saw families go broke because of an unexpected illness or injury. I saw elderly people suffer in pain because they couldn't afford a knee replacement. I saw young people not getting health checks because it was too costly.

Not that long ago, we saw Medicare almost broken and people putting off seeing a doctor or buying their medicine. Why? Because Medicare was neglected under the LNP and, as a result, it became too costly. This Labor government, like those before it, is committed to Medicare and has poured billions of dollars back into strengthening the system. Those opposite don't like it when we get out that green and gold card in this House, but our communities do.

It's a strong reminder of the LNP's efforts to undermine Medicare every time they're in government. I outlined some of the history earlier. They know their record when it comes to investing in health care. It's shameful. The previous leader of the LNP, Peter Dutton, was voted the worst health minister in the world. Under Scott Morrison, they were sharpening their knives to privatise Medicare. That's their go to. They froze GP bulk-billing for years, leading to higher costs to see a GP, and the list goes on.

On this side of the House, we know the importance of backing our healthcare system, we know the importance of making sure our communities have access to high-quality affordable health care when they needed it. What's Labor done? We've been funding our hospitals, we're investing in Medicare, we're rolling out urgent care clinics across the country, including one in my electorate, in Kelvin Grove. We've had almost 4,000 patients visit that clinic, and it's only been open for less than six months. We're increasing bulk-billing rates, we're rolling out mental health centres across the country, and we're providing $25 scripts—or $7.70, if you're on concession. Why? By backing a strong healthcare system, we are backing everyday Australians. We're making sure every person in my electorate and every person across the country has access to affordable health care when they need it.

With this bill, we're going further. We're protecting consumers who are under the private health insurance system as well because that is a key part of our healthcare system. We're providing greater transparency so that patients and people who need medical care can make informed decisions in relation to their health care. I commend this bill to the House.

(Quorum formed)

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