Julie-Ann Campbell (Moreton, Australian Labor Party) Share this | Link to this | Hansard source

Australians take out private health insurance for one main reason: peace of mind—the reassurance that, if something goes wrong, they are covered. But peace of mind requires information, and right now that is difficult for consumers to come by. You can hold a private health insurance policy, you can pay your premiums faithfully, and you can be referred to a specialist yet still have no reliable way of knowing what an appointment is going to cost you until that bill arrives. That is not peace of mind, and it's not good enough. The Health Legislation Amendment (Improving Choice and Transparency for Private Health Consumers) Bill 2026 is about fixing that information gap, because Australians shouldn't have to take a financial leap of faith when it comes to specialist health care.

This bill delivers on the Albanese Labor government's commitment to strengthen Medicare. We created Medicare over 40 years ago, and we do not let it sit idle. Because we care about Medicare, we invest in it. We make it bigger, we make it better, we make it stronger. Whether it's by creating more bulk-billing, whether it's by creating new Urgent Care Clinics, whether it's by investing in Medicare mental health clinics or whether it's by making the biggest investment into women's health in history, this bill goes to those same principles.

This bill helps Australians find the best value when they need specialist medical advice and treatment, and provides more confidence in their private health insurance by outlawing product phoenixing. Specialist fees in Australia can vary enormously, even for the same procedure in the same part of Australia. According to the ABS, the cost of medical and hospital services is a key driver of health inflation for consumers, which feeds into higher out-of-pocket costs and higher private health insurance premiums.

As the Minister for Health and Ageing outlined recently, a growing number of Australians are choosing not to follow through on GP referrals to medical specialists. This is because the cost is a major barrier. During 2024-25, an estimated 8.6 per cent of people—that's more than 800,000 Australians—delayed or entirely skipped specialist appointments because they could not afford them. Right now, if you need to see a specialist, it can be difficult to find out what you'll be charged before you walk in the door. It can also be difficult to compare these costs against the fees charged by other specialists.

The Medical Costs Finder website exists to help with this, but it has been limited in what it can tell you. Participation in the Medical Costs Finder has been extremely low. Only one to two per cent of specialists and 10 per cent of insurers opted to publish their fees and out-of-pocket costs information. The proposed legislative amendments will allow the Medical Costs Finder website to publish individual medical practitioner fees and insurer out-of-pocket data for common medical services.

It's about taking what we know and making sure that it's transparent to people who need that information. Medical practitioners will no longer need to upload their billing information, as it will be drawn from Medicare and hospitals and insurer billing data already collected by government. This is a smart and practical reform; the data already exists, and the government already collects it. We are simply making it visible to the people it affects the most—to patients, to Australians.

This bill will ensure Australian patients have the power to compare costs and make informed choices about their own medical care, while not imposing any administrative burden on doctors. Specifically, the bill will amend the Health Insurance Act and the Private Health Insurance Act to allow for the publication of information about medical practitioners, including their names, their locations, their fees charged by location and their use of gap cover arrangements with insurers. It will also allow for publication of information about hospitals and insurers, including gap cover and contracting arrangements, and the proportion of policyholders experiencing various out-of-pocket costs. Consumer peak bodies and insurer bodies are highly supportive, given the growth in specialist fees and out-of-pocket costs and the rising costs of living.

This is unsurprising, because people deserve to be able to make those informed decisions about their health care, and they need it more than ever. This government understands that cost of living is the No. 1 thing on families' minds and on Australians' minds. To protect all parties, the bill also includes an immunity from civil proceedings for the publication of this information and modernises the secrecy regime to make it consistent with amendments made by the Regulatory Reform Omnibus Act.

The second major component of this bill addresses something that has eroded consumer confidence in private health insurance, and that's product phoenixing. Product phoenixing is where an insurer closes an existing product then opens an identical or similar new product at a higher premium. And why would someone do that? Well, they do it to pull the wool over consumers' eyes.

This is a government that knows that, when times are tough, our job is to protect Australians and to make sure that their money is safe and their health is looked after. Yes—under existing arrangements, your private health insurer can close your product, open a new one that is functionally identical and charge you more for it, all without the Minister for Health and Ageing scrutinising that premium increase.

Phoenixing doesn't just disadvantage people who are signing up to private health insurance for the first time and feel the consequences immediately; it is also detrimental to the wider community of 15.3 million Australians who already hold health cover. These existing members are left vulnerable because changes to products, pricing or fund behaviour often escape proper scrutiny. As a result, longstanding policyholders can face unexpected shifts in what their insurance covers, how much they pay or how secure their policy is over time.

When these kinds of changes are happening—when things are being deliberately done to Australians to pull the wool over their eyes, and all they want to do is focus on their health, their recovery and their treatment—we need someone to step in, and that's what this bill does. In this way, this cynical practice undermines consumer confidence in the entire system, creating uncertainty not only for those newcomers but for everyone who relies on private health insurance to protect their wellbeing. It's been a loophole, and it has been exploited.

Currently, private health insurers are required to apply to the Minister for Health and Ageing if they wish to change the premium for an existing product. This bill amends the Private Health Insurance Act to require an insurer to seek ministerial approval for the premium charged for a proposed new product and for changes that reduce cover, reduce a benefit or change a term or condition of an existing product. This closes that loophole. It means that, if an insurer wants to launch what is essentially the same product at a higher price or quietly reduce the value of a product you hold, they need ministerial sign-off. They need to stump up what they're doing. And that is proper accountability.

The bill also makes important modernisation changes to the premium approvals process more broadly. It introduces an approved application period that gives legislative backing to the existing premium round, which has operated administratively for many years. It applies a public interest test to applications within this period, with a more stringent test for out-of-cycle applications. The minister will be able to delegate the power to approve a premium application, but not the power to refuse one. That is an important safeguard. The bill provides legislative backing for existing processes, including the ability to request further information or ask an insurer to resubmit their application. These are sensible, proportionate reforms that give consumers greater confidence that those premiums that they are being charged reflect genuine value.

The shadow Treasurer thinks he knows what's wrong with our health system. Just before taking on his role, he told the parliament it was 'a system designed to keep people ill' for Labor's political benefit. But, unlike those opposite, this Albanese Labor government came into office with a commitment to strengthen our healthcare system, not talk it down—and not talk Australia down—but strengthen and build our health system, which is one that is the envy of so many the world over.

We have not stopped delivering on that promise, on that commitment. We have made the biggest investment in Medicare since its inception. We've backed bulk-billing in. In my electorate, what that means is that we've got 11 practices that were formerly mixed-billing and are now fully bulk-billing, with nine out of 10 GP visits to be bulk-billed by 2030. We've rolled out urgent care clinics so that Australians can get care without sitting in an emergency department, and 80 per cent of Australians will soon live within a 20-minute drive of one of those fully bulk-billed clinics. I've got two pretty close to me: one at the bottom of Canossa and one at the bottom of the PA.

We've reduced the cost of PBS prescriptions and invested in women's health, aged-care wages and the health workforce of the future. I was at a pharmacy in Corinda the other day. When I spoke to the pharmacist about the impact of $25 PBS medicines, she said that people were taking their medicine, particularly those with chronic disease. People who might not have made that choice previously because of price were now doing that. So these investments in health care impact real people and they help people in our communities.

If the shadow Treasurer would like to join us in strengthening Medicare, we would welcome him to work with us. But his record tells an incredibly different story. In 2011, he told the Sydney Morning Herald that delivering sustainable health services requires a free-market approach. We know what that means. I'm a Queenslander; I know what that means. It means privatisation, and it means cuts again and again. That is what we see from this opposition. Those are the shadow Treasurer's words. We believe that health care should be for everyone, not be in the hands of a privatised few.

Alison Penfold (Lyne, National Party) Share this | Link to this | Hansard source

I, too, believe that health care should be universally available. The services of the government should be universally available to all Australians. But I've stood up in this parliament numerous times asking for an urgent care clinic in Taree, a community that was smashed in May last year by a one-in-500-year flood. What response have I got? I've written five times to the minister. Do you think he's responded to me once? I've even written to the minister to request a meeting. I'm trying to work cooperatively on this very important issue—one I agree with the government on—and the minister has said: 'No. I won't meet with you.'

I'm flabbergasted that the member who just spoke said there's going to be an urgent care clinic within 20 minutes of every Australian. I don't think the member for Durack would have an urgent care clinic within 20 minutes of all of her constituents, and I know there's not one federally funded urgent care clinic between Coffs Harbour and Newcastle—not one.

Let me come to this bill, the Health Legislation Amendment (Improving Choice and Transparency for Private Health Consumers) Bill 2026. I welcome the opportunity to speak on this bill and support its intentions. The bill will allow for Medicare, hospital and insurer billing data already collected by the government—including what individual specialists charge for particular medical services—to be published on the Commonwealth's publicly accessible Medical Costs Finder website. People will be able to compare those costs against the fees charged by other medical practitioners, ultimately helping people make informed decisions about their health care. Greater transparency in healthcare pricing, which this bill seeks to achieve, is a good thing.

This bill will also amend the Private Health Insurance Act 2007 to require insurers to seek the Minister for Health and Ageing's approval of the premiums they intend to charge on new health insurance products. This is important because it will help tackle a shady tactic widely utilised by private health companies, referred to as 'product phoenixing'. As it stands, private health insurers can open a new health insurance product at any time at any premium without the health minister's approval. This is different from the process for changing the premiums of existing products, where insurers must seek the minister's approval first. This difference has led to the practice of insurers closing a health insurance product and opening a similar new product at a much higher price. Product phoenixing tends to result in consumers paying higher prices for health insurance or receiving lower levels of value or coverage. Putting a stop to product phoenixing and formalising ministerial oversight of premium setting for private health insurance products is a necessary move.

However, there is more—much more—that needs to be done when it comes to reforming the private health insurance industry. The record profit take and exorbitant management fees charged by insurers continues unabated. While Australians with private health insurance are forced to foot record premiums in a cost-of-living crisis and are consequently experiencing the largest downturn in living standards in the developed world, the private insurers' profits are reaching new heights. In 2024-25 alone, industry heavyweights Bupa and Medibank saw profits explode. Bupa saw its after-tax profits soar by a staggering $182.1 million to $593.9 million last year. Medibank's after-tax profit grew by $21.7 million to bank $573.7 million. This bill does absolutely nothing to address that. Instead, with the minister's approval, private health insurance premiums will rise at their fastest rate in almost a decade after the federal government approved a 4.41 per cent average increase from April. Even though private health insurance companies must receive ministerial approval to increase their premiums, Minister Butler did not reject their proposed price hike. Instead, he consented to it and has since defended the above-inflation rise, the largest increase since 2017. In doing so, he has forsaken the interests of Australians in favour of the profit of private corporations.

A family from Lorne emailed me to convey their outrage over the minister's approval:

We are appalled at this current situation—

under Labor's administration. They wrote:

We, a retired couple, whom have worked extremely long and hard (beyond retirement age) to secure a self funded retirement, so as not to burden this country or our government by asking for financial assistance, are once more targeted by this Labour Party.

We recently received an email informing us that on April 1, our private health insurance will increase by $50 a month. This is due to price increases under Labour's policies …

We feel this next increase, will drive deserving, frail and ailing older people from private health insurance and will increase a multitude of issues in our public healthcare system and their services.

Shame on you!

On top of this, whilst the private health insurance companies siphon record profits, Australians and my constituents are paying more for their private health insurance and getting less value in return. About 15 million Australians hold some level of private health insurance, and they are all seeing their premiums go up and up whilst their coverage is drastically narrowed.

Over the last five years, the health insurers have dramatically skewed their focus in favour of lesser coverage—namely, silver, bronze and basic-cover policies. A record 70 per cent of people with private hospital cover—some 8.8 million Australians—have major exclusions built into their policies. Often they are unaware of these restrictions until they are sick or injured and at their most vulnerable.

Insurers have been forcing customers away from full and comprehensive gold-level policies. As the Commonwealth Ombudsman found in 2024, health insurers have used a legislative loophole to inflate gold-level cover by 45 per cent over four years, when official average premium increases totalled 11.9 per cent over the same period. The benefit to insurers is that customers are still paying higher premiums each year, and, if they get sick or injured, there are a slew of basic treatments and care provisions they are not covered for and for which they will need to pay substantial out-of-pocket costs. This represents a massive saving for insurers.

The bill also does nothing to confront insurers who are not meeting the expected benefits ratio, or the percentage of premiums people pay each year that flows to healthcare providers. As it stands, Australia's private hospitals, including those in the Lyne electorate, face an existential crisis. Since COVID, the viability of private hospitals has seen a steep decline. This threat has now crossed a line that sees many hospitals simply unsustainable.

Predominantly funded by private health insurance, prior to COVID the benefits ratio was 90 per cent. Over the last four consecutive years, it has languished at or below 85 per cent. This is because there is no mandatory minimum benefits ratio that private health insurers must comply with. There is no mechanism to ensure premium increases are passed on to healthcare providers. Instead, the private health companies are allowed to negotiate with the private hospitals to set the benefits ratio. In reality, the five largest health insurers—Medibank, Bupa, HCF, nib and HBF—all use their market dominance to overpower hospitals and get a favourable agreement for themselves. Private insurance companies are not so much negotiating with private hospitals as coercing them. As a result, over the last several years, insurers have been keeping more of the cash generated through high premiums for themselves and paying less of it to the hospitals. Despite massive windfalls, Medibank barely shifted the dial on the benefits ratio paid to private hospitals—up just 1.3 per cent on 2024 to come in at 87.1 per cent for the year. Bupa actually went backwards, paying out even less than in 2024—down 0.45 per cent for a paltry 83.3 per cent payout ratio.

APRA data shows that, over the last four years, health insurance companies underpaid private hospitals to the tune of more than $4 billion. Over the same period, the health insurance companies recorded unprecedented profits of more than $7 billion. That has to change. Without enforceable, mandated ratios, insurers will continue to underfund the private system. After four years of insurers failing to meet their obligations to private hospitals, the federal health minister's March 2024 warning for them to dramatically improve the benefits ratio has fallen on deaf ears.

Mandating this requirement is now essential and needs to happen quickly to halt the alarming rate of private hospital closures. Some 20 private hospitals have already closed their doors entirely, while 80 services, predominantly mental health and maternity, have been permanently cancelled in the remaining hospitals, including Mayo Private Hospital in Taree. The Australian Private Hospitals Association is aware of at least nine private hospitals at imminent risk of closing, which is on top of the issues being confronted by non-APHA member Healthscope, of whose hospitals 12 are in doubt of continuing. All of this dramatically erodes the access, choice and quality that people rightly expect from the ever-increasing premiums they pay for private health care. Not only does this erode the choice, access and value of private health care; it places more pressure on an already overstretched public hospital system.

Australia's healthcare system relies heavily on Australia's 633 private hospitals and their more than 36,000 beds, so getting the private sector right is critical for our public sector. Private hospitals account for 41 per cent of all hospital admissions—some 5.14 million each year—and 70 per cent of all planned surgeries, with 1.72 million procedures last year. They also perform the majority of many complex operations. The complementary nature of Australia's hospital system—private and public together—has long been a strength, and it's why we have historically been regarded as the world's best. Private hospitals shouldering so much of the workload alleviates massive pressure on the public system, but the financial viability issues confronting all private hospitals are adding and will continue to add to those public pressures.

In Lyne, the Mayo Private Hospital employs 243 people and admits 12,201 patients, or thereabouts, each year. Forster Private Hospital employs 155 people and admits over 11,000 patients each year. If either of these facilities were to close because of private insurance companies refusing to meet prepandemic benefit payout ratios, Manning Base Hospital, the only public hospital in the Lyne electorate, would be forced to pick up the slack. My constituents and I know too well that this is simply not possible. Manning Base Hospital is not receiving its fair share of funding and resources, and the state government's latest attempt to break the back of regional health has gone so far as to downgrade the hospital and remove beds. Without an urgent care clinic for Taree, which, as I said earlier, I've repeatedly requested, and without any real progress taken by the Minns New South Wales government on the delivery of the Forster-Tuncurry urgent care clinic, secured by my colleague Tanya Thompson, and a public hospital in Forster, health in the Lyne electorate—the oldest electorate and one of the poorest—will reach unprecedented and unimaginable lows.

On another issue—in my electorate, countless constituents have contacted me about the Australian government's planned reclassification of MBS items for eye injections, from a type B to a type C procedure, for private health insurance purposes on 1 July 2026. This change will result in over 12,200 people who currently receive eye injection treatment in private hospital and day surgery settings no longer being able to use their private health insurance to pay for their treatment. Countless individuals will have to stop treatment due to the high out-of-pocket cost. As the only treatment they have access to is in a private ophthalmology clinic, patients will be at greater risk of irreversible vision loss and blindness because of this change.

John, who lives in Lakewood, has told me:

without this treatment, I will not be able to see… This is the second time I have had to complain about the way our Labor Government is treating people like myself.

Fiona from Kendall said:

I am a carer for my husband. I would not be able to afford injections if the rules change. We live in regional NSW and have no other option. If I lose my sight, I will not be able to drive. Who will look after my husband?

I cannot understand the rationale behind the government's decision to do this. It is extremely concerning, and I've written to the Minister for Health and Ageing, urging him to reconsider. Any loss of eyesight caused by this government's decision is unacceptable and, importantly, avoidable.

While I support this bill, I call on the minister to go further. Implement the necessary mechanisms to ensure health insurers pay their fair share by mandating a return to 90 per cent benefit ratios from annual premiums. I also urge the minister, for the sake of Australians, to seriously consider the need for a mandatory code of conduct in contracting between private health insurers and private hospitals.

Joanne Ryan (Lalor, Australian Labor Party) Share this | Link to this | Hansard source

I rise tonight, and I'll share with the member opposite that I, too, communicate regularly with the Minister for Health and Ageing. I send him thankyou notes and I smile at him when I walk past the corridors, because Werribee has an urgent care clinic. We also have an endometriosis and pelvic pain clinic, servicing the city of Wyndham, with a population of 360,000 people. I'll repeat that: 360,000 people. And, yes, most of them live 20 minutes distance from the urgent care clinic. I also want to thank the health minister for making it possible for 80 per cent of the people in my community to see a GP who bulk-bills, because we were a long way from that when we took government four years ago. I was meeting with constituents every day about the cost of health care.

Like the member opposite who just spoke, I've also met with many constituents about the rising costs of private health care, private health insurance and seeing specialists. So I'm really pleased to stand today to support this legislation, because, like the actions that we have taken to strengthen Medicare and to breathe life back into our universal health system in communities like mine, I'm pleased that we are also reaching into this space, which is incredibly important.

This bill is another example of the Albanese government delivering on its election promises. It will help the people in Lalor struggling with the rising cost of living by making health care more accessible and more affordable. At the last election, we promised voters that we would strengthen the healthcare system, helping Australians find the best value when they need a specialist or specialist medical advice and treatment. This bill delivers on that promise.

We also promised to stop private health insurers from price gouging their most vulnerable customers—people who need gold levels of hospital cover—by outlawing product phoenixing. The private healthcare system is subsidised by the government through the private health insurance rebate. This bill makes sure that that investment achieves value for money for consumers and taxpayers. This bill is yet another step towards strengthening and securing our world-class healthcare system.

And what about the local impact? This legislation will benefit people in my electorate in two clear ways. Firstly, it offers transparency by default. Secondly, it fulfils our election commitment to outlaw the practice of product phoenixing. When we talk about transparency by default, what does that mean? It means the bill improves transparency by giving people more information about specialist care providers and preventing dramatic increases in private healthcare premiums by stealth. These proposed changes will mean that individual medical practitioner fees and insurer out-of-pocket data will be published for common medical services. This information will be made available on the Medical Costs Finder website. The information will include names, locations, fees charged by location and the providers' utilisation of gap cover arrangements with insurers—where insurers pay a medical practitioner more if they agree to charge no or fixed out-of-pocket costs. It will include information about hospitals, including medical practitioners who provide services at the facility, and insurers that have gap cover or contracting arrangements with the facility. It will have information about insurers, including the proportion of policy-holders who experience different gap cover arrangements and the out-of-pocket costs under those arrangements. It is transparency by default. Automatically, people will be able to look this up.

Critically, medical practitioners will not need to upload their billing information; it will be taken from data entry already collected by the government, so there will be no extra burden on doctors. People in Lalor will be happy to know that this represents the first significant step towards addressing rising specialist fees and damaging out-of-pocket costs. There is more to be done, and people in Lalor should rest assured that this government is rolling up its sleeves and working hard to drive down their medical bills.

Now, I had an opportunity to speak recently to quite a few GPS as I went to visit GP clinics that had moved to bulk-billing. I've had a few conversations with our local doctors, and they've raised the process of referrals to specialists. I've had some conversations with some of them about what we're planning in this piece of legislation, and they're really pleased. They say it often ends up being a double visit, because they might meet with a patient and say, 'I'm going to refer you to a specialist.' They look up specialists, they do a referral and the patient leaves and goes home. The patient then does their own research, talks to a few neighbours, rings the hospital, goes through a lot of work and ends up back with their GP, saying: 'I actually can't afford this specialist. Do we have a different option?' This will mean that, sitting in the GP's rooms, the patient or the GP could look up the cost finder website and then make an informed judgement about what can be afforded, where this specialist operates and whether they operate in a public hospital as an option, as opposed to simply going automatically to the specialist rooms and then to a private hospital somewhere. So this costs finder website will make a huge difference in communities like mine, where people are making health choices based on cost. This is a government that wants to change that narrative back to a universal health system where people don't have to consider those things, and this is a step in that direction.

Interestingly, what we're doing here is building on what was the former government's commitment to creating this costs finder website. But, unfortunately, with an opt-in system, only 50 doctors registered for the use of this. Every specialist in the country will now be on this list. It will assist GPs to do referrals. It will assist patients to make assessments and judgements about which specialists they want to work with. I think it's incredibly important. That's just one thing that this legislation does.

This legislation also deals with product phoenixing. It's the second thing the bill fixes—the practice of private health insurers protecting their profits by price-gouging their most vulnerable clients. Here's how product phoenixing works. Right now, when health insurers want to change the premiums of an existing product, they must make an application to the minister for health. Private health insurers are creating new products that are identical or very similar to existing products and are dramatically increasing their premiums and bypassing the step to the minister. They can then cancel the original product, leaving the new, more expensive product as the only option for consumers. It's not seen as an adjustment to an existing one, so it doesn't require the minister's approval. It also means that they get around that obligation. They no longer have to seek approval from the minister. It's a simple practice. It's clever, but it has a devastating effect on those who need the most comprehensive cover. Those people, of course, are most likely to have a multiplicity of health issues and be dealing with medicines on a large scale. They are often the people who can least afford it.

According to CHOICE, the price of gold hospital cover has increased by approximately 58 per cent in the past five years. Cost-of-living pressures mean that many people have had to give up their gold health insurance. People forced to make sacrifices have dropped down to lower levels of cover. I know I've had conversations with constituents in my community about the fact that they've been to health insurance; they've gone to do the shop-around. They've got an existing policy. They're looking for something that's more tailored to their needs, and they're looking mostly for something that's cheaper. And the advice they're getting is: 'Don't give up what you've got. I know it's expensive, but the next product won't give you the same service.' Private health insurers have been increasing the cost of the highest levels of cover on a dwindling number of customers—typically, those who need the highest levels of medical cover. That means that the most vulnerable are being price-gouged to prop up the profits of private health insurers.

We promised at the last election that we would end this shameful practice, and that is exactly what this bill delivers. The proposed legislation makes sure that ministerial approval is required for a proposed new product and is required for the reduction of cover offered by an existing product. This legislation strengthens the Australian Prudential Regulation Authority's ability to make sure that people are not being ripped off, because this government cares about protecting the most vulnerable. This government is passionate about constantly improving the healthcare system, because good health is the foundation of thriving communities. Good health helps us be better parents, partners, friends, workers and community members.

This bill makes sure that people in my community who require specialist care can find options that provide the best value. It gives my constituents the opportunity to avoid paying high out-of-pocket costs. And, as one GP relayed to me, this bill will actually help GPs find specialists who better suit their needs and those of their patients. The bill also ensures that people who need gold levels of private health insurance cover are not price-gouged to preserve the profits of health insurers.

According to the Australian Bureau of Statistics, the cost of medical and hospital services is a key driver of health inflation for consumers. Higher out-of-pocket costs for specialist care and higher private health insurance premiums are a serious concern for Australians dealing with cost-of-living pressure. Fees can vary widely across specialists, even for the same procedure in the same part of Australia. This bill helps Australians make more informed decisions by helping consumers understand which providers offer the best value. The bill delivers on the government's promise to deliver transparency by default. On this side of the House, we understand that government plays a central role in making markets work for Australians. Unlike the ideologues who have captured the opposition, Labor understands that commonsense regulation makes markets more efficient and improves outcomes for consumers.

This government respects the expertise and dedication of Australia's healthcare providers. These changes, carefully designed to ensure there's no additional administrative burden on the people providing care, give the minister powers to delegate the approval of new or changed products or premiums; however, only the minister can reject applications. This means that beneficial changes will not be slowed down, and products that hurt Australians will receive the scrutiny they deserve.

As the Minister for Health and Ageing, the member for Hindmarsh, reminded us recently, the shadow Treasurer wants to see the transfer of health financing shifted from government to individuals. We know he doesn't mean ending private health care subsidies. We know he doesn't mean ensuring that private health care subsidies fund services that provide value for money. He means moving towards an American-style healthcare system. And it's not just those on this side of the House who understand that. The people in my community absolutely understand that, when those opposite get their hands on the levers of government, health care is one of the first places that they undo great Australian systems.

In 2021, when the shadow Treasurer was speaking about allowing young people to claim dependent status on their parents health care for longer, he argued that superannuation contributions were the real threat to health care in this country. Australians know the real risk to health care—it's the ideologues in the Liberal Party, and the member for Goldstein is just that. In this place he said:

…when you take money from young Australians and lock it up in super, they can't do other things, like afford private health insurance or homeownership.

We don't see health and housing as diametrically opposed. This is a government that takes action in both spaces. On this side of the House, we know that the only thing Australians need to secure their health care is a Medicare card and a healthy health system. Those opposite don't want a fair healthcare system. They want an American-style system where the only people that can access health care are those who can afford to pay for it.

We're going to hear a lot about Australian values from those opposite before the next election. I want people in Lalor and around the country to know it's a ruse. Now that the ideologues are in charge, they will try to trick you into a more expensive, less fair healthcare system. This bill represents, for all Australians, another delivered election promise by the Albanese government. It will help people in Lalor struggling with the rising cost of living by making health care more accessible and more affordable, and it will drive a healthier Lalor and healthier communities across the country.

Monique Ryan (Kooyong, Independent) Share this | Link to this | Hansard source

The cost of accessing health care in this country is not just a wellbeing issue; it is a cost-of-living issue, it is a labour market productivity issue and it is an economic issue for any treasurer who is serious about Australia's long-term prosperity. When Australians can't afford health care, they delay or forgo it. Improving health outcomes is therefore not just desirable for our wellbeing; it's an important determinant of Australia's productivity and growth.

Healthy people are more likely to participate in the workforce, to contribute to society and to spend into our economy, and they require less expensive care. Over decades, Australia has been drifting away from the universal promise of Medicare and back towards a user-pays healthcare system, which is increasingly pricing Australians out. Gap fees for non-bulk-billing GPs and specialists, bills from private hospitals and the increasing cost of some prescription medications—these kinds of out-of-pocket healthcare costs are now exceeding $33 billion annually for Australia. That is a higher share of total health spending than in the UK, Canada or the United States.

Cost pressure is most acute in specialist care. On average, patients' bills for specialist appointments are $300 a year. Australian patients are now paying out of pocket for two-thirds of all specialist appointments in this country. The average out-of-pocket gap payment for specialist attendances increased from $49 in 2010-11 to more than $115 in 2023-24. That's a 136 per cent increase over a period in which the consumer price index increased by only 40 per cent.

It is increasingly common for Australians to be charged $1,000 for an initial specialist appointment, $650 to see an obstetrician, $600 to see a cardiologist and $1,000 to see a psychiatrist. It's a similar situation in private hospitals. Out-of-pocket payments for private procedures rose 300 per cent in the five years to 2025. As many as 40 per cent of private hospital patients find themselves with bills of $1,000 or more after inpatient treatments. Disadvantaged Australians are rarely bulk-billed when they see a specialist. Three quarters of people who are earning less than $500 a week in this country paid a bill for at least one specialist visit in 2023.

These are extraordinary costs at a time of personal vulnerability for patients. It's not surprising that the 2025 Australian Healthcare Index found that 49 per cent of Australians have delayed seeking medical support due to increasing out-of-pocket costs. A recent cross-country comparison found that Australia ranks second-last amongst wealthy nations on access to care; we're now only ahead of the United States. That is a sobering finding for a country that has rightly prided itself for a long time on the universal promise of Medicare.

It's not just the high gap fees and out-of-pocket costs that worry patients. As an MP, I hear all the time from constituents that I represent about bill shock—unexpected bills that take constituents by surprise. At least one in two Australians receiving specialist care receive unexpected bills. I'm also hearing of hidden booking and administrative fees, some of which are unlawful, which violate the spirit of informed financial consent. Informed consent is enshrined in medical care but it's also a basic consumer right. It's ridiculous, remarkable and unacceptable that we demand it in other parts of our medical practice but not this one.

For many Australians, private specialist care is increasingly the only timely option. In many parts of Australia, public waitlist times for specialists are now stretching from months into years. Fifty specialities across our major cities have public waiting times of longer than a year. For a child in regional Australia who needs to see a paediatrician, waitlist times are between 18 months and four years.

We need a market for specialist medical care that works. Price is part of the story. Patients should be able to compare prices before they arrive at a consultation. GPs should know what specialists charge. Specialist fees in turn need to be fair, transparent, reasonable and proportionate. That's why I'm pleased to see the government legislating reform to the Medical Costs Finder website. Just to remind the House: in 2019 the Morrison government spent $24 million on a tool to give Australians a way of understanding the cost of specialist services before they committed to their care. The website relied on voluntary fee disclosure, and it was a profound failure. Of approximately 11,000 eligible specialists, only seven chose to publish their fees by the end of 2022. The price transparency tool was, in effect, entirely devoid of prices. Three years later, only 88 doctors had voluntarily disclosed their fee information; that represents a participation rate which rounds down to zero.

The website did contain some useful aggregate data about average out-of-pocket costs for consultations across different specialities and about bulk-billing rates by speciality. At least half a million patients have used the site since its launch, but its central purpose—helping patients to understand what their doctor will charge them—has never been realised. Voluntary disclosure will always reflect a self-selected cohort of the most competitively priced practitioners. It will therefore present a skewed picture that further disadvantages consumers.

So, in 2025, this government invested another $7 million to deliver the technological capacity to analyse Medicare, hospital and insurer data. This bill now legislates those changes by amending the Health Insurance Act and the Private Health Insurance Act to allow the department to publish information about doctors and their billings, including the use of gap cover arrangements with insurers.

It will also allow publication of information about healthcare facilities and insurers, including the proportion of policy holders who experience different gap cover arrangements and the out-of-pocket costs associated. That data already exists—it's in Medicare—but this bill allows Medicare, hospital and insurer billing data to be published cumulatively, helping patients make informed decisions and allowing them to compare costs against the fees charged by other doctors.

But I'm still concerned that the bill as drafted is not going to deliver on its stated objective. The EM for the bill proposes that the data presented will be a single figure against the medical practitioner's provision of a service. We've been told that the department is going to develop an analytical approach for the derivation of that figure, but we have no visibility into the derivation of that fee. A price which might be brought down by discounting for some but not all consumers could give an inappropriately low cost point on the website, and the complexity of billing practices could well render the interpretation of fee schedules quite challenging for many individuals.

It doesn't matter what the cost of the service is if you still can't afford it. To be effective, the Medical Costs Finder has to put downward pressure on specialist fees. As it's drafted, the single fee given will be a static snapshot of the previous year's charges. That figure needs to be updated more regularly if we're truly to drive prices down. While I recognise that price is an important metric, high-quality medical services can't be adequately qualified or quantified by a simplistic price comparison tool. There is a common misconception that doctors who charge more provide better quality care. As a medical specialist of 30 years standing, I know this to be untrue. While this bill is an important step in informed decision-making, it doesn't contemplate the publication of quality markers. Publication of complication rates, readmission or patient-reported outcomes could well support patient safety and more informed decision-making, and that's been used with success in other jurisdictions.

But, by addressing the structural drivers of the increasing cost, we're still not driving care. We know that the Medicare Benefits Schedule has not been appropriately indexed for years, nor has it meaningfully kept pace with inflation. During that time, wage and equipment costs—and increasingly restrictive private health insurance policies—have shifted the cost burden from Medicare onto the consumer. Fee transparency will reveal the size of the gap, but it cannot of itself close it. If the underlying cause is a Medicare rebate which is frozen in real terms while operating costs escalate, publishing fees will tell patients how bad the problem is, but will not equip them to solve it.

The government has to consider other policy levers to manage the cost-of-care crisis. I'm proposing two to this House. The first is Medicare rebates. The second is workforce. Medicare rebates have long been underindexed. That has driven higher out-of-pocket costs. The schedule should undergo ongoing review, and it should more accurately reflect the cost of care. At the same time, we should ensure that no specialists are engaging in excessive or exploitative billing.

The bill does not address the ongoing maldistribution of specialist supply. Specialist billing has actually fallen by 10 per cent over the last five years, while the Australian population has grown by more than seven per cent. Doctors charge based on the competition in the areas in which they work. People living in areas with fewer doctors, like those in regional areas, face higher fees. You can't comparison-shop for a specialist if there isn't one in your region. The inadequacy of training positions in multiple specialities has been repeatedly identified by inquiries and studies. Australia needs to ensure that we are producing a pipeline of doctors able to provide the services required.

The existing Health Workforce Taskforce is not designed for or tasked with development of the national workforce strategic directions and priorities. Because health regulation operates at a state and territory level, new initiatives must be legislated in multiple jurisdictions. This deficiency has been identified by a number of inquiries, including the Snowball Review, the 2017 Accreditation Systems Review and most recently the 2022 to 2031 National Medical Workforce Strategy, which called for creation of joint medical workforce planning and advisory structures with sufficient authority and expertise to make recommendations in relation to the size and structure of the national medical workforce. I have long argued for national coordination of specialist training positions.

This bill also addresses a second systemic issue in the healthcare system—the practice known as product phoenixing—wherein private health insurers close the product and then reopen identical one at a higher price or reduce the value of that product. Insurers will be required to seek ministerial approval for premiums on new products and for changes that reduce cover or the value of existing products. The issue with this is that we have seen, as was demonstrated by CHOICE just this week, that the price of many private health insurance packages, particularly of a gold level, has increased well beyond the level of inflation despite the measures that the government believes that it has put in place to keep those costs in line.

This bill doesn't compel any reduction in specialist fees. It doesn't cap gap payments. It doesn't require bulk-billing by specialists. It doesn't mandate that the information displayed on the website is presented in a way that will be genuinely comprehensible to patients with low health literacy. And with only $7 million allocated for its implementation against the $24 million already spent on the failed initial model, questions about platform quality and data integration are legitimate.

The voluntary Medical Costs Finder was an expensive policy fiction. It was a website that looked like transparency but delivered almost none. Moving to mandatory publication of data that the government already holds, it would appear to be a straightforward correction of a structural error. But it would be a mistake to allow this bill to serve as a substitute for the deeper and bigger reform that the specialist market requires—meaningful Medicare rebate indexation, regulation of those extreme fee outliers, expansion of public specialist clinic capacity and genuine workforce planning tied to community need.

Australians deserve a healthcare system that is accessible, affordable and genuinely centred on patients. With those principles in mind and without declining to give this bill a second reading, I commend this bill to the House, and I move amendments (1) to (4) in my name:

That all words after "That" be omitted with a view to substituting the following words:

"whilst not declining to give the bill a second reading, the House notes that:

(1) while the government is advancing broader economic and health reforms, out-of-pocket costs of receiving specialist medical care continue to rise in a way that exacerbates cost-of-living pressures;

(2) consumer price indexation figures show that 'medical and hospital services' increased by 4.2 per cent in the 12 months to January 2026, outpacing headline inflation;

(3) medical and hospital services should be non-discretionary items, however costs have resulted in approximately one million Australians missing out or delaying specialist care every year; and

(4) while the measures in this Bill will improve price transparency, further reforms are needed to keep specialist healthcare affordable for all Australians, including fixing specialist billing practices, extending Medicare rebates across specialists, indexing Medicare rebates in line with inflation and reviewing gap fee limits".

Terry Young (Longman, Liberal National Party) Share this | Link to this | Hansard source

Is the amendment seconded?

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

I second the motion and reserve my right to speak.

Jo Briskey (Maribyrnong, Australian Labor Party) Share this | Link to this | Hansard source

Before I get underway with my contribution to this really important piece of legislation, I'd like to correct the member for Lyne on some of the issues that she raised in her contribution a little earlier this afternoon. The member raised some important issues around the potential of a reclassification of important eye injections and the potential for that to lead to out-of-pocket costs for patients. I'm pleased to correct the member for Lyne and to reassure her constituents that that is not the case. In fact, a couple of weeks ago, the Albanese Labor government announced that it would not be moving ahead with those changes and decided not to reclassify those special eye injections as out-of-hospital services, protecting the out-of-pocket costs for patients. Minister Butler said:

After reviewing and listening to the views of older Australians, we will no longer be proceed with the change so people can continue with their existing arrangements with their existing clinician and won't see an increase in their out-of-pocket costs.

So I hope that the member for Lyne is able to take that really good information and news back to her electorate. It's just another example of how this Albanese Labor government is delivering for every Australian.

Australians are rightly proud of Medicare. It has shaped the public's understanding of health care in this country as a system that is grounded in fairness, transparency and access based on need. Many Australians reasonably expect those same principles to apply under the broader health sector, including when they engage with the private health system. But, in practice, that expectation is not always met. In my community, people tell me the same story in different ways. They do the right thing. They take out private health insurance to protect their family, to shorten waiting times where they can and to have options when life throws a curveball. But too often that promise of security is undermined by opaque pricing, fragmented information and practices that feel like the rules are written for everyone except the consumer.

Australia's health system is one of our great achievements. Medicare is its foundation—a guarantee that essential care is available regardless of income. But most Australians move between public and private services across their lives. When those parts of the system work together well, patients benefit. When they do not, people are left juggling referrals, deciphering bills and making decisions without the basic information any reasonable person would expect. This bill addresses two problems that are widely felt and are long overdue for action. First, it tackles the lack of transparency around fees and out-of-pocket costs. Second, it strengthens oversight of private health insurance premiums and ends the practice known as product phoenixing.

On transparency, let's be frank about the current experience. A person receives a referral to a specialist. They book an appointment, sometimes weeks away. They may not be told the fee until the day of, or they may be given an estimate that is impossible to verify. If the specialist recommends a procedure, the patient then has to piece together separate quotes—surgeon, anaesthetist, assistant, hospital fees—often while they are anxious, in pain or caring for a loved one. Too many only learn the full cost after the decision has effectively been made. That is not informed choice; it is consent under pressure. The consequences are real. Unexpected bills can force families to dip into savings, postpone other essentials or take on debt. Some delay care because they cannot risk the cost. Others go ahead and simply hope that they can cope later. Either way, uncertainty becomes a barrier to health.

This bill takes a clear approach: transparency by default. It enables publication of meaningful, comparable information about fees and typical out-of-pocket costs for common medical services. Crucially, it does this by better using data already collected through Medicare, hospitals and insurers. The point is not to create a new burden for clinicians or drown the sector in paperwork. The point is to unlock the value of information that the government already holds and put it to work for the people it ultimately belongs to—the patients.

With better information in the public domain, Australians will be able to see how fees vary for common services, what gap arrangements are in place and what they are likely to pay. That will help people ask smarter questions: Is there a no gap option? What will my insurer cover? What are the alternatives? It will help people understand whether a quote is within a typical range or whether it is an outlier that warrants further conversation. This is not about naming and shaming practitioners; it's about equipping patients. Most clinicians already communicate well and charge fairly. Transparency will support them by lifting the overall standards and reducing the confusion that too often sits between patient and provider. For those doing the right thing, it's a trust builder.

The bill also recognises that a patient's bill is not determined by one person alone. Out-of-pocket costs are shaped by the broader arrangements that sit behind the scenes between hospitals and insurers and between insurers and providers. Consumers deserve to know what arrangements exist, what they cover and how they affect the final cost. That is why this bill provides for the publication of information about hospitals and insurers as well: who provides services where, what arrangements are in place and how those arrangements influence what the patient pays. It helps Australians see the system as it operates, not as it is marketed.

Of course, transparency must be done properly. Data must be accurate, timely and presented in plain language. It must be contextualised, so it's meaningful and not misleading. It must protect privacy and uphold confidentiality. This bill modernises the relevant legislative frameworks for data sharing and safeguards so those disclosures can occur responsibly. Transparency is the first pillar of consumer confidence. Fairness is the second.

This brings me to premiums and product phoenixing. Australians understand that premiums change. They know costs can rise as demand increases and medical practice evolves. What they expect, quite reasonably, is that premium changes are subject to constant scrutiny and that insurers cannot game the system by changing labels. Product phoenixing has damaged trust because it looks and feels like a workaround. An insurer closes a product and replaces it with one that is substantially similar but more expensive or less valuable. The change can avoid the scrutiny that would normally apply to premium increases. Consumers can be shifted with limited notice and limited clarity. For many, the practical ability to compare or move is constrained by time, health needs or the fear of losing continuity. For the policy holder, the technical distinction between an old product and a new product is beside the point. If they are paying more for the same cover or receiving less for the same premium, the impact is the same.

This bill closes that loophole. It strengthens the premium approval framework by requiring approval not only for the changes of premiums on existing products but also for the premiums associated with new products and for the changes that reduce coverage, benefits or conditions. That is an important shift because it recognises that value can be eroded in ways that are not captured by price alone. This bill does not stop insurers from improving products or responding to changing circumstances. It does not freeze the market, but it does require that significant changes, whether to price or value, are transparent and assessed against public interest.

It also formalises key aspects of the premium approval process that had previously been administrative, and it introduces a legislative application period. It also clarifies how further information can be requested, sets out resubmission processes, applies a public interest test and provides for appropriate delegation of decision-making. Those details are important because they create predictability for industry and accountability for consumers, strengthening the integrity of decisions that affect millions of households.

The bigger issue here is trust. Private health insurance relies on a social contract. People pay now to protect themselves later. They accept that they are joining a pool, sharing risk and funding care that they may never personally use. This only works when consumers believe the system is understandable, honest and regulated in their interest. When people feel blindsided by fees, confused by gaps or trapped by product changes that seem designed to evade scrutiny, that trust frays. People disengage. They downgrade. Some leave altogether. That is not good for families, not good for private hospitals and providers, and not good for the public system that then carries more demand.

This bill strengthens the social contract in a sensible way. It does not set fees. It does not pretend that health care is a simple retail transaction. What it does is make the system easier to navigate for ordinary Australians, giving people the information that they need while ensuring that the rules governing premiums and products operate transparently and fairly.

This bill reflects a fundamental difference in approach. On this side of the House we believe Medicare must remain the foundation of our health system, with private health insurance working alongside it through transparency and fairness, not confusion or hidden costs. Those opposite have often and for too long sought to weaken Medicare while relying on a less regulated private system that shifts costs between patients, risking a drift toward a model where access depends on what you can afford. This government rejects that direction. This bill ensures that private health insurance strengthens Medicare by improving transparency, by closing loopholes like product phoenixing and by putting fairness back at the centre of our health system. It will also help local providers demonstrate the value they deliver and compete on openness and patient experience, not just reputation. That is why stronger premium oversight is so important.

For a young family, it means fewer nasty surprises when a child needs specialist care. For older Australians, it means more certainty when planning for procedures and managing fixed incomes. For people with chronic illness, it means clearer expectations and an ability to budget over time. For small-business owners and the self-employed, it means making decisions with a better handle on what they are likely paying. It will also support the many clinicians and providers who already prioritise clear communication. When transparency is the norm, it reinforces the professionalism that patients rely on.

Implementation will matter, and it absolutely should be done in partnership. We should work with clinicians, hospitals, insurers and consumer advocates to ensure published information is useful and fair. We should monitor impacts carefully to ensure transparency improves decision-making and does not create unintended distortions. We should be honest about what success looks like—fewer unexpected bills, better comparisons, stronger consumer protections and a system that feels more transparent to the people who fund it.

Australians should not need to be experts in item numbers, gap schedules and the fine print to protect their families. They should not discover the true cost of care only after they've had to commit to it. They should not see their insurance product re-emerge under a new name at a higher price without proper scrutiny. This bill responds to those expectations. It complements Medicare's universal foundation by improving transparency and accountability in the private system. It empowers patients with clearer, comparable information. It strengthens consumer protection by ending product phoenixing and applying consistent oversight to meaningful changes in price and value, and it further embeds fairness in our healthcare system. I commend the bill to the House.

Sophie Scamps (Mackellar, Independent) Share this | Link to this | Hansard source

I rise to speak on the Health Legislation Amendment (Improving Choice and Transparency for Private Health Consumers) Bill 2026. This bill is about clear, transparent and accurate information for people making decisions about their health. The purpose of this bill is to improve fee transparency for consumers by allowing the Department of Health, Disability and Ageing to publish information on medical fees charged by medical practitioners on the Medical Costs Finder website and to abolish product phoenixing in the private health insurance sector.

Product phoenixing is the practice of closing existing policies and replacing them with almost identical policies at a higher price. This bill would ensure that private health insurers are required to seek ministerial approval for new products and for existing products where certain changes are proposed. The bill has been welcomed by both the Australian Medical Association and Private Healthcare Australia, as it gives the consumer greater visibility of fees and out-of-pocket costs, which will help them to compare options and make informed choices about their health care.

I support these steps that improve choice and transparency for consumers. However, without a single independent steward to oversee and regulate the private health insurance sector, these gains won't stick. Private health insurance is a vital part of our health system. It works to take pressure off our public health system. The government's private hospital financial health check confirms how vital that capacity is. Private hospitals deliver around 70 per cent of elective surgeries and more than 40 per cent of all hospitalisations. Over 12 million Australians are insured for hospital treatment. Keeping these services accessible depends on funding settings that reward care, stabilise contracting and support the workforce that makes care possible.

My electorate of Mackellar has one of the highest rates of private health insurance in the country, with around 77 per cent of people aged 18 or over having private hospital cover and 83 per cent having ancillary cover. To break it down a bit further, this amounts to over 22,000 individuals and around 92,000 families with hospital cover, and over 25,000 individuals and over 98,000 families with ancillary cover.

The average age of people with private health cover on the Northern Beaches is 63. Here lies one part of the problem. More than 50 per cent of patients admitted to hospital on the Northern Beaches for surgeries are aged 65 to 84 years of age. Whilst it is a huge benefit for older members to rightly use their private cover to get elective surgery done sooner, when they make up a larger share of the pool, funds face more hospital claims. This in turn drives higher system-wide costs and cross-subsidy needs, which in turn feed into higher premiums. The consequence is that this hits the price-sensitive younger households first, risking people downgrading their policy cover or dropping out altogether, which puts more demand on the public system.

The Australian Medical Association's annualprivate health insurance report card, which was released in December last year, describes a private health insurance system that is under pressure. It describes the system as 'increasingly failing to deliver value for money for consumers' and 'no longer fit for purpose'. The AMA has called for greater whole-of-system reform to align with our changing health needs. This includes ensuring that private health insurance delivers value for consumers in terms of meeting an individual's health needs, as well as those of an ageing population with increasing chronic disease and multimorbidity.

Around 6.4 million hospitalisations per annum, or 55 per cent of the total, are due to chronic disease, which costs around $82 billion a year. So we need to ensure private health insurance aligns with this increase in chronic disease in Australia, which makes up 85 per cent of our burden of disease. If private health insurance products are designed mainly around episodic acute interventions and not around the growing burden of chronic illness and multimorbidity, then the system will increasingly fail the population it is supposed to serve. We need product settings and payment models that support continuity, rehabilitation, mental health care and multidisciplinary management, not just narrow episodes of care.

When premiums rise year after year, faster than inflation, wages, health inflation and the indexation of the Medicare Benefits Schedule, consumers notice. They notice because their direct debit gets larger, while the benefit they receive feels smaller. The AMA's Private health insurance report card 2025 put it plainly. Every year since 2008, premium growth has outstripped the consumer price index as well as health sector inflation, average weekly earnings and Medicare Benefits Schedule indexation. That is not a sustainable proposition for households already under cost-of-living pressure.

The impact of that pressure is now visible across the system. We are seeing more Australians hold health insurance products that do not give meaningful security when they actually need that care. By June 2025, there were 640,000 more policies than five years earlier, yet the number of gold-tier policies had fallen by 360,000. This shows people are downgrading to cheaper products that exclude important services. This is not consumer choice in its fullest sense; it is consumers being priced into lesser cover, and we know what that means in practice. Gold cover is the tier that guarantees no-wait access to services such as maternity, psychiatric care and many joint replacements. When people are pushed out of gold cover, it means women and families can lose confidence that private cover will deliver maternity care when they need it. It means people needing mental health care can find that the policy that they have paid for does not give timely access. It means older Australians who have paid premiums for years can discover that their cover has narrowed just as their health needs become more complex.

The AMA has warned that product phoenixing has made this especially acute in gold-tier cover, where new customers can end up paying hundreds more for effectively the same product. This is why I welcome the bill's action on product phoenixing. It closes an obvious loophole. It says that, if an insurer wants to bring out a new product or materially alter an existing one, that change should not escape proper public interest scrutiny. This bill is therefore necessary and overdue.

But banning one bad practice does not by itself fix the deeper structural weaknesses in the system. One of those deeper weaknesses is: where is the money going? Over the six years to June 2025, insurers increased benefits paid for in-hospital treatment by only 18.1 per cent. At the same time, sector profits grew by nearly 50 per cent over that period. The latest quarterly figures cited by the Australian Private Hospitals Association show the benefit payout ratio at 86.3 per cent at December 2025. That is still short of the 90 per cent level that the health minister has repeatedly said should be the benchmark the sector works towards.

Another structural problem is that there is no single fit-for-purpose independent steward responsible for the overall functioning of the private health system. We do, of course, have regulation. The Australian Prudential Regulation Authority, APRA, has an important role around licensing and supervising insurers, setting and enforcing capital solvency, governance and risk management requirements, as well as collecting and publishing industry statistics. The Private Health Insurance Ombudsman has a consumer complaints and information role. The health department administers premium approvals and policy settings. But no one body has the mandate to do a number of other things, including overseeing the interaction between insurers, hospitals and medical practitioners; setting the baseline expectations for contracting; monitoring whether products are delivering real value; or advising government on whole-of-system reform before problems become crises. The AMA has been making this point consistently and has called for an independent private health system authority to fill that gap.

The AMA has warned that selective contracting and no-gap arrangements between private health insurers and doctors may constrain patient pathways. It can affect a patient's choice of doctor and hospital, and can interfere with clinical autonomy. When there is no independent umpire setting fair rules and minimum standards, the bargaining imbalance between insurers and providers can ultimately be felt by patients. That's why an independent private health system authority is needed. It would not replace APRA's prudential role nor duplicate the ombudsman's consumer role. It would be tasked with better regulating and having appropriate oversight of the private health system, including: providing independent, evidence based advice to government; driving reforms that deliver value for customers that meet a person's health needs and the needs of an ageing population with increasing chronic disease and multimorbidity; and also conducting ongoing reviews and continual alignment of all private health system policy levers. Its role would include: overseeing contracting arrangements across insurers, hospitals and medical practitioners; recommending and setting standard terms and conditions for fair dealing and transparency; monitoring value for money and pay-out performance across the sector; and publishing system-wide indicators on affordability, coverage and access. This is the kind of stewardship a public health system that integrates private health insurers into it requires. But the authority should not stand alone. It should sit alongside concrete reforms that deal with the immediate pressures consumers and providers are facing right now.

First, there is a strong case for a legislated minimum benefit payout ratio. The federal minister for health wants to see at least 90 per cent of premiums returned to consumers as benefits. The major private hospital peak bodies, the Australian Private Hospitals Association and Catholic Health Australia, recently publicly backed that principle as part of a package to restore sustainability, arguing that returning to 90 per cent would inject around $1.2 billion a year into hospitals and health services.

Second, we need fair contracting rules. APRA and CHA have called for a mandatory code of conduct for insurer-hospital contracting, overseen by the Australian Competition and Consumer Commission, to improve transparency, consistency and fair terms. Whether that code is housed directly under the ACCC or developed in concert with the new independent authority, the principle is sound. There must be clearer rules set so that opaque contracting disputes do not keep destabilising hospitals, eroding services and limiting patient choice.

Third, transparency needs to extend beyond fee publication alone. Private Healthcare Australia has backed stronger Medical Costs Finder laws and has also argued for stronger protections against surprise billing, including clearer informed financial consent and consequences where patients are not properly informed of charges in advance. This complements the AMA's position that the public deserves the full picture of what specialists charge, what Medicare pays and what insurers contribute. Consumers need all three pieces of information together.

If health insurance is unaffordable and people leave the system, the pressure does not stay with the private market. It lands in public hospitals, in emergency departments, in elective surgery queues and, ultimately, on taxpayers. Preserving a strong private system is not about privileging one sector over another; it's about protecting the mixed model that allows our entire health system to function.

This bill deserves support. Publishing more accurate fee and rebate information on the Medical Costs Finder and closing down product phoenixing are sensible and necessary reforms. Both have been welcomed by key sector voices and both should pass. But parliament should not mistake this bill for a complete reform agenda. The evidence is clear—if we are serious about protecting patient choice, keeping private care accessible and preventing spillover into the public system, then we need the next step as well: an independent private health system authority, backed by a legislated 90 per cent minimum payout ratio; fair contracting rules; stronger surprise-billing protections; and product reform that reflects the realities of chronic disease and an ageing population.

I commend this bill to the House and I move:

That all words after "whilst" be omitted with a view to substituting the following words:

"not declining to give the bill a second reading, the House:

(1) notes that:

(a) since 2008, average private health insurance premium growth has exceeded inflation, average weekly earnings and Medicare Benefits Schedule indexation;

(b) over the six years to June 2025, insurers' benefits for in-hospital treatment rose only 18.1 per cent, while sector profits grew by nearly 50 per cent in the same period;

(c) the current benefit payout ratio is still below the Federal Health Minister's 90 per cent benchmark; and

(d) there are no standard terms and conditions for private health insurers' 'no-gap' and 'known-gap' contracts with doctors; and

(2) calls on the Government to establish an independent Private Health System Authority to better regulate, review and oversee the private health system, to ensure value for consumers and that Australians' changing health needs are met".

Carina Garland (Chisholm, Australian Labor Party) Share this | Link to this | Hansard source

Is the amendment seconded?

Nicolette Boele (Bradfield, Independent) Share this | Link to this | Hansard source

Yes. I second the amendment and reserve my right to speak.

Steve Georganas (Adelaide, Australian Labor Party) Share this | Link to this | Hansard source

I rise to speak today on this very important bill. I support the introduction and passage of the Health Legislation Amendment (Improving Choice and Transparency for Private Health Consumers) Bill 2026. It is a very important bill when it comes to the transparency of our private health insurers. Improving transparency assists the consumer. It ensures that transparency is there, and it gives confidence in the system and confidence in the private health legislation area.

A key concern for Australians across the nation is the cost of health insurance. Many of us speak to many constituents. Not a day goes by without people coming to see me about a whole range of issues, and we get on to health care. One of the things raised, especially by elderly Australians, is that they tighten their belts to ensure that they have private health cover. Therefore, when people are doing it tough, as they are at the moment, it's really important that there is real transparency when consumers are purchasing a health insurance product or using health insurance services. As I said, right now Australians are doing it tough, so it's really important for this transparency to be in place. That's why this bill is very important. It's something that provides that transparency and assists the confidence of the consumer.

Health costs have risen recently, along with the costs of many other things. While this government has made the largest investment in strengthening Medicare, opening many after-hours urgent care clinics and ensuring there are more doctors bulk-billing, we know that Australians still have to deal with the different healthcare practices that exist.

Many years ago, when you took out health cover, it was pretty straightforward. You took out cover, and it would cover you for a whole range of things, whether it was a hospital stay, doctors, specialists or operations. For the last 20-odd years, we've seen the development of health insurance products diverge into a whole range of different products, from extras and excesses to certain procedures. If you want to make the choice not to be covered, it can be there, bringing down your costs. Or, if you take all the whistles and all the beaut things that go with them, that will make the cost even higher.

When receiving private health cover, the last thing Australians want is to be slammed by ballooning out-of-pocket charges in an already extremely complicated private health insurance system. Likewise, no family wants to have insurers sneakily substitute their services for more expensive products. In other words, they don't want to see a service morphing into a different product—which is really the same old product—and pay more for it. They don't want to see out-of-pocket fees skyrocket at each new renewal of the policy or at each new visit that they have with a doctor. It's simply more stress that the everyday family, parent or student, or whoever it is, has to bear when we see increasing costs in private health cover.

Australians want and demand transparency on the fees that are charged to consumers and protection against any dodgy practices, and so should we as legislators. The Australian public certainly want an assurance that the cost of their health care won't saddle them with debt that they cannot manage. Australians deserve access to quality medical advice at the best value that they can find. That's also why this Albanese Labor government is committed to improving the quality of transparency in the area of private health insurance, and that's what we're delivering today with this bill.

The bill provides a series of considered measures that allow Australians to access information on healthcare costs and closes what are called product phoenixing loopholes. In other words, you're offering different products, perhaps as a health insurer, and you then write to all your customers and say, 'At the renewal of this policy, this particular product that you have on your insurance policy will cease to exist, but we offer this product, which is similar but much better.' The reality is that sometimes it's just a sneaky way of increasing the premium by keeping the same product, tinkering with the edges of it and saying, 'It's a brand new product and we're charging a different price for it.' This bill is going to stop the phoenixing product loopholes.

The bill will also allow people to compare costs between medical practitioners and the insurers that they deal with, see details on how they utilise their gap over arrangements and see how practitioner fees change between locations. With the passage of the bill, the Australian public will be able to find fees for every single medical practitioner and they'll be able to locate the out-of-pocket costs for common medical procedures on the Medical Costs Finder website. That's important information for health consumers. After all, when we do go in for a procedure, to see a specialist or to go to the hospital, we want to know what it will cost.

There's no other product that we purchase as consumers where we don't know what the upfront cost is. It just doesn't make sense that we shouldn't have the same information available for health products. If you're going to the hospital, you should know what it's going to cost you at the end of the day and be able to make a comparison with other hospitals, doctors, specialists or other places that are offering this procedure so you can make a choice. If it is dearer, you want to know why a particular product is dearer than another product. That is what this bill is all about. It's about being able to find the fees for every medical practitioner and locate those out-of-pocket costs for common medical procedures on the Medical Costs Finder website.

The government will also publish information about which medical practitioners provide services at each hospital's facilities and which insurers have contracting arrangements with these facilities. For example, if you're going in for a procedure at a hospital, you'll find that the surgeon who's performing the procedure usually has an arrangement with particular hospitals for certain costs. If you don't actually get that information upfront, you could be going to a hospital that your surgeon does not have an arrangement with and they decide to charge you more, or the hospital charges you more, than normal. So I think it's really important that that information is made public, that everyone knows. Now, most doctors, or surgeons, are pretty good; when you go and see them, they'll tell you: 'I operate at XYZ hospitals'—make a choice out of two or three—'That's where I've got an arrangement, and that'll be the lowest cost for you.' But it's not up to them to tell you—they don't have to at this point. This will make it possible for the consumer to know exactly what they're up for.

This bill seeks to close the ability for insurers to engage, as I said, in product phoenixing loopholes as well—loopholes that allow the insurer to replace those existing products with similar new products at a higher premium. I explained that a little bit earlier, where you've got a product and you just decline to offer it at the next renewal of the policy and say, 'We now don't offer that product, but we offer this one'—which is exactly the same. It's just a phoenixing method and an increase in the cost, because it's a roundabout way of increasing the cost without having to go through the proper procedures, where nine out of 10 times they may be told that they can't increase it. These loopholes allow the insurer to replace existing products with similar ones at a higher premium. Not only is this behaviour reducing consumer confidence in private health care; it's also raising the cost paid by the average consumer. And, as I said earlier, some people are doing it really tough. They're tightening their belt on other things, like food, holidays et cetera, just to make sure that they keep their private health cover going.

This bill will amend the Private Health Insurance Act 2007 to require an insurer to seek ministerial approval for premiums for a proposed new product or for changes that reduce that cover. In addition to this, we're passing the modernisation changes for all premium approvals, making sure that this legislation is comprehensive and fit for purpose. Together, these measures are intended to reduce cost-of-living pressures on Australians and increase the transparency of the private healthcare system. The changes will help Australians find the best-value care, and it will improve coverage from insurance premiums by preventing those insurer loopholes.

The government have not brought this legislation in just on their own. They've consulted far and wide to ensure that they get this right. Services Australia, the Attorney-General's Department, the Office of Parliamentary Counsel—each had no concerns with the execution of this bill. The Australian Prudential Regulation Authority, the private health insurance ombudsman and the Australian Competition and Consumer Commission have also helped further refine and assist with the implementation of this legislation. The AMA, Private Healthcare Australia, Members Health Fund Alliance and numerous consumer peak bodies support these measures. So we can be confident Australians will benefit from the clarity, transparency and peace of mind provided by these changes.

These are changes that'll help in seeking the best value medical advice and instil confidence in private health insurers by outlawing that product phoenixing, which is just a sneaky way of increasing the premiums. It has been used, and there was evidence of that. Simply, this government is ensuring that Australians can make informed decisions about their healthcare team and ensure that private insurers act in good faith with their members—yet another way we've delivered on our election promise of a fairer and more transparent health system.

We're helping medical practitioners too by automatically uploading their Medicare, hospital and insurer billing information to the Medical Costs Finder website, which will be a trove of information. This information, which is already collected by the government, will allow us to expand the variety of medical practitioners and out-of-pocket insurance costs accessible on the website—that'll be immediate. We know that the cost of medical and hospital services is a key driver of health inflation for consumers. These costs feed directly into the cost of out-of-pocket treatment and higher private health premiums from insurance companies. By outlawing product phoenixing by insurers, we can be confident that we can provide transparency and predictability to price increases created by private insurance agencies.

This bill intends to give Australians confidence that their coverage will remain the same and ensure that insurers cannot continue to find sneaky ways of increasing their premiums—which, in the end, is no different to ripping off the everyday Australian consumer. For proposed new products and changes, the government will require that the insurance providers seek and receive approval before passing the cost on to consumers—so there will be ministerial approval. Someone will look at the product that is the new product, and the new prices on the product, and it will not be allowed if it's just a phoenixing product—in other words, a similar product tinkering with the edges, getting rid of the old product and saying, 'Now you have only this choice and we have to increase the premium.'

On top of this, the bill requires no additional administrative burden on medical practitioners—none whatsoever. The cost of the specialist care varies widely. As we know, when costs increase Australians lose. With access to pricing information, we'll be able to arm the Australian health consumer with the knowledge that they are finding the best quality health care at the best price they can get. We can also safeguard Australians from insurers' little secret price increases that are adding to the cost of private health cover. The legislation corrects this issue by preventing insurers from making meaningless product substitutions; instead, insurers can make submissions to the minister to request a change that decreases overall cover or even increases overall cover—but at what price? That's what they'll be looking at. This legislation is absolutely crucial, and I commend this bill to the House.

Allegra Spender (Wentworth, Independent) Share this | Link to this | Hansard source

I rise to support the Health Legislation Amendment (Improving Choice and Transparency for Private Health Consumers) Bill 2026. One of the things Australians are most proud of is our healthcare system. We value a system that ensures everyone can access the care they need through Medicare, through bulk-billing and through a network of high-quality public hospitals delivering world-class treatment. But Australia has many other aspects to its incredible Medicare system, and this bill deals with two that are of critical importance—the private health insurance part of the healthcare system, and our specialists.

Private health insurance is a crucial part of our system and of our balance. It works alongside Medicare to give people greater choice, to relieve pressure on the public system and to ensure that we can sustain a mixed model of care into the future. When it is working well, it supports timely access to treatment, greater flexibility and choice for patients, and better outcomes across the system as a whole. But, for that to remain true, Australians need to have confidence in it—confidence that it is transparent, that it offers real value and that it is supporting, not undermining, the broader healthcare system.

On specialists, I'm delighted that in Wentworth we have some of the best specialists and healthcare providers in the country. But increasingly I hear from constituents that while care is available from specialists it's not always accessible, because costs are unclear, unpredictable and sometimes unaffordable. In a cost-of-living crisis, this matters to people. It can be the difference between accessing care and choosing not to book an appointment, or it can have a tangible impact on daily decisions about spending and family accounting. This matters. While for some a referral to a specialist may be urgent, for others it may be preventive. If the price is prohibitive, this may discourage patients from accessing the preventive care tests and treatment they may need. This can have significant impacts on their health months, years or decades down the line. This is one of the core problems this bill seeks to address.

Right now, a patient will often go to their GP, receive a referral to a particular specialist and simply assume that it is appropriate or the only option, but what they are not told—and often can't easily find out—is how that specialist's fees compare to others. Right now, a patient will often go to their GP, receive a referral to a particular specialist and simply assume that it is appropriate or the only option, but what they are not told—and often can't easily find out—is how that specialist's fees compare to others. Many patients feel uncomfortable raising costs with their GP, even where there is strong trust. They may hesitate to speak openly about their financial situation or worry that asking about fees could be questioning a referral to a high-quality specialist. Two specialists with similar qualifications, experience and expertise can charge very different fees. There are often valid reasons for that, but it is not fair that patients making decisions about their health care don't have access to that information.

Health care is one of the most important decisions a person will make, yet, unlike almost every other part of our economy, we do not equip consumers with the tools to compare price, understand value and make informed choices. We know the consequences of that. In 2024-25, around 8.6 per cent of Australians, more than 800,000 people, delayed or missed specialist care because of cost. That is not just a statistic; that is people putting off essential care because they do not know how much it will cost them. This bill begins to change that.

Now to what this bill does. Schedule 1 introduces a transparency-by-default model. It amends the Health Insurance Act and Private Health Insurance Act to allow the department to publish clear comparable information on medical fees and expected out-of-pocket costs. Crucially, this information will no longer rely on voluntary participation. It will be drawn from existing databases—Medicare claims, hospital data and insurer billing data—and brought together to give consumers a clearer picture of the cost of their care. This means patients will be able to see in one place what different specialists charge for the same service, the likely out-of-pocket costs after Medicare and insurance, whether a doctor participates in gap-cover arrangements and where services are provided. It also enables publication of information about hospitals and insurers, including what policies cover, how gap arrangements work and how often patients face out-of-pocket costs. Importantly, this is done without publishing any patient information, so privacy is protected.

I'm glad this process will be done without requiring specialists to manually provide this information, instead using existing data. However, it is important that we continue to hear feedback from specialists as this process evolves to ensure that there's a smooth transition and that the data that is collected is actually an accurate representation of what is being offered to the patients. This reform will breathe new life into the Medical Costs Finder. We know that the current model hasn't worked. Despite a $24 million investment, only around one to two per cent of specialists have opted in to share their fees. This bill fixes that by making transparency systemic not optional.

I'm also supportive of the member for Kooyong's amendments, one of which seeks to use future data drawn from Medicare to provide upfront information about quality indicators—such as complication rates, readmission and patient reported outcomes—and information about whether procedures or specialists typically employ upfront or gap-cover arrangements. However, I believe this framework should only be available for the secretary to use when appropriate and alongside publication of relevant case complexity where relevant. This will ensure that it doesn't inadvertently discourage specialists from taking on more complex cases, which may carry higher readmission or complication rates regardless of the quality of care provided. This provides further information to consumers to better understand pricing arrangements and transparency regarding differences in prices, as higher prices do not always indicate higher quality outcomes. I'm also supportive of an amendment from the member for Kooyong which will ensure that the minister must update published information as soon as practicable if they become aware of a greater than 10 per cent reduction in the price of services over a three-month period.

Schedule 2 addresses another critical issue, the cost of private health insurance itself. Private health insurance covers more than 15 million Australians and represents a $30 billion industry but has also become increasingly complex and, in many cases, more expensive. One of the key issues has been product phoenixing, where insurers close an existing product and reopen a near-identical one at a higher price, avoiding the usual premium approval process. This bill closes that loophole. It requires insurers to seek ministerial approval not just for premium increases on existing products but also for new products and for changes that reduce coverage or value. It also formalises a premium approval process in legislation, introduces a clear application period and applies a public interest test to ensure the premium decisions are made with consumers in mind.

I appreciate that this is a good solution to solve a very difficult problem. I appreciate that there will be a public interest test for premium approval for new applications made by insurers within an approved application period and that there will be an allowance for the minister to delegate approval decisions but not refusal decisions. However, as is often the case when new regulatory requirements are introduced, I'll be watching closely to ensure that this does not slow down insurers' ability to bring new products and benefits to the markets.

We do not currently see from the government strong accountability when it comes to decision-making timelines. We do not see it from the government, from departments, from government agencies or from regulators, and that matters here. I do not have faith that we will see it in these instances, despite best intentions. That is why I am moving a second reading amendment in my name to address this. I move:

That all words after "not" be omitted with a view to substituting the following words:

"declining to give the bill a second reading, the House:

(1) acknowledges that while the bill introduces important measures to improve transparency and accountability in the private health insurance system, these reforms rely on decisions made by the Minister or a delegated authority;

(2) notes the Government, regulators and agencies have not consistently demonstrated strong accountability in decision-making timeframes in recent years, including in areas such as environmental approvals and delays within the Administrative Review Tribunal;

(3) recognises that delays in the approval or refusal of new or amended insurance products risk slowing the intended benefits of new products and may ultimately disadvantage Australians; and

(4) calls on the Government to:

(a) establish and enforce clear timeframes within Schedule 2 of this legislation for decisions on new product applications from insurers, and to adhere to those timeframes in practice; and

(b) establish and enforce clear timeframes across other government departments, regulators, and agencies to ensure that decisions are made in a timely way to allow businesses and Australians greater certainty of timeframe on government decisions".

I really want to make the point that delays in approvals are not just administrative; they have real consequences. They can limit access to new or improved cover, reduce choice and ultimately disadvantage patients. So, while I support stronger oversight, it must be matched with timely, efficient decision-making, because, at the end of the day, when the system slows down, it is consumers who bear the costs.

I want to talk more broadly, particularly about my second reading amendment and about government timeframes for making decisions. This is an issue I see time and time again when I talk to members of my community and when I talk to businesses in my community. I see this when I talk to businesses trying to make large investment decisions. They approach the ATO about making sure that their investment decision is being covered in a particular way, and the ATO just doesn't get back to them, sometimes for 18 months or for two years. You can't run a business like that. I see this where people are applying for visas and where family members or businesses are trying to sponsor people to come to Australia. The timeframes are indicative of what the government would like to see, but, actually, they just aren't borne out by reality. That's not a fair way to deal with people. I see this in waiting times, sometimes for things like Services Australia. I see this in home-care packages where people are promised a home-care package and then don't get it delivered for a long period of time.

I see this in an area of government that drives me crazy, which is drones. I'm going to digress here because it's really important. Drones are a capability for the future, and, when we look at what is going on in the wars overseas right now, we need to recognise that drones are probably one of the most important defence capabilities we have. But we have in this country a system where approvals of innovative drones are really slow. That is not good enough.

The government—agencies and regulators—are not accountable for the timeframes of their decisions. Government is a monopoly. Government agencies and regulators are monopoly providers of services. They do not hold themselves accountable to businesses or consumers who rely on timely decisions and who often are afraid to push for more timely decisions, because they're scared that they're going to get a negative outcome. That is why putting everything back in the hands of the minister makes me nervous. What is the commitment of the minister to make timely decisions? What is the commitment of the government to ensure that this doesn't just slow down new products being offered to Australian consumers who need them?

To return to the key part of the bill, however, I do support the intention of the bill, which is that of practical reforms that will improve transparency, strengthen oversight and help restore confidence in the private health system. I just wish that this bill included something that committed the government to a timeframe in which to do its work. It is important that this oversight remains and that transparency remains. Again, I'm supportive of the member for Kooyong's amendment, which requires the minister to, after each financial year, call a review of applications for new product subgroups and changes made on premiums in order to keep parliamentary oversight of harmful private insurance practices front and centre.

But we should also be clear that this is not the end of the reform task. Transparency is essential, but transparency alone does not guarantee affordability. We still need to address the underlying drivers of rising healthcare costs. We need to ensure that rebates, gap arrangements and incentives are aligned with high-quality, accessible care and investment in prevention, and we need to ensure that private health insurance is delivering real value to Australians.

This bill lays some important foundations. It ensures that patients are no longer navigating the system in the dark and that they are equipped with more of the information they need to make informed decisions about their care. That is a fundamental principle of a fair and effective healthcare system. So, for those reasons, I commend this bill to the House.

Carina Garland (Chisholm, Australian Labor Party) Share this | Link to this | Hansard source

Is the amendment seconded?

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

I second the amendment and reserve my right to speak.

Ali France (Dickson, Australian Labor Party) Share this | Link to 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.

Kate Chaney (Curtin, Independent) Share this | Link to 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.

Cassandra Fernando (Holt, Australian Labor Party) Share this | Link to this | Hansard source

Access to health care lies at the very foundation of the Australian Labor Party. It is not an optional extra. It's not a privilege reserved for those who can afford it. It is a right and it has been a defining mission of Labor governments for generations. It was the great Ben Chifley government that, in 1946, put forward a referendum to give the federal parliament the power to legislate for sickness and hospital benefits. That referendum led to what we now know as section 51(xxiiiA) of the Constitution, empowering the Commonwealth on 'the provision of maternity allowances; widows pensions; child endowment; unemployment, pharmaceutical, sickness and hospital benefits; medical and dental services, but not so as to authorise any form of civil conscription; benefits to students; and family allowances'. It was another Labor government, under Prime Minister Gough Whitlam, that established Medicare in 1974. It was the first truly universal health insurance scheme in this country. And it was a Labor government, under Prime Minister Bob Hawke, that delivered Medicare in 1984. The system remains one of the proudest achievements of modern Australia.

Medicare is more than a program; it is an expression of our national character. It says that, in Australia, your access to a doctor depends on your Medicare card, not on your credit card. Access to health care was a central pillar of Labor's re-election campaign because we know that cost-of-living pressures are real and that healthcare affordability is at the centre of those pressures. That's why, when we were re-elected, Labor committed to restoring bulk-billing for GP visits, investing over $8.5 billion so that all Australians can see a GP for free. That is the largest investment in Medicare in its history. But we know that restoring bulk-billing is only part of the solution.

Throughout my first term in this parliament, I heard from countless families across my electorate about the very real difficulties they face accessing health care. I have sat with young parents who are working two or three jobs and still struggling to cover medical fees. I have spoken with older residents who delay scans or follow-up appointments because they simply cannot afford the out-of-pocket cost. I have met with families who told me about the heartbreaking decisions they are forced to make each week—whether to put food on the table, pay the mortgage or see a medical specialist. This is not an Australian promise. Many residents have raised concerns about exorbitant specialist fees even after being referred by their GP. These fees are often in the hundreds or even thousands of dollars per visit. They are rising year after year. For many families in rapidly growing outer suburbs and communities like mine, this is simply unsustainable.

Our government is committed to fixing this, and this is why we are now turning our attention to specialist fees. This bill represents the first step in that process. This bill will increase transparency by allowing the Department of Health, Disability and Ageing to publish medical practitioner fees and out-of-pocket expenses on the government's Medical Cost Finder website. The department already holds significant amounts of this information through Medicare, hospital and insurer billing data. Once passed, this legislation will enable the department to publish that information without requiring provider consent, ensuring that patients have access to clear, accurate and up-to-date data, because transparency matters.

In a report by Private Healthcare Australia, titled Restoring affordable access to specialist care in Australia, it was found that one in two patients did not know their fee before attending an appointment. Nearly 30 per cent of Australians have delayed or cancelled specialist care because of cost. This is a situation that cannot stand. Health care delayed is often health care denied. When people put off appointments, conditions get worse. What might have been a manageable issue can turn into something far more serious and far more expensive for both families and the healthcare system.

This issue is worse in outer suburbs where people are making those difficult decisions between paying the mortgage or going to a specialist appointment. Specialist fees can vary significantly between suburbs, between providers and between hospitals, sometimes with no clear explanation for patients. By uploading specialist fees online for all providers, we are allowing consumers to check fees before they attend a specialist appointment, empowering them to make informed choices. Patients will be able to compare costs for their health care and shop around for the best prices, just as they would for groceries, household services or any other everyday expenses.

The report by Private Healthcare Australia further showed that patients are now paying a median of $270 for specialist in-hospital care. Outside of hospitals, some patients are being asked to pay up to a thousand dollars for an appointment with a specialist doctor. Rachel David, from Private Healthcare Australia, stated, regarding the reforms:

Private Healthcare Australia has welcomed the Federal Government's legislation to upgrade the Medical Costs Finder website, saying it is a critical step toward tackling Australia's growing specialist fee crisis.

Catholic Health Australia director of health policy, Katharine Bassett, said making the data publicly available 'is critical, as out-of-pocket costs for specialist care are rising and becoming increasingly unpredictable for patients'.

We know that greater transparency increases competition, and competition, in turn, places downward pressure on excessive pricing. This reform is about restoring balance in a system where patients often feel powerless. Let me be clear. This is not the end of the conversation. The Minister for Health and Disability, Mark Butler, has indicated that the Albanese government is considering how far it can go, and it will test constitutional boundaries that have long constrained government regulation of specialist fees because, to every Australian out there, this is a government that has heard your struggle, and this is a government that has your back.

There is a second and equally important element of this bill, one that goes directly to fairness for the nearly half of Australians who hold private health insurance. Around half of all Australians choose to take out private health insurance, often at significant expense to their household budgets. In Holt, 68,700 people are covered by private health insurance, meaning 35.4 per cent of all people are covered by private health insurance plans. For many families in communities such as Cranbourne, Clyde and Hampton Park, those premiums are not small change. There are hundreds of dollars a month paid in good faith, with the expectation of certainty and value.

Each year, private health insurers must apply to the Commonwealth government for approval to increase their premiums. Those applications are carefully scrutinised. They are assessed against the financial sustainability of the sector and the impact on policyholders. Often insurers seek increases that are well above the CPI, and the government's process exists for a reason: to protect consumers. But some companies have sought to get around that safeguard. In cases where the government has limited or rejected proposed premium increases, some funds have engaged in a practice known as phoenixing. Product phoenixing occurs when an insurer closes an existing insurance product, often one whose price rise has been restricted, only to launch a nearly identical product days later at a much higher premium—same coverage, same target market, different name, higher price. It is underhanded, it is sneaky and it undermines the very regulatory framework designed to protect Australian families. In a year when private health insurers have collectively made over $2 billion in after-tax profits, and when families are grappling with mortgage stress, grocery bills and rising energy costs, this behaviour is not acceptable. Private health insurance is not a luxury item marketed to the highest bidder. It is a core part of Australia's health system. When companies exploit loopholes to push through excessive price increases, they erode public trust not just in their own brand but in the system as a whole.

This bill will close that loophole. It will outlaw the practice of product phoenixing, ensuring that insurers cannot bypass government oversight by gaming the system with technical restructures and product relaunches. If a premium increase is not approved, insurers will not be able to simply repackage the product and impose it anyway. This reform strengthens consumer protection, and it sends a clear message: transparency and fairness are not optional in Australia's health system. Labor believes that, whether you rely solely on Medicare or choose to take out private cover, you deserve honesty, accountability and respect. This bill delivers exactly that. By increasing transparency in pricing and expanding consumer protections, we are making sure the healthcare system continues to work for all Australians.

I know there is much more work to be done. I know that Labor is the only party that will deliver real reform that delivers for families in communities like mine in the outer suburbs. Labor has always been the party of Medicare. We created it, we have defended it and we will strengthen it—because access to health care is not just a policy; it is about dignity. It is about ensuring that no parent has to choose between their child's health and the weekly grocery bill. It is about ensuring that no pensioner skips a specialist appointment out of fear of the unknown invoice. It is about ensuring that every Australian, regardless of income, background or postcode, can access the care they need. That is the Labor tradition. That is the responsibility we carry. That is exactly what this legislation seeks to advance. I thank the Minister for Health and Ageing, the Hon. Mark Butler, for his work on this bill and for his continued work on ensuring our healthcare system is accessible for every Australian. I commend this bill to the House.

Alice Jordan-Baird (Gorton, Australian Labor Party) Share this | Link to this | Hansard source

Today I rise to support the Health Legislation Amendment (Improving Choice and Transparency for Private Health Consumers) Bill 2026, brought forward by the Minister for Health and Ageing, and I commend him for doing so. I'm so proud to be part of the Albanese Labor government as we remain resolute in our commitment to make quality health care accessible for every Australian.

It means making health care more affordable by strengthening Medicare and putting more medicines on the PBS. It means putting an end to life insurance practices that discourage people from getting life-saving genetic testing, as we are doing with the Treasury Laws Amendment (Genetic Testing Protections in Life Insurance and Other Measures) Bill. I had the pleasure of contributing to debate on that bill earlier this week. It means making sure that information about healthcare costs is readily accessible to Australians so they can make informed choices about their own health care. It means stamping out insurance provider practices that circumvent regulation and increase costs to Australians without proper oversight. This bill does exactly that. It's another important piece in the Albanese Labor government's work to make sure that, when it comes to health care, everyday Australians come first.

We know that there are Australians who are not taking up referrals to specialists because of the cost. In 2024-25, 8.6 per cent of people delayed or missed specialist care because of cost. That's 800,000 people across our communities who have not received the health care they need because of the high cost of specialist appointments. That's really concerning. It's not right, and it's why we need greater transparency in the medical sector, as well as better regulation.

Since 2022, specialists and insurers have been invited to publish their fees on the Medical Costs Finder. The Medical Costs Finder allows Australians to search and compare out-of-pocket costs for common treatments and procedures. It has the aim of promoting transparency in the sector, giving Australians better visibility of the potential cost of treatments and the ability to compare costs so they can choose the most cost-effective option for them. Unfortunately, the Medical Costs Finder has been limited in its efficacy. That's because there have been low levels of participation from medical specialists, who have to opt in to this service.

In December 2025, only one to two per cent of specialists and 10 per cent of insurers were participating in this website. This means it hasn't been delivering the transparency Australians deserve. That's not good enough. People should be able to access this information so they can find out easily what the potential cost will be for a specialist or treatment they've been referred to and can make their own informed decisions about the next steps of their medical journey. This amendment will allow for the publication of the relevant data on the Medical Costs Finder, without the need for input from medical practitioners. It will be drawn directly from Medicare, hospital and insurer billing data collected by the government, and it will make a real difference.

This bill is about improving the transparency of the costs of specialist services, promoting the efficient access to these services and helping people make informed decisions about their health, because empowering Australians to make informed choices about their health is what accessible health care looks like.

The second part of this bill is about stamping out a problematic practice used by private health insurers to charge more for existing products. At the moment, the PHI Act requires private health insurance providers to apply to the minister for approval to change the premiums they charge. This has meant that the minister can make sure that private health insurers are complying with government-set limits on increases to health insurance premiums, and it has also meant that insurers have not been able to change the cost of these products without a green light from the minister. This protects Australians from excessive annual increases to health premiums and also prevents health insurers from changing the cost of these premiums without government oversight. However—and there is a however—private health insurance providers have instead been circumventing regulation through product phoenixing.

The existing regulation has meant that private health insurers are not allowed to change the cost of existing products, but they are allowed to close products and open new products without government oversight. Private health insurance providers have been using this loophole to close products and open similar or identical ones at a higher premium, avoiding the requirement for premium change approval. Because of this, insurance providers have been able to effectively increase the price of existing products without oversight, leaving customers with few options but to pay the new expensive premium or move to a lower level of care. The Commonwealth Ombudsman reported that, in 2024, private health insurers' newly released products were about 14 per cent more expensive than the policy that was replaced. This practice cannot be tolerated. For consumers, it reduces visibility into the value for money they're getting with their insurance and obscures the real reason for price increases. This makes it difficult for them to make informed choices and often results in them being charged more for the same product.

The bottom line is that this practice does not put Australians first, and it has to stop. With this bill, we're requiring private health insurers to apply to the minister for approval of premiums charged for new products. When it comes to stamping out this practice, we're leaving no stone unturned, making sure we can continue regulating premiums effectively and giving Australians the transparency they need to make informed choices about their private health cover.

This bill is about making sure we're regulating the medical sector effectively, but also it's fundamentally about the value of specialist medical treatment. There's no doubt that medical specialists are incredibly important in our community. Receiving care from a medical specialist saves and changes lives every day. The importance of this kind of care being readily available can't be understated. We're lucky to have some of these specialists now serving their communities in this very chamber. I acknowledge the work of the incredible member for Macarthur, Dr Mike Freelander, and his long-term career as a paediatrician and now as a federal parliamentarian and chair of the Standing Committee on Health, Aged Care and Disability, of which I am a proud member. I know the member for Macarthur, like me, is very passionate about the availability of specialists across Australia.

I was holding a mobile office in Deer Park a few weeks ago and had a long chat to one of my constituents, Brett. We chatted about the problem he's been facing—accessing specialist medical treatment. For Brett, seeing a specialist would improve his quality of life immensely. But, due to a lack of available specialists in the electorate, he's only been able to get into a clinic in Sunshine—and, even then, there's a long waitlist, so it'll still be at least another nine months before he can see the specialist. Brett's story demonstrates an important issue my community is facing around the availability of specialists. It demonstrates the importance of specialists and the consequences of those services not being available.

We know there's more to do in this space, and this bill is an important first step towards making specialists more accessible. It's about empowering Australians with the knowledge of what they can expect to pay to see a specialist or for treatment in the private health sector. Ultimately it's about giving them power to make informed choices about their own care. This is all part of our government's push to ensure health care remains affordable and accessible to all Australians. Our government has a laser-sharp focus on this because we know that, to communities across Australia, accessible health care matters. It matters to communities like mine in Melbourne's western suburbs, where young families are moving in and building their homes and their futures—young families who are facing mounting pressure on mortgages, at the supermarket and, yes, when taking care of their health. An electorate like mine—young, diverse and aspirational—has many needs that have yet to be met.

One area that has struggled to keep up is access to health services. Gorton residents experience significant disadvantage in accessing health services. Even within Melbourne's north-west, the burden of disease disproportionately impacts my constituents. In the city of Brimbank, a staggering 28 per cent of residents between 18 and older have been diagnosed with two or more chronic diseases—conditions that need to be managed throughout their lives. For locals who are navigating chronic conditions, for those who need to see specialists regularly and throughout their lives, these changes are making this easier.

Ensuring cost transparency when seeing a specialist or receiving treatment in the private sector is one piece of the puzzle of improving access to health care for Australians, including those in Melbourne's north-west. But it is by no means all the Albanese Labor government is doing for affordable and accessible health care. With record investments in bulk-billing, we are strengthening Medicare by increasing bulk-billing incentives. Thanks to these record investments in Medicare, there are now 23 Medicare bulk-billing clinics in my electorate of Gorton in Melbourne's western suburbs; that's 72 per cent of the GP clinics in our local area that you can get an appointment at for free. The national bulk-billing rate is now sitting at over 80 per cent, and 96 per cent of Aussies live within a 20-minute drive of a fully bulk-billed practice. We're also growing Australia's health workforce with the largest GP training program in Australian history.

This is real cost-of-living relief, and it makes a difference to those families whose credit cards are taking the hit when at the supermarket checkout, buying petrol or paying the bills. Hardworking Aussies like those in my community deserve free health care, and that's what we're doing for Australians. With this bill here, we're also ensuring costs to see specialists are transparent so that Australians can be empowered to make informed choices about their care. We've also introduced Medicare urgent care clinics around the country so that Australians can access free walk-in care to take the pressure off our hospital systems.

Last year I was lucky enough to open the 90th urgent care clinic, in Melbourne's west, with the Prime Minister and my friend the member for Fraser. That urgent care clinic was one of two urgent care clinics near my community, both recently opened, in Sunshine and Melton. This is great. We know that it's making real change, and it's working.

I recently had a conversation with a local pharmacist, Chris Luu from Deer Park Compounding Pharmacy. Chris grew up in Deer Park, and he's been working at the Deer Park Compounding Pharmacy for 30 years. Chris is so incredibly passionate about his community. He wants his customers—some of whom he's seen grow up and have kids themselves—to thrive. He showed us a mural of Deer Park's history made with students at a local school, which he moved and reassembled outside his building, making sure it was preserved for future generations. We are very lucky to have him in our community. Chris and I chatted about the cost of medicines on the PBS. Chris told me that he wished more people knew the original prices of medicines so they could see how much they were saving every time they got a script filled on the PBS. He knows the changes that our government is making because he sees them every day, like capping the cost of medicines listed on the PBS to just $25. Last year the maximum cost for a PBS medicine was $31.60, and, from January this year, it was reduced to just $25. This is more than a 20 per cent cut in the maximum cost of PBS medicines, and it's saving Australians over $200 million a year. That's giving my community and Chris's customers real access to the medicines they need and tangible relief on the cost of health care.

Someone who has a lot to say about the cost of health care is the current shadow treasurer. Over the years, the shadow Treasurer has told us, many times, that he'd like to privatise Medicare. He told us in 2011 when he said that he'd like to see the health burden shifted from government to individuals. He told us again in 2021 when he said, 'When you push the cost of health care away, the obligations and the sense of responsibility people have to it diminishes.' When someone shows you who they are, believe them. Just like they were in 2011, the opposition is still more interested in making sure Australians know how much they cost to look after, rather than making sure they are actually looked after. On this side of the House, we're about real change that looks after Australians, puts food on the table, reduces household bills and makes a doctor's visit affordable—no Australian held back and no Australian left behind.

And that's why we brought this bill here—a bill that gives back to Australians by providing transparency and strengthening the regulation of our healthcare system. And, on that note, I commend this bill to the House.

Mike Freelander (Macarthur, Australian Labor Party) Share this | Link to this | Hansard source

First of all, I thank the member for Gorton for her very kind remarks, which were probably undeserved, but I'm very grateful. I'll start by saying, if I can be allowed a short preamble, it's often said in my profession that, if you put 100 doctors in a room and ask them how to fix the health system, you'll get 110 answers. I admit my biases, and I have a very personal view of how we can improve our health system.

I've worked in health care in the public hospital system now for over half a century, and I'm in this House as a Labor member because the Labor Party is the party of health care. This was identified very well by my great hero, Gough Whitlam. It's important to understand that he's the one that introduced the original Medibank, the first national health insurance program, designed by Scotton and Deeble, two health economists, in late 1960s. It was done for a reason. It was done because we had an inequitable healthcare system where people who could afford it were getting very good health care, and many people were missing out on health care because they couldn't afford it. It's a little-known fact—but it is a fact—that the most common cause of bankruptcy in Australia prior to the introduction of Medibank was health costs. People were sent to the wall because of the costs they were incurring in providing health care. For me, Labor is the party of health care. I started my private practice, which I ran for 40 years, on the same day that Medicare became operational in Australia, introduced by the Hawke Labor government. I saw patients whose families couldn't afford to see a paediatrician in the past; they'd never seen a paediatrician in spite of the fact they often had significant disability. This was really a sign to me that Labor is the party of health care, and it's continued along those lines.

It's really important to note that, since the start of the first Albanese government, I can hardly remember a question being asked by the opposition about health care in this House at question time. I can't remember one. We have the now shadow Treasurer making comments like our healthcare system being 'a system designed to keep people ill to feed the benefits of the unions and the people that they are paid to represent and to maintain the political control by the Australian Labor Party'. What absolute tripe! This is coming from the shadow Treasurer. Can you believe it? It's just crazy. That is a quote from Hansard. So, too often, I hear those opposite talk about Medicare as if it's a burden, as if it's a thorn in the side of their attempts to privatise and make Americanised our healthcare system. When I hear contributions from the member for Goldstein, I don't hear a defence of Medicare. I don't hear support for one of the best health systems in the world. I don't hear a commitment to strengthening universal access to health care. Instead, what I hear is an ideological position that leans away from collective responsibility and towards an individual burden of health care. The member for Goldstein is always talking about how Medicare is broken and how people should pay their own way. He really has some crazy ideas about health, and I think that's replicated in many other members of the opposition.

This legislation is really important legislation that improves the transparency of our health system. As I've said, I ran a private practice for 40 years. I did have a position where I would bulk-bill people who I felt should be bulk-billed—including all those with healthcare cards, but also many with chronic illness—and privately bill others. The introduction of Medicare meant that the scheduled fee was 100 per cent of the recommended fee, and the Medicare rebate was 85 per cent of that scheduled fee. The 15 per cent gap was not paid by the government for bulk-billed patients, but the rebate was. That was because, by bulk-billing, you remove the cost of privately billing people and sometimes having to chase them for fees afterwards. That used to happen occasionally; we had to make sure that we could follow people for the fees because we didn't charge people upfront. They were allowed to pay the full fee once they received their Medicare cheque, usually in the mail. That 15 per cent gap was supposed to be the cost of having to get the fees from privately billed people.

What has happened over time, of course, is that the gaps got bigger as the rebate didn't increase in line with inflation. But we now have a point where many of the gaps are bigger than the actual scheduled fee, particularly for things like cataract surgery and some subspecialty consultations. They are often opaque; the patients aren't aware of them when they have their first consultation. The gaps can vary from specialist to specialist. Often these are not advertised, can be difficult for patients to find and can be quite a shock when they first see a doctor in consultation—especially with some of the procedural specialists, who charge quite large gap fees.

I'm not going to get into arguments about whether they're too much or too little. The reasons for specialist fees can vary. The costs of specialist practice are quite expensive. The training is now very prolonged. Many people go into medicine after a first degree. Their medical degree is their second degree and their specialist qualifications are often their third degree. The costs of running a practice, including insurance, have increased a lot. Rents have increased a lot. Equipment fees, which some specialists, such as ophthalmologists, require have become more and more expensive. The Medicare rebates haven't kept pace with the actual costs of doing medical business, if I can put it that way.

This bill does increase transparency and it does mean costs will be findable by patients prior to their consultation or hospitalisation. It is really important that people do get that transparency so they can find out how much doctors will charge them and how much they will have to pay out of pocket. It is very important to understand that there are some procedures that we do now that weren't available in the time of the advent of Medicare. Because the rebates don't exactly fit the procedure, sometimes the costs are much higher than for the previous treatments. It is reasonable, though, that specialists make their fees available for patients.

The bill delivers on yet another commitment by the Albanese government—to make health care more accessible for all. When you look at the things that we have already done in a relatively short period of time, they have made health care much more accessible and much more equitable—things like the bulk-billing incentives. In my electorate of Macarthur, over 90 per cent of GP consultations are now bulk-billed, which is a huge turnaround. The 60-day prescribing for common pharmaceuticals has been of tremendous benefit to patients. The maximum fees for pharmaceuticals, including making the maximum fee $25 for non-healthcare cardholders and just over $7 for healthcare cardholders, have made medicines much more accessible. Our increased training positions for nurses and doctors have made health care much more accessible. Our increasing scope of practice for pharmacists, nurses and allied health professionals has made accessibility much better.

There is much more to do; we know that. In rural and regional areas there are huge difficulties in attracting specialists and in getting people access to specialists. In my own field of paediatrics, in some areas of western New South Wales, for example, the waiting times to see a paediatrician are measured in years, not in months or weeks. This is delaying health care for some of the most vulnerable. There is much more for us to do and we are certainly working on it.

We also need to look at more innovative ways of getting specialist opinions for people who live in rural, regional and remote areas. Improvements in telehealth, which have been a real focus of the Minister for Health and Ageing, Mark Butler, have been a really important change in improving access to specialist opinions.

Our women's health packages have been dramatic in improving access to pelvic pain clinics and endometriosis treatments. The scheduling of new treatments for pregnancy control and for endometriosis et cetera has really made a dramatic difference for many women around the country.

This is part of the government's commitment to ongoing improvements in our very equitable health system. We do not want an Americanised system, in spite of what many in the opposition would want. We will deliver on our election commitments but we will also do more. This is a gradual process. We can't fix every issue immediately, but we are gradually working towards improvements in our health system that will make sure it is the best in the world. The introduction and passage of the genetic information bill has been really important, and it's something that the government committed to over a long period of time. It's yet another improvement in our health services.

This bill also looks at how we can make private health insurance more transparent and reduce the ability of private health insurers to change insurance programs and products willy-nilly, to phoenix some products and to continue to make large profits at the expense of people who are paying significant amounts for health insurance. My own personal view is that having three tiers of private health insurance is counterproductive to making sure our hybrid health system continues to work well. I would like to see private health insurance be one product—you either have it or you don't—and to have a community rating of risk through that private health insurance, rather than different levels of insurance, but that is something for another day.

There are many more things we need to do, but this is continuing the progress towards a better and better health system, which Mark Butler and the Albanese government are committed to, and I'm very proud to be part of it. I know that we can—

Colin Boyce (Flynn, Liberal National Party) Share this | Link to this | Hansard source

Would the honourable member please resume his seat. Member for Moncrieff?

Angie Bell (Moncrieff, Liberal National Party, Shadow Minister for Youth) Share this | Link to this | Hansard source

Members should be called by their correct title. I'm just highlighting that for the member.

Colin Boyce (Flynn, Liberal National Party) Share this | Link to this | Hansard source

I would ask the member for Macarthur to address people by their correct title.

Mike Freelander (Macarthur, Australian Labor Party) Share this | Link to this | Hansard source

I'm sorry. I inadvertently made that mistake. I think that the opposition really need to improve their attitude towards health care. That would hold us to account and make us more likely to improve our discussion with them about having a universal healthcare system. I think they need to adopt the universal health insurance program that Labor has been committed to for the last half a century and stop their attacks on Medicare, but I'm not here to give a lecture to the opposition. I'm here to talk to our process of continuing to improve our wonderful health system.

I believe in our health system, and I think that this bill continues with those improvements. It will improve transparency with health costs, but I would stress that it's not just about greedy doctors charging large amounts of money; it's about how we can improve transparency and access to health care. We need to support our highly trained specialists to provide the best care they can in an equitable manner across the country. I would also like to see a huge investment, by federal and state governments, in our public hospital outpatient system, as another way of improving equitable access to health care. We do need to continue to examine our private health insurance system so that it works in the most efficient manner.

I congratulate the health minister on this bill, and I look forward to further improvements in our health system by the Albanese Labor government.

Louise Miller-Frost (Boothby, Australian Labor Party) Share this | Link to this | Hansard source

Prior to Medicare, medical bills were the major cause of bankruptcies in Australia. That ended overnight. It's worth noting that medical bills are still a major cause of bankruptcies in the US, and consequently Americans choose to avoid seeking health care or seeking a diagnosis. They fear the costs pushing them into bankruptcy and homelessness. That's why the US health system is the most expensive in the modern world and has the worst results at a population level. This is not what we want for Australia and for Australians. Despite its challenges, Australia's health system is the best in the world. If you are sick or injured, you wouldn't want to be anywhere else.

We know that those opposite oppose Medicare. The shadow Treasurer has said that we should get rid of Medicare and instead have individual accounts that we can draw down on when we need care, which of course would be a disaster for those who are particularly unwell. If you had a lifelong condition, a chronic disease, a cancer diagnosis, a catastrophic injury or a progressive disease, your account would run dry.

Despite the benefits of Medicare in making Australian health care affordable as a blended public-private system, gap fees do accrue to patients, and constituents contact me about having to pay an unexpected gap fee or even the entirety of the cost of a GP referred specialist appointment. Health care should not be a financial risk in this country. It shouldn't require hedging your bets when your health is at stake.

More than half of Australians are on some form of private health insurance. Private health is crucial to the sustainability of Australia's broader health system, helping in particular to alleviate an already overburdened public health sector. Yet we all know that private health premiums are rising year on year. Patients deserve peace of mind, knowing that the cost of the care they're receiving is being paid with the full knowledge of their options—peace of mind that they don't need to worry about money in the midst of a serious health crisis, peace of mind that they can seek screening tests or diagnosis without having to worry about unexpected bills. We want Australians to seek diagnosis and early intervention for their own best health outcomes and also to manage costs in the health system by keeping them out of hospital where possible. In this country, equitable health access is a right, not a privilege, no matter whether you're paying for it via private health or Medicare, and that is why the Albanese Labor government is committed to delivering a private health insurance framework that is fair, efficient and accessible.

The Health Legislation Amendment (Improving Choice and Transparency for Private Health Consumers) Bill 2026 seeks to course-correct longstanding deficits in the private health system. It seeks to enshrine private health consumers' rights and their ability to be the masters of their own health destiny. It does so in two ways. Firstly, it ensures that Australians are able to make an informed choice about the cost of specialist medical advice and treatment through improvements to the Medical Costs Finder tool. Secondly, it ensures that price gouging by private health insurers by way of product phoenixing is curbed. As a result, private health consumers can be confident that the cost of their medical service is market standard. The bill ensures that Australians are able to access detailed information about the costs and associated costs of their medical specialist appointment and treatments.

The Australian Bureau of Statistics reports that the cost of medical and hospital services has contributed to health inflation more generally, with flow-on effects for the out-of-pocket costs and higher insurance premiums. The most common cause of out-of-pocket costs are medical specialist fees. The typical out-of-pocket cost for a specialist procedure in Australia is $1,000. Unsurprisingly, this has seen patients refuse to take up a specialist referral from their GP owing to their fears of the potential costs, which are often unknown and unpredictable. In the financial year 2024-25, 8.6 per cent of patients delayed or missed specialist care, citing cost factors—that is, over 800,000 people. One in two patients don't know what their bill is going to be before an appointment; 38 per cent received an unexpected bill.

The proposed legislative arrangement follows Labor's 2025 election commitment and the 2025-26 budget measure to improve transparency in medical pricing information in order that Australians are able to make informed and knowledgeable decisions about their healthcare needs. Because patients shouldn't be slapped with a bill without the full knowledge of what they're paying for, how much they should be paying, and having the opportunity to compare other medical providers. Additionally, knowing what private health insurers are prepared to cover will help consumers determine their out-of-pocket costs.

The former coalition government previously invested $22 million in the Medical Costs Finder website, which is informed by data from Medicare and from the information volunteered by Medicare medical practitioners. By the end of 2022, of the 6,300 medical practitioners registered to practice in the 11 specialities included in Medical Costs Finder, only six decided to voluntarily offer up their pricing information. Three years later, only 88 doctors have signed up. As at December 2025, that's maybe one to two per cent of specialists and 10 per cent of insurers who decided to participate in the Medical Costs Finder.

The problem with the former government's voluntary model, as the president of the AMA, Dr Danielle McMullen describes it, is that private health insurers were extremely reluctant to upload their information, which also created a significant disincentive for doctors to upload their own billing data. Indeed, she continues:

The AMA has pushed hard for Medicare rebates and insurer benefits to be included on the Medical Costs Finder, so that patients get the full picture of why they may face an out-of-pocket cost …

Access to insurer data is crucial for patients, alongside clear information on Medicare rebates, which have failed to keep pace with inflation for decades and remain a major driver of out-of-pocket costs. The amendment will allow the Medical Costs Finder website to publish individual medical practitioner and insurer out-of-pocket costs for common medical services, but medical practitioners, including specialists and GPs, will no longer be required to volunteer their own billing information. Instead, it will be taken from Medicare, hospitals and insurer billing data already collected by the government

Specifically, the bill will amend the Health Insurance Act 1973 and the Private Health Insurance Act 2007 to allow for the publication of information about medical practitioners and their billing, including names; qualifications; speciality; any languages spoken; fees charged by location; and their utilisation of gap cover arrangements with insurers, where insurers pay a medical practitioner more if they agree to charge no or fixed out-of-pocket costs. The bill will allow for the publication of information about health facilities such as hospitals, including information about medical practitioners who provide services at the facility and insurers that have gap cover or contracting arrangements with the facility, and will allow for the publication of information about insurers, including policy holders who experience different gap cover arrangements and the out-of-pocket costs under those gap cover arrangements.

We all know that specialist fees vary drastically across the country and even within individual communities. These changes to the Medical Costs Finder will provide patients and consumers with efficient and at-hand access to detailed pricing information in order that they can compare costs and make the right decision for themselves. The ability—the right—to shop around is crucial to the private health marketplace. In fact, the visibility and transparency of medical pricing will reinforce a standard among medical practitioners and insurers that is in keeping not only with market expectations but also with community expectations.

The bill also outlaws a widespread practice among private health insurers called product phoenixing. Health insurers are required to limit price rises to a percentage approved by the Minister for Health and Ageing on an annual basis. Some health insurers have been employing what the Commonwealth Ombudsman has dubbed a 'loophole tactic', a deliberate and cynical strategy to get around this price increase limitation. Product phoenixing is when a private health insurer closes an existing product and then reopens an identical product at a higher premium, skirting regulatory oversight and ministerial scrutiny.

Despite being warned by the minister for health, private health insurers have continued this deceptive practice. Indeed, an investigation by consumer group CHOICE found that the price of gold-tier policies increased on average by more than 30 per cent over a three-year period. This kind of price gouging is not only amoral and unethical; it should be illegal. As the president of the AMA has stated:

Private health insurance premiums have outpaced wages and inflation in recent years, all while insurers' management expenses and profits continue to soar … The widespread practice of phoenixing is a major factor in consumers struggling to access the level of cover that meets their needs, and it is eroding public confidence in the private health system.

So the minister for health has acted to eliminate this specific practice. This amendment will restore consumer confidence in the private health system. Current arrangements oblige private health insurers to seek the minister for health's approval for change to the premium of an existing product, which is managed administratively during the annual premium round process. The proposed amendment would require that approval would additionally need to be sought from the Minister for Health and Ageing where a new product is being proposed or where mooted changes will reduce cover, a benefit, or a term or conditions of an existing product.

The amendment will also improve and enhance current arrangements for premium approvals, including creating in legislation specific premium round submission dates and an instrument that will allow the minister to vary those dates; creating a stronger public interest test for submissions outside the premium round to compel more applications within the approved period; creating a power for the minister to delegate approval authority, which is likely to be used in the instances of more straightforward applications that are clearly in the public interest; creating a legislative basis on which the minister can request further information about an application and request that the insurer respond, resubmit or further justify their application; and creating a rule-making power to set a fee for insurer applications for premium approval. By banning product phoenixing and streamlining the premium approvals process, consumers can be confident that they will not be shortchanged on their policy because of private health insurers underhanded and unethical getting around of government regulatory oversight.

The Health Legislation Amendment (Improving Choice and Transparency for Private Health Consumers) Bill 2026 will ensure that the private health experience of patients is fair, reliable and accessible. The bill is about enforcing a culture of transparency across the private healthcare landscape, prioritising, in the first instance, the individual patient's right to access the full suite of medical information, including costs, not after but prior to their specialist appointment and treatments. It will clamp down on the backroom practices of private health insurers who seek to make a profit off the health anxieties of their consumers. Fundamentally, this bill is about guaranteeing better health outcomes for all patients, it is about modernising and improving private health provision across this country, it's about embedding a culture of fairness and transparency in the private health marketplace, and it's about ensuring that Australians have, as a basic expectation, financial certainty during a time of great uncertainty as they battle with illness and disease.

Having worked in the sector for a couple of decades, I know how important our health system underpinned by Medicare is to the quality of life we enjoy as Australians. This government is acting to ensure that the health system continues to support the health of Australians. I commend the bill to the House.

Emma Comer (Petrie, Australian Labor Party) Share this | Link to this | Hansard source

The Health Legislation Amendment (Improving Choice and Transparency for Private Health Consumers) Bill 2026 goes to the heart of something every Australian cares deeply about—the ability to access timely, affordable and high-quality health care. It is about trust in our health system, confidence in private health insurance and making sure that, when Australians make decisions about their health, they are not doing so in the dark.

At its core, this legislation delivers on the Albanese government's commitment to strengthen Medicare while ensuring Australians who engage with the private health system are better informed, better protected and better supported. This reform is about giving Australians the information they need and closing the loopholes that undermine confidence in the system. Australians should not need to be health experts or to do hours of research to understand what they're being charged. They should not be left guessing about out-of-pocket costs or whether their insurance policy will actually deliver when they need it most. This bill is about fixing that. It is about enabling Australians to make informed decisions about their health care and their private health insurance.

One of the key reforms in this legislation is improving transparency in healthcare pricing. For too long, patients have faced a system where costs can vary dramatically between specialists for the exact same procedure, often within the same city or region. These variations are not always visible upfront. Patients frequently only discover the true cost after they've already committed to treatment. That is not transparency; that is uncertainty. Uncertainty in health care creates stress, financial pressure and, in some cases, people delaying or avoiding health care altogether. This bill addresses that directly through improvements to the Medical Costs Finder.

The reforms will allow the Medical Costs Finder website to publish individual medical practitioner fees alongside insurer out-of-pocket cost data for common medical services. This is a significant step forward. Importantly, this change doesn't impose new administrative burdens on doctors. Medical practitioners will no longer be required to manually upload billing data. Instead, the system will draw on existing data already collected through Medicare, hospitals and private health insurers, and that is what reform should look like—reducing red tape while increasing—

Debate interrupted.