Private health insurance reforms: Private patients in public hospitals

The impact of privately insured patients in public hospitals will be considered in the broader National Health Agreement context, to ensure the best outcome for a sustainable balance between public and private health systems.

Page last updated: 17 October 2017

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  • The government is consulting with the community on options to better support patient access to public hospitals. Options related to privately insured patients in public hospitals will be discussed with jurisdictions as part of the negotiations for the next National Health Agreement.

Why is this important?

  • The Australian Government is committed to ensuring a sustainable balance between our public and private health systems.
  • The use of private health insurance by patients in public hospitals has increased significantly in recent years, apparently driven by state and hospital policies to encourage patients to use their private health insurance to increase hospital own source revenue.
  • Growth in the number of patients utilising their insurance in public hospitals over the last five years has contributed about 0.5% a year to premium increases.

Who will benefit?

  • Patient’s rights will continue to be protected and respected when it comes to their choice to elect to access public hospital services as a public patient, free of charge, or choose to be treated as a private patient in a public hospital.
  • The premiums paid by people holding private health insurance may decrease if options agreed on reduce the number of privately insured patients in public hospitals.
  • The rights of doctors’ to treat privately insured patients in public hospitals will be supported.

How much will this cost?

Funding will be discussed and finalised as part of the National Health Agreement negotiations.

What impact will this change have on private health insurance?

Any changes to patients using their private health insurance in public hospitals will seek to continue the sustainability of the public and private health systems. It is important that any actions taken by one part of the system does not inappropriately change the balance and inadvertently disadvantage patients and other parts of the system