![[APHA]](/images/logo_apha.svg){kind=logo}
THE latest data from the Australian Prudential Regulation Authority (APRA) is damning of the health insurance industry, seemingly hell-bent on squeezing private hospitals out of existence, while banking record profits from the premiums everyday Australians are paying.
"APRA's Quarterly Private Health Insurance Statistics (March 2025) exposes that the proportion of patient payments going to private hospitals has continued to nose-dive, falling to just 80.7% from 82.9% last quarter," APHA CEO Brett Heffernan said.
"It's a far cry from the traditional 88% benchmark, which is a threshold insurers have not met on an annual basis since 2019-20.
"In the wake of Toowong Private Hospital's impending closure due to insurer underpayments and a raft of insurance contracting abuses, this data is indefensible and clearly shows the insurance industry is failing to meet its obligations to the healthcare costs of insured patients.
"We are advised that as many as eight more private hospitals now face imminent closure.
"Meanwhile, health insurance companies have pocketed an average $2 billion a year in unprecedented profits from people's annual premiums, in addition to $3.5 billion a year in higher 'management fees', all while short-changing private hospitals by over $1 billion a year. In this last quarter alone, APRA reveals the insurers banked another $431 million in profits.
"When the middlemen in healthcare are allowed to gouge their members at one end and shortchange private hospitals at the other, the funding model is being abused to the point that it is broken. It reduces choice and access for patients, while compromising quality healthcare delivery and foisting even more pressure on already over-stretched public hospitals.
"Two months ago Federal Health Minister Mark Butler publicly put the health insurance industry on notice, recognising that their profits are up, their management fees are up, but the ratio of benefits paid to hospitals has fallen. He gave them three months to correct it or he'd regulate them to fix it.
"Two months on and our members are reporting no improvements. It's high time the government put an end to this insurance racket, which is undermining the sustainability of the healthcare system, costing hundreds of jobs and plunging many thousands of vulnerable patients into unnecessary chaos and confusion.
"Health insurance is just a means to an end. Often seen by punters as a necessary evil. It's the quality healthcare provided by private hospitals, with patient choice of doctor and no waiting list, that makes the financial pain worth it.
"But that equation no longer adds up. Australians are paying more and more to health insurance companies but getting less and less for it."
-ENDS-
Next Media Centre:
6/6/2025 Insurance exclusions main cause of out-of-pocket costs
Previous Media Centre:
29/5/2025 Toowong Private Hospital to close