The number of Australians with private health insurance hospital cover drops


New data shows 45.1 percent of Australians have private health insurance hospital cover, the lowest level for almost a decade.

The June quarter Australian Prudential Regulation Authority (APRA) data showed participation had dropped 0.3 percentage points since the March quarter, and was down 0.9 percentage points compared to the same quarter in 2017.

Australian Private Hospitals Association (APHA) CEO Mr Michael Roff said the latest figures sent some conflicting signals.

“The drop in participation is a concern, but there is also a ‘green shoot’ in the number of private patients being treated in public hospitals dropping slightly, down 1.2 percent over the quarter and 1.6 percent in the year.

“This continues to be an issue for Australians who are being coerced into using their private health insurance in the public system, so we hope this reversal continues.

“The latest data also shows that Australia private hospitals are doing their part, taking pressure off the public system – with almost four million episodes of care occurring in the private overnight or day hospitals each year,” he said.

Despite a drop in private health insurance members, the number of episodes of care provided in private hospitals for the year ending 30 June increased by 0.9 percent over the previous quarter and by 2.1 percent over the previous year.

Mr Roff said the data also pointed to the high level of complexity in the case load for private hospital admissions. More than half the private health insurance payments went to treatment of Australian aged 65 years old and over, Australians who may have co-morbidities and challenges in their treatment and recovery.

“Private hospitals, including rehabilitation hospitals, increasingly manage older people with challenging health conditions, complex surgeries and difficult recovery pathways,” he said.

However, concerns remain regarding private health insurance policies that exclude access to some services. The APRA data shows about 45 percent of policies now have exclusions.

This is an increase of 1.0 percentage points over the quarter and an increase of almost four percentage points compared to the same quarter last year.

“The rise in policies with exclusions is a concern because we are all very poor predictors of our own future health needs, so we may choose to exclude a service we find we need down the track.

“I encourage all Australians to review their private health insurance at least once a year and make sure the policy you first bought still meets your changing health needs,” Mr Roff said.


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