The hidden cost of private health insurance in Australia
Davinia S. E. Seah A , Timothy Z. Cheong B and Matthew H. R. Anstey C D
+ Author Affiliations
- Author Affiliations
A Dana Farber Cancer Institution, 450 Brookline Avenue, Boston, MA 02446, USA. Email: Davinia_Seah@dfci.harvard.edu
B Royal Victorian Eye and Ear Hospital, 32 Gisborne Street, East Melbourne, VIC 3002, Australia. Email: timothy.cheong@eyeandear.org.au
C Beth Israel Deaconess Medical Center, Harvard Medical School, W/CC 470, 1 Deaconess Rd, Boston, MA 02115, USA.
D Corresponding author. Email: manstey@bidmc.harvard.edu
Australian Health Review 37(1) 1-3 https://doi.org/10.1071/AH11126
Submitted: 7 December 2011 Accepted: 12 June 2012 Published: 3 December 2012
Journal Compilation © AHHA 2013
Abstract
The provision of health services in Australia currently is primarily financed by a unique interaction of public and private insurers. This commentary looks at a loophole in this framework, namely that private insurers have to date been able to avoid funding healthcare for some of their policy holders, as it is not a requirement to use private insurance when treatment occurs in Australian public hospitals.
References
[1] Medicare Australia. The Australian Health System. Australian Government; 2010. Available at http://www.humanservices.gov.au/customer/services/medicare/medicare.[2] Wikipedia The Free Encyclopedia. Free rider problem; 2011. Available at http://en.wikipedia.org/wiki/Free_rider_problem [verified 30 April 2011].
[3] Commonwealth of Australia. Government surcharges and incentives. Canberra: Private Health Insurance Ombudsman. Available at http://www.privatehealth.gov.au/healthinsurance/incentivessurcharges/default.htm [verified 20 April 2011].
[4] Private Health Insurance Administration Council. Operations of the Private Health Insurers Annual Report 2009–10. Canberra: Australian Government; 2010.
[5] Smith J. Tax expenditures and public health financing in Australia. Discussion paper Number 33: The Australia Institute. 2000. Available at http://www.tai.org.au/documents/dp_fulltext/DP33.pdf [verified 15 October 2012]
[6] Australian Institute of Health and Welfare (AIHW). Health expenditure Australia 2008–2009. Health and welfare expenditure (HWE) series no. 42. Cat. no. HWE 51. Canberra: AIHW; 2010.
[7] Duckett SJ, Jackson TJ. The new health insurance rebate: an inefficient way of assisting public hospitals. Med J Aust 2000; 172 439–42.
| 1:STN:280:DC%2BD3czivVKhtg%3D%3D&md5=43f03d5f711b59af947e9e9bc5261084CAS | 10870538PubMed |
[8] Private Health Insurance Administration Council. Quarterly statistics June 2011. Canberra; 2010. Available at http://www.phiac.gov.au/resources/file/quarterlystatistics/Qtr%20Stats%20Jun11.pdf [verified 21 September 2011]
[9] Butler JR. Policy change and private health insurance: did the cheapest policy do the trick? Aust Health Rev 2002; 25 33–41.
| Policy change and private health insurance: did the cheapest policy do the trick?Crossref | GoogleScholarGoogle Scholar | 12536860PubMed |
[10] Frech HE, Hopkins S, MacDonald G. The Australian private health insurance boom: was it subsidies or liberalised? University of California at Santa Barbara, Economics Working Paper Series: Department of Economics, UC Santa Barbara; 2002. Available at http://escholarship.org/uc/item/6j47s8kq [verified 21 September 2011]
[11] Health Policy Solutions, Casemix Consulting, Aspex Consulting. Activity based funding for Australian public hospitals: towards a pricing framework. Health Policy Solutions, Casemix Consulting, Aspex Consulting; 2011. Available at http://www.ihpa.gov.au/internet/ihpa/publishing.nsf/Content/EB8EFD07DF85BC70CA25798300033BE1/$File/IHPA%20Draft%20Pricing%20Framework_long%20version.pdf [verified 21 March 2012]
[12] Colombo F, Tapay N. Private health insurance in Australia: a case study. France: OECD; 2003. Available at https://www1.oecd.org/australia/22364106.pdf [verified 21 March 2012]
[13] Metherall M. Silence on private patient funding. Sydney; 2010. Available at http://www.smh.com.au/national/silence-on-private-patient-funding-20100506-uh2q.html [verified 7 May 2010].
[14] Paris V, Devaux M, Wei L. Health systems institutional characteristics: a survey of 29 OECD Countries. OECD Health Working Papers, No 50. OECDPublishing; 2010. http://search.oecd.org/officialdocuments/displaydocumentpdf/?cote=DELSA/HEA/WD/HWP%282010%291&docLanguage=En [verified 5 November 2012]
[15] Australian Bureau of Statistics (ABS). Reasons for insuring 2007–2008 National Health Survey Table 19. Canberra: ABS; 2008. http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4364.02007-2008%20%28Reissue%29?OpenDocument
[16] Australian Bureau of Statistics (ABS). Health services: patient experiences in Australia 2009. Canberra: ABS; 2010. Available at http://www.ausstats.abs.gov.au/ausstats/subscriber.nsf/0/4DE1EBF2E29AAC71CA2577730022B837/$File/4839055001_2009.pdf [verified 20 April 2011]
[17] Hurley J, Vaithianathan R, Crossley TF, Cobb-Clark D. Parallel private health insurance in Australia: a cautionary tale and lessons for Canada. Institute for the Study of Labor (IZA); 2002. Available at http://ssrn.com/abstract_id=320084 [verified 20 April 2011]
[18] Denniss R. Who benefits from private health insurance in Australia? Canberra: The Australia Institute; 2005.
[19] Ausralian Institute of Health and Welfare (AIHW). Australian Hospital Statistics 2009–10. Health Services services no. 40. Cat. No. HSE 107. Canberra: AIHW; 2011. Available at http://www.aihw.gov.au/publication-detail/?id=10737418863
[20] Parnell S. Public hospital patients offered perks to shift costs to insurers. The Australian. March 23 2010; http://www.theaustralian.com.au/news/health-science/public-hospital-patients-offered-perks-to-shift-costs-to-insurers/story-e6frg8y6-1225844021233.
[21] Ballarat Health Services. No out of pocket expenses. Available at http://www.bhs.org.au/?q=node/61 [verified 1 October 2012]
[22] Government of Western Australia DoH. Private patients. Available at http://www.scgh.health.wa.gov.au/Patients_Visitors/PrivatePatients.html [verified 20 April 2011].
[23] Sullivan N, Redpath R, O’Donnell A. Public hospitals: who’s looking after you? The difficulties in encouraging patients to use their private health insurance in public hospitals. Aust Health Rev 2002; 25 6–14.
| Public hospitals: who’s looking after you? The difficulties in encouraging patients to use their private health insurance in public hospitals.Crossref | GoogleScholarGoogle Scholar | 12136566PubMed |
[24] Department of Health and Ageing (DoHA). Australian Health Care Agreement between the Commonwealth of Australia and the State of Victoria (2003–2008). Canberra: DoHA; 2008. http://www.health.gov.au/internet/main/publishing.nsf/Content/B02C99D554742175CA256F18004FC7A6/$File/victoria.pdf
[25] U.S. Department of Health and Human Services Centers for Medicare and Medicaid Services. Medicare and other health benefits: your guide to who pays first. Baltimore; 2011. http://www.medicare.gov/Pubs/pdf/02179.pdf
[26] Paolucci F, Butler JRG, Van de Ven WPMM. Subsidising private health in Australia: why, how and how to proceed? Working Paper Number 2. Canberra: Australian Centre for Economic Research on Health; 2008. Available at www.acerh.edu.au/publications/ACERH_WP2.pdf [verified 1 October 2012]
[27] Department of Health and Ageing. Private Health Insurance Premium Round Outline of premium approval process. 2011. Available at http://www.health.gov.au/internet/main/publishing.nsf/Content/privatehealth-summary-premiumincreases [verified 1 October 2012]
[28] Private Health Insurance Administration Council. About PHIAC. Available at http://www.phiac.gov.au/about-phiac/ [verified 1 October 2012].
[29] Butler J. A comment on the response from Graham Wright. Aust Health Rev 2003; 26 10–1.
| A comment on the response from Graham Wright.Crossref | GoogleScholarGoogle Scholar | 15485366PubMed |
[30] Segal L. Why it is time to review the role of private health insurance in Australia. Aust Health Rev 2004; 27 3–15.
| Why it is time to review the role of private health insurance in Australia.Crossref | GoogleScholarGoogle Scholar | 15362292PubMed |
