The Value of Private Health Insurance

There has been a lot of discussion lately about the cost of private health insurance. GMHBA completely appreciate and understand our members’ concerns regarding affordability, and we will continue to do everything possible to keep premiums lower.

GMHBA CEO Mark Valena

GMHBA CEO Mark Valena

There has been a lot of discussion lately about the cost of private health insurance. We completely appreciate and understand our members’ concerns regarding affordability, and we will continue to do everything possible to keep premiums lower.

However, with roughly half of the Australian population covered, it’s important to remember the value of private health insurance and the role that it plays in our health system.

Having private health insurance protects members and their families so they have the cover and treatment they require, by the doctor or specialist of their choice, when they need it most.

To put it simply, when people ask me the question about the value of private health insurance, in turn I ask them how much they value their health .. and the quality of their life?

Consider this: an uninsured man has long-standing knee pain due to a sporting injury. He is told he needs a knee replacement and has been deemed a low priority on a public hospital waiting list, and it may take up to a year before he has surgery. In the meantime, it is difficult for him to work in his trade as a builder, play the sport he enjoys and engage in family activities with his children. If he was privately insured he would have had the surgery he needed within weeks, with a choice of hospital and surgeon, and be able to return to his normal activities quickly.

Or think about a patient who might be presented with a bill of $149,000 at the end of their hospital stay, where the patient had a prosthesis implanted and rehabilitation after fracturing their hip. This is not a fanciful figure; it is taken directly from our recent claims data.

If you’re in an emergency situation, Australia undoubtedly has a world class public health system. However, there are a number of less acute, but highly debilitating conditions for which access to care is much less certain. Close to two out of three non-emergency surgeries are performed under private health cover.

And if it’s not life-threatening, you could find the public system is not there for you.

During a hospital stay, the experience of being a private patient can be profoundly important at what can be an extremely challenging and stressful time. Privacy is important to everyone, and the emotional and psychological benefits of being in a private room are vast, including the benefits of improved sleep.

Private health insurance also provides cover for ancillary health services not covered by Medicare, such as dental, physiotherapy, optometry and chiropractic, which people don’t always factor into the cost of their healthcare. Many people only access these services because of their private health insurance cover. These services perform a key role in keeping our members healthy and optimising function and quality of life.

We encourage our members to regularly assess their policies and work out what is right for them; and to maximise the value of their policy. Examples include accessing the full suite of extras benefits, or determining whether their cover is appropriate for their particular stage of life.

The latest research shows that close to 75 per cent of PHI holders in Australia value it and want to keep it (Ipsos). Our job is to continue to work with the Government, the private health sector, our partners and within our own business to do everything possible to keep premiums lower, and continue to ingrain value into everything we do. The job of our members is to be active consumers and extract the maximum value from their policies. We will continue to work with our members on achieving this.

A strong private health insurance sector is vital for Australia and the sector plays a critical role in taking pressure off the public health system, and those who rely on it.

Private health insurance gives people the opportunity to take control of their health and their health care. It’s in your hands.

Ipsos – Healthcare & Insurance in Australia (2017)

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