Reforms are good news for GMHBA Members

Category: Member news & services

GMHBA welcomes the Federal Government’s private health insurance reforms, which ultimately will lead to savings for GMHBA members.

GMHBA, fellow health funds, and our peak industry body Private Healthcare Australia, worked with Government to identify and develop a range of much needed reforms that will contribute to making private health insurance more appealing and affordable.

These reforms will be implemented over a two-year period, starting in April 2018.

GMHBA CEO Mark Valena said he is very happy with the outcome of the negotiations, which ultimately are good for GMHBA members and critical for the future of private health insurance and the provision of healthcare in Australia.

“I am pleased that these reforms take an important first step in reducing the upward pressure on private health insurance premiums,” Mr Valena said. “The government has indicated there are more reforms to come and I am keen to see the additional changes that will continue to address the underlying causes of premium growth so that we can ensure the future sustainability of the private health insurance sector, which plays such a critical role in taking pressure off Australia’s public health system.”  

 “These reforms mark a significant step in reducing upward pressure on private health insurance premiums and will certainly help us keep premiums lower,” Mr Valena said.

“The changes also start to address key issues such as the number of people leaving private health insurance and the need to get more young people to take up private cover.”

Key changes include:

  • Reform of the Prosthesis List pricing arrangements expected to generate savings of $300m over two years for Australian consumers
  • The establishment of clear categories of health insurance – Gold, Silver, Bronze and Basic – so consumers know exactly what they are getting
  • Discounts for people aged 18-29 to encourage more young people take up private health cover
  • The introduction of a mental health safety net to help more people have a once off opportunity to upgrade their cover to include in-hospital mental health services without a waiting period
  • Expansion of the role of the Private Health Insurance Ombudsman and the strengthening of its ability to protect consumers’ interests
  • The introduction of a rural health product offering travel and accommodation benefits to country members

The private health system plays a critical role in taking pressure off Australia’s public health system and the government has committed to taking further steps to improve the sustainability of the private health insurance sector.

Mr Valena said he is particularly pleased to see the government addressing the Prosthesis List pricing arrangements which have resulted in patients in private hospitals paying inflated prices for medical devices, such as hips, pacemakers, replacement bones and corneas,  sometimes up to five times what it costs in the public system for exactly the same device

“This addresses the rorts and kickbacks that were distorting the medical device pricing system and leading to poor outcomes for Australian consumers,” Mr Valena said.  “As a not-for-profit health insurer, GMHBA remains committed to passing on these savings to fund members to improve the affordability and value of its products.”

For further information about the reforms, follow this link