Health insurers' games

Health insurers are quick to deflect and point the finger at anybody and everybody else. 'Price of surgery is sick' (Adelaide Advertiser, 17/10.25) saw the claim that surgeon out-of-pocket costs have soared in the last five years. But the insurers have a case to answer.

A massive 8.6 million hospital insurance policies, or a record 68% of all policies, now come with exclusions, restrictions or limitations. That's up 10% (or two million policies) in five years. Patients are getting caught out paying more for their health insurance each year but getting less cover for it.

Punters just don't know what they're getting or, more to the point, not getting in their health insurance. It's deliberately confusing, jargon-laden and designed to entrap. Most of the gap payments are due to insurance policies that are not transparent and do not cover patients adequately.

Brett Heffernan, CEO, Australian Private Hospitals Association. Published in the Adelaide Advertiser on 20 October 2025.

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