Insurers are the real healthcare culprits

DOCTORS' fees are an issue, but by far the biggest out-of-pocket costs patients face are because of often hidden exclusions in their health insurance cover. Patients simply don't know what they are covered for or, more to the point, not covered for.

Unfortunately, your piece omitted this salient point ("Labor Left pushes for hard cap on specialist doctor fees").

In demonising surgeons and other specialists, don't let health insurance companies off the hook. Their pursuit of doctors is a convenient distraction from their own rampant profiteering, pocketing more than $2 billion a year in record after-tax profits.

Today, 9.1 million people with hospital insurance, a staggering 72 per cent of policyholders, have exclusions in their cover. It may seem counter-intuitive but insurers price people out of the Gold cover to save on claims costs. Patients are increasingly getting caught out paying more for their health insurance each year but getting less cover for it.

Health insurance is deliberately confusing, jargon-laden and designed to entrap. It needs reform. Most of the gap payments are because of insurance policies that are not transparent and do not adequately cover patients.

Sure, make doctors accountable. But don't be distracted from the real culprits.

Brett Heffernan, CEO, Australian Private Hospitals Association, Barton, ACT. Published in the Australian Financial Review on 15 July 2026.

Previous Letters to the Editor:
3/7/2026 Clinical cost-cutting bad for healthcare