Don't spare insurers in health cost debate

HEALTH insurers are masters of misdirection. Going after medical specialists on gap charges ignores the fact that the biggest out-of-pocket costs patients face are – often hidden – exclusions in their cover ("Out-of-pocket medical costs up 28pc: Bupa").

Your article misses a glaring point. The Medicare Benefits Schedule hasn't kept pace with costs for more than a decade. So it's hardly surprising that doctors' gap fees go up. But this is paltry compared with the insurance gaps.

A staggering 72 per cent of hospital insurance policyholders have exclusions in their cover. It may seem counter-intuitive but insurers price people out of the gold cover and cold-call existing members to suggest they downgrade policies.

Doing so lowers their claims costs; never mind that it leaves their customers high and dry.

Patients are increasingly getting caught out continuing to pay high premiums for the silver cover, only to cop huge out-of-pocket costs, in the tens of thousands of dollars, when they get sick or injured.

In demonising doctors, the Albanese government ignores its role in failing to meet higher medical costs while masking health insurers' rampant profiteering.

Each year now, health insurers bank more than $2 billion in unprecedented after-tax profits and $3.4 billion in so-called management expenses. It's the new norm, and it's all from your premiums.

They also short-change private hospitals by more than $1 billion every year.
Sure, doctor fees need to be transparent. But it's past due to hold health insurers accountable.

Brett Heffernan, CEO, Australian Private Hospitals Association. Published in the Australian Financial Review on 20 October 2026.

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