Reform the key to keeping Australia’s health care system out of intensive care


All Australians would benefit from an overhaul of private health care to allow insurers to fund more out-of-hospital services, address waste, and create empowered consumers, according to a report commissioned by Bupa Health Insurance.

The report A sustainable private health sector: an economic study – highlighted the current limitations restricting private health insurers from funding services that would make private health care more relevant, affordable and simpler for consumers, and help take more pressure off the public system.

Bupa CEO, Hisham El-Ansary said Australia’s mixed public-private health system has long been considered one of the best in the world, but COVID-19 has exposed its limitations.

“A combination of our ageing population, increasing chronic and complex disease and advances in clinical care exposed the structural flaws, and the COVID-19 pandemic exacerbated them. The AMA says our public hospitals are in crisis[1], with wait times for surgery increasing year on year since 2015, while the cost of care keeps going up,” Mr El-Ansary said.

“Private health insurance contributes more than $61 billion to the Australian economy each year and adds to economic wellbeing by helping people remain healthy and productive. It also benefits those without insurance through the reduction of public hospital waiting lists.

“But outdated regulations for private health insurance have not kept pace with modern care delivery or the needs of our population. They make it difficult for consumers to access early interventions and out of hospital treatments that would keep them well or reduce the length and cost of their hospital stay.  

Hisham El-Ansary, CEO Bupa Australia & New Zealand

This report demonstrates that private health insurance is absolutely central to maintaining the world-class, universal health system that underpins Australia’s health and productivity. Private health reform is key to driving participation and taking pressure off our under-pressure public health sector, so it can care for those most in need.

Hisham El-Ansary, CEO Bupa Australia & New Zealand

Bupa will use the report’s findings to champion reforms that will make private health care more relevant, affordable and simpler for consumers, including:  

·       Reducing red tape so that private health insurance can cover more preventative and out of hospital care that reflect modern care delivery and address the increase in chronic illness

·       Incentivising best practice care and focusing on outcomes for patients

·       Removing waste and inefficiencies that drive unnecessary cost for consumers

·       Providing private health insurers with more flexibility in how they discount premiums, so they can more meaningfully respond to customer needs and individual circumstances

·       Empowering consumers to better navigate, understand and control their own health care through improved reporting, transparency and data sharing.

Mr El-Ansary said Bupa supported reform centred around empowering consumers to better manage their own health and care. This would be underpinned by a system that is easier to navigate and more personalised, including simple, connected care journeys for consumers through the health system.

“By 2057, the number of Australians aged 65 and above will double, putting extreme pressure on health care if the system is not fit for purpose. Addressing these issues now will enable health insurance to become more productive and sustainable for consumers and importantly, help create a healthier Australia,” Mr El-Ansary said.

Bupa Health Insurance commissioned the report from economics consultancy Evaluate to examine the value of private health insurance, and factors affecting its long-term sustainability.

To download the report please click here.



[1] AMA Public Hospitals: Cycle of Crisis October 2021