AMA President Professor Steve Robson released the AMA’s private health budget submission today, which calls for a Private Health System Authority to ensure the sector is appropriately regulated.

“We need an independent body that has the capacity, objectivity, and expertise to ensure the system is fair for patients and balances everyone’s interests,” Professor Robson said.

“We have seen people signing up in droves to insurers and at the same time we’ve seen management expenses increasing. We want to see a mandatory minimum payout with 90 per cent of every premium dollar going back to the patient.

“We also need to have more money flowing to improving patient health outcomes and less going into management expenses and profits of insurers, which continue to increase, while the proportion of premium revenue going towards hospital patient benefits has gone backwards over recent years.”

Professor Robson said the current regulatory and legislative frameworks were not fit-for-purpose and reform was needed.

“A new referee would create a platform for all the key players in the sector to come together and make once-in-a-generation reforms,” he said.

“This change is needed for the best interests of patients, day hospitals, private hospitals, private health insurers, medical device manufacturers, and doctors.

“We are currently seeing patients wading through unexpected out-of-pocket costs, restricted choice, and additional complexity.

“An independent body could make things more streamlined and create a protective buffer for patients.”

AMA Pre-Budget Submission 2024–25, Chapter 3: Private Health