On 29 March 2017, the Senate agreed that on 1 June 2017 it would refer the following matter to the Senate Community Affairs References Committee for inquiry and report:
The value and affordability of private health insurance and out-of-pocket medical costs.
The terms of reference are:
- private and public hospital costs and the interaction between the private and public hospital systems including private patients in public hospitals and any impact on waiting lists;
- the effect of co-payments and medical gaps on financial and health outcomes;
- private health insurance product design including product exclusions and benefit levels, including rebate consistency and public disclosure requirements;
- the use and sharing of membership and related health data;
- the take-up rates of private health insurance, including as they relate to the Medicare levy surcharge and Lifetime Health Cover loading;
- the relevance and consistency of standards, including those relating to informed financial consent for medical practitioners, private health insurance providers and private hospitals;
- medical services delivery methods, including health care in homes and other models;
- the role and function of:
- medical pricing schedules, including the Medicare Benefits Schedule, the Australian Medical Association fee schedule and private health insurers’ fee schedules,
- the Australian Prudential Regulation Authority (APRA) in regulating private health insurers, and
- the Department of Health and the Private Health Insurance Ombudsman in regulating private health insurers and private hospital operators;
- the current government incentives for private health;
- the operation of relevant legislative and regulatory instruments; and
- any other related matter.
Submissions were sought by 28 July 2017. The reporting date is 27 November 2017.