MARCH 1999

© Commonwealth of Australia 1999
ISSN 1440-2572

View the report as separate downloadable parts:











APPENDIX 1 - Submissions received by the Committee


APPENDIX 2 - Public hearing


APPENDIX 3 – Summary of Legislative Changes


For further information, contact:

Committee Secretary
Senate Standing Committees on Community Affairs
PO Box 6100
Parliament House
Canberra ACT 2600

Phone: +61 2 6277 3515
Fax: +61 2 6277 5829


Membership of the Committee


Senator Sue Knowles, Chairman LP, Western Australia
Senator Andrew Bartlett, Deputy Chair AD, Queensland
Senator Kay Denman ALP, Tasmania
Senator Alan Eggleston LP, Western Australia
Senator Chris Evans ALP, Western Australia
Senator Ross Lightfoot LP, Western Australia

Participating Members

Senator Eric Abetz LP, Tasmania
Senator Bob Brown Greens, Tasmania
Senator Mal Colston Ind, Queensland
Senator the Hon Rosemary Crowley ALP, South Australia
Senator the Hon John Faulkner ALP, New South Wales
Senator Michael Forshaw ALP, New South Wales
Senator Brenda Gibbs ALP, Queensland
Senator Brian Harradine Ind, Tasmania
Senator Meg Lees AD, South Australia
Senator Dee Margetts GWA, Western Australia
Senator the Hon Chris Schacht ALP, South Australia
Senator John Woodley AD, Queensland



Health Legislation Amendment Bill (No. 4) 1998



1.1 The Health Legislation Amendment Bill (No. 4) 1998 was introduced into the House of Representatives on 3 December 1998. On 9 December 1998, the Senate, on the recommendation of the Selection of Bills Committee (Report No. 13 of 1998), referred the provisions of the Bill to the Committee for report by 8 March 1999.

1.2 The Committee considered the Bill at a public hearing on 17 February 1999. Details of the public hearing are referred to in Appendix 2. The Committee received 15 submissions relating to the Bill and these are listed at Appendix 1.



2.1 The Health Legislation Amendment Bill (No. 4) 1998 sets in place through three schedules the framework for the introduction of reforms to the private health insurance product. These reforms complement the recently enacted 30 per cent private health insurance rebate and are designed to make the health insurance product more attractive to consumers by enabling greater product flexibility.

2.2 The proposed reforms implement a number of recommendations from the Industry Commission's Report on Private Health Insurance [1]. The reforms contained in Schedule 1 of the Bill as introduced into the House of Representatives will:

  1. Allow registered health funds to offer discounted premiums to contributors based on the administrative savings of health funds;
  2. Allow health funds to offer loyalty bonus schemes to contributors (which may be pecuniary in nature or may be provided through goods and services) in recognition of the period of time over which the contributor has paid premiums. There is also a provision which ensures that health funds uphold the principle of `community rating' with respect to the provision of a loyalty bonus scheme to persons covered under a given insurance table;
  3. Allow waiting periods to be extended for certain conditions, ailments or illnesses;
  4. Allow health funds to cover the PBS patient co-payment for prescribed pharmaceutical benefits for in-hospital treatment;
  5. Allow health funds to pay benefits for `out-of-hospital procedures' which are undertaken in `approved procedures facilities'; and
  6. Create a new class of benefit payable by health funds to cover specialist health services.

2.3 Schedule 2 provides amendments which in respect of Parts (5) and (6) of Schedule 1 will:

2.4 Schedule 3 of the Bill establishes separate provisions to deal with health fund rule changes that relate to a change in the rates of contribution of contributors (ie changes in premium levels) and all other rule changes. Ministerial power to monitor rule changes will be broadened by allowing the Minister to consider the impact of those rule changes not just upon the health fund and its members (the existing grounds) but also upon the broader interests of the health insurance industry and the overall public interest. [2]

2.5 In addition, the Bill allows for the transfer of the rates of contribution rule change provisions from the Minister to the Private Health Insurance Administration Council and, at an appropriate time, to increase the independence and flexibility of health funds with respect to rates of contribution rule changes. [3]

2.6 On 16 February 1999 the Minister for Health and Aged Care, Dr Michael Wooldridge, wrote to the Committee Chairman advising:



3.1 The organisations providing submissions and evidence were generally supportive of the Bill, with some providing comments relating to the implementation of aspects of the legislation. As ACHCA said `rather than having huge provisos, we have simply wanted to put on the table areas which need to be carefully monitored'. [5]



4.1 The Committee reports to the Senate that it has considered the Health Legislation Amendment Bill (No. 4) 1998 and recommends that the Bill as proposed to be amended in the House of Representatives proceed.

Senator Sue Knowles

March 1999




  1. This Bill contains a number of separate proposals which collectively aim to further deregulate the private health insurance funds. The late withdrawal of Part 6 of the Bill and the unavailability of the amendments which the Minister has foreshadowed has hampered the ability of the Committee to consider the impact of the Bill.
  2. The evidence presented to the Committee does not support the view that all organisations were generally supportive of the Bill. A large number of issues were raised by different groups.
  3. The key issues which remain unexplained are:
  4. The Opposition will not be supporting the Bill as it stands and will move amendments to address the concerns that have been raised when the Bill is considered in detail.

Senator Chris Evans Senator Kay Denman

(ALP, Western Australia) (ALP, Tasmania)



The Health Legislation Amendment Bill (No 4) 1998 introduces a number of changes to the regulatory framework for private health insurance.

The Democrats recognise that the Government has a role in regulating private health insurance, however, we believe that the Government's first priority in health should be the public system. The public health system is currently struggling to cope with increasing demand and an inefficient funding system that discourages coordination between jurisdictions. These are major structural problems that will not be addressed through minor changes to the regulation of private health insurance. The Democrats support the general intention of this legislation to encourage private health insurance funds to be more innovative in developing attractive products for consumers. The Democrats have been disappointed at the lack of consumer focus shown by many funds in the past. However, we do not believe that this Bill will assist the majority of Australians who rely on the public system for their health care.

Senator Meg Lees

Australian Democrats Senator for South Australia

Senator Andrew Bartlett

Australian Democrats Senator for Queensland


APPENDIX 1 - Submissions received by the Committee

1 Association of Independent Retirees, Inc
2 National Seniors Association
3 Australasian Day Surgery Association
4 Australian Private Hospitals Association Limited
5 Medical Benefits Fund of Australia Limited (MBF)
6 Australian Health Insurance Association Ltd
7 Consumers' Health Forum of Australia
8 Commonwealth Department of Health and Aged Care
9 Health Consumers' Council WA (Inc)
10 Medibank Private
11 Australian Catholic Health Care Association (ACHCA)
12 Australian Consumers' Association
13 Australian Medical Association (AMA)
14 Australian Healthcare Association
15 William M Mercer (Aust) Ltd


APPENDIX 2 - Public Hearing

A public hearing was held on the Bill on 17 February 1999 in Senate Committee Room 2S1.

Committee Members in attendance

Senator Sue Knowles (Chairman)
Senator Kay Denman
Senator Alan Eggleston
Senator Chris Evans


Australian Health Insurance Association (AHIA)

Mr Russell Schneider, Chief Executive

Australian Medical Association (AMA)

Dr Bill Coote, Secretary General

Australian Catholic Health Care Association (ACHCA)

Mr Francis Sullivan, Executive Director

Department of Health and Aged Care

Ms Lynelle Briggs, First Assistance Secretary, Portfolio Strategies Division
Ms Chris Woodgate, Assistant Secretary, Private Health Industry Branch
Mr Peter Callanan, Director, Insurance and Hospital Services Section


[1] Industry Commission, Private Health Insurance, Report No.57, February 1997.

[2] Explanatory memorandum, pp.2, 7-14 and Submission No.8, p.3.

[3] Explanatory memorandum, p.3, 17.

[4] Committee Hansard, 17.2.99, p.1.

[5] Committee Hansard, 17.2.99, p.11.