Terms of Reference

The value and affordability of private health insurance and out-of-pocket medical costs, with particular reference to:

  1. 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;
  2. the effect of co-payments and medical gaps on financial and health outcomes;
  3. private health insurance product design including product exclusions and benefit levels, including rebate consistency and public disclosure requirements;
  4. the use and sharing of membership and related health data;
  5. the take-up rates of private health insurance, including as they relate to the Medicare levy surcharge and Lifetime Health Cover loading;
  6. the relevance and consistency of standards, including those relating to informed financial consent for medical practitioners, private health insurance providers and private hospitals;
  7. medical services delivery methods, including health care in homes and other models;
  8. the role and function of:
    1. medical pricing schedules, including the Medicare Benefits Schedule, the Australian Medical Association fee schedule and private health insurers’ fee schedules,
    2. the Australian Prudential Regulation Authority (APRA) in regulating private health insurers, and
    3. the Department of Health and the Private Health Insurance Ombudsman in regulating private health insurers and private hospital operators;
  9. the current government incentives for private health;
  10. the operation of relevant legislative and regulatory instruments; and
  11. any other related matter. 

Committee Secretariat contact:

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

Phone: +61 2 6277 3515