Latest APRA release confirms continued growth in PHI membership

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The latest statistical release from the Australian Prudential Regulatory Authority has revealed another increase in people taking out private health insurance.

According to APRA, hospital treatment membership increased by 2.2 per cent, or 257,797 persons, for the 12 months to the end of 2023.

Members in the 50 and over age group increased by 2.3 per cent, or 108,820 persons, and membership among the younger population (20 to 49) increased by 2.5 per cent or 103,830 persons.

"Premium revenue in the year ending 31 March 2023 increased by 2.6 per cent through a combination of rising membership and premium increases. Claims costs increased over the period by 4.9 per cent, which reflected higher levels of utilisation of services," said APRA.

“APRA data shows that there have been 11 consecutive quarters of growth in private health insurance membership with a record 14.5 million Australians now having private health cover. This means an additional 865,213 people have joined a health fund since the beginning of 2020, and are now treading a tightrope between the rising cost of living and public hospital waiting lists reported as up to 6-8 years long," said Private Healthcare Australia CEO Dr Rachel David.

Recent YouGov research revealed that people are joining private health insurance due to concerns about quality and access in the public system and greater choice and lower waiting times in the private sector.

Dr David continued, “Australian families are under increasing financial pressure with inflation and cost of living hitting hard. Our public health system is struggling and more and more Australians are turning to private health cover to access surgery and health care. It is critical that the overpricing of medical devices for private patients is reigned in to keep premiums affordable and take pressure off our public hospital system.

“Health funds are doing all they can to keep costs under control and ensure private cover is available to as many Australians as possible. However, without further government intervention to address medical device pricing and bring it in line with the public health system and comparable countries, there’ll be further pressure on private health insurance premiums and as a consequence, public hospitals. With hospitals struggling with the rising costs of recruitment, power and food, we simply can’t let this wasteful spending continue.

“The Government must prioritise medical device pricing reform so these families can retain their private cover to access timely health care and relieve pressure on the public hospital system. Every dollar saved by health funds as a result of this reform will be returned to members in the form of lower premiums,” added Dr David.

In response, the Medical Technology Association of Australia (MTAA) said greater transparency and controls are required to ensure that savings from reform are passed on to consumers.

CEO Ian Burgess said the latest APRA data showed that reform of the Prostheses List reforms is continuing to deliver significant savings, which now total more than $2.1 billion since 2017.

“The MedTech industry is continuing to play its part to help ease cost-of-living pressures for Australians, it’s well time a mechanism was introduced by government to compel corporate insurers to pass on the savings, delivered by our industry, to consumers,” he said.