Health Legislation Amendment (Improving Choice and Transparency for Private Health Consumers) Bill 2026

Mr ZAPPIA (Makin) (11:08): This legislation—the Health Legislation Amendment (Improving Choice and Transparency for Private Health Consumers) Bill 2026—delivers on the Albanese government's election commitment to ensure greater transparency in costs charged by medical specialists, rebates provided by health insurers and outlawing product phoenixing. It is also legislation that, ultimately, will assist with cost-of-living pressures that Australians are experiencing because the legislation will help people make informed decisions about their health care and their private health insurance needs.

This will be done through the Medical Costs Finder website, which will publish individual medical practitioner fees and insurers' out-of-pocket data for common medical services. One of the most frequent grievances I hear from people in my electorate is about the fees charged by a medical specialist, the low rebate paid by Medicare or the low private health insurance rebate that they get and therefore the out-of-pocket costs paid by the patient.

Whilst the medical specialists, private health insurers and Medicare each blame each other for the often exorbitant out-of-pocket costs, there is general agreement across the community that some medical specialists are simply charging too much for their services. With respect to that, I'll quote directly from a press release issued on 17 October 2025 by Private Healthcare Australia which I believe exposes the staggering increase in some medical bills.

The press release says: Between 2018-19 and 2023-24, the median out-of-pocket medical fees charged by doctors including surgeons, anaesthetists and assistant surgeons has surged for many procedures. Some of the biggest price rises have occurred for: Deep brain stimulation surgery for Parkinson's Disease—up from a median out-of-pocket cost of $790 to $6,000. Biliopancreatic diversion surgery for major weight loss—now $5,650 compared to $650 in 2019.

Double knee replacement surgery more than tripled from $1,910 to $4,750. Kidney removal due to a tumour—tripled from $1,110 to $3,510. Prostate surgery—more than doubled from $1,830 to $3,900.

Spinal fusion surgery—increased from $700 to $2,640 The press release goes on to say: Australian Prudential Regulation Authority (APRA) data shows average out-of-pocket fees for hospital episodes have risen by 65% since 2020. It then goes on further to say: Doctors are entitled to charge fairly, but fees that double, triple and increase up to nine times in a few years are unsustainable.

Patients end up facing massive bills or waiting years for treatment in the public system. Neither Medicare nor private health insurers can keep pace without pushing up taxes and premiums. The last part of the press release says: Studies by the Australian Bureau of Statistics, La Trobe University and Patients Australia show up to 20% of Australians are delaying or skipping specialist appointments due to cost.

The Grattan Institute estimates over a million people each year miss out on seeing a specialist because they cannot afford it. Those figures confirm why this legislation is so important and welcome. It's a step in the right direction and it will help patients.

In particular, I refer to schedule 1, which the minister also referred to in his second reading speech. I note the member for Brisbane in her contribution just a few moments ago also referred to schedule 1. Schedule 1 is effectively the summary of what is going to happen with respect to ensuring that people have access to the information that they need.

I will read directly from the minister's speech: Schedule 1 will amend the Health Insurance Act 1973 and the Private Health Insurance Act 2007 to: allow for the publication of information about medical practitioners and their billing, including names, locations, fees charged by location and their utilisation of gap cover arrangements with insurers where insurers pay a medical practitioner more if they agree to charge no or fixed out-of-pocket costs allow for the publication of information about hospitals, including medical practitioners who provide services at the facility and insurers that have gap cover or contracting arrangements with the facility allow for the publication of information about insurers, including the proportion of policy holders who experienced different gap cover arrangements and the out-of-pocket costs under those arrangements include an immunity from civil proceedings … Importantly, with these changes and with the additional information that will be provided on the Medical Costs Finder site, no patient information will be published, and the privacy of consumers will continue to be protected.

I believe having that information available to people is critical in ensuring that they can make the choices they need to in order to make a decision that is in their best interests. The government is certainly trying to bring down medical costs for people across the country, and we have done so through a number of measures. This is going to add to that.

I can use the measure of bulk-billing data. As a result of the government's increasing of the bulk-billing incentive for doctors, we've now seen nationally that 81.9 per cent of people are getting bulk-billed, and that's a 4.6 per cent increase. It is higher than at the same time last year.

In South Australia, the figure is 80.4 per cent. That is almost six per cent higher than it was, again, this time last year. In my own electorate of Makin, we are now seeing bulk-billing rates of 85.6 per cent, whereas, in October 2025, before the bulk-billing initiative was expanded to include all Australians, it was just 78.4 per cent.

We now have in my electorate of Makin 17 GP practices that fully bulk-bill, and that is an increase of 10 on what it previously was. I quote these figures only to highlight how, by providing information and additional support, people are able to get their medical needs looked at without being out of pocket in the way they would have been previously. That is a good thing, because if people can afford to see their doctors at the right time, it ensures that they perhaps don't develop further and more expensive complications down the track.

So we need to try and ensure that people get to their doctors when they need to, and that includes their specialists. As I said and quoted from that press release earlier on, when nearly a million Australians are choosing to defer their appointment with their specialist, ultimately it will mean that their medical condition will deteriorate. That in turn means that, when they finally do need the treatment, it will be much, much more expensive for them.

If they don't go to a medical specialist, then their choice is to go to a public hospital. Again, if they go to a public hospital, the problem is that, firstly, the public hospitals are already under pressure right around the country, as we know. But, secondly, they will very likely have to be put on a waiting list, which again means that they're not only suffering for a long period of time but, by the time they come to getting the treatment they need, the costs might have gone up as well.

So it's a lose-lose situation for everybody if we can't get those people who need medical attention treated at the time they are first diagnosed with the treatment that they need. I suspect that, as a result of this legislation, some people who are already on elective surgery waiting lists—by the way, in some cases, people are waiting for a year or more for the surgery or the treatment that they need.

But as a result of this legislation, it is my view that, when people are able to shop around, when people know that there perhaps is a cheaper alternative, even if it means that they have to pay for it themselves, they may well come off the elective surgery waiting list in the public hospital and choose to go to a private specialist because they can now find a private specialist that they can afford to provide the treatment that they need.

Whereas, right now, most people usually get a referral from their GP. The referral is to a specialist that they don't question, and they have no idea whether they could possibly get the same treatment at a much better rate using another surgeon. It's not often that people shop around when it comes to medical treatment.

They usually rely on the advice of their GP, and I think that's going to change as a result of this legislation and change for the better. What it will also hopefully do—this is clearly one of the intentions—in ensuring that people have access to the list of costs for what specialists are charging, is bring some of those fees down a little. As I pointed out earlier, when quoting those costs from the press release that I referred to, some of the fees, in the minds of most people, are unrealistic and, quite frankly, it is time that some of them did come down—even in the medical field.

Every day there is new technology out there—and, yes, sometimes it's expensive—that allows for much more efficient procedures. As a result of that, you would think that perhaps the costs of those procedures would come down. But that hasn't always necessarily been the case.

People just get used to charging a certain fee, and then they continue to do so even though they might be able to deliver the same treatment at a much reduced fee because of the new technology that is around. Again, this is all about bringing down prices and costs for consumers. In my view, that is a good thing.

It is a good thing because people will be able to not only save money but perhaps afford to pay for treatment that they need to get. The other matter relating to all of this is obviously the issue of some private health insurers using the practice of phoenixing. This is where they drop a particular type of cover, pretending that it is no longer available, but then reintroduce it in a different format and charge a lot more money for doing so.

That is going to be outlawed. I welcome the practice because it is stopping people from accessing health insurance, or it is at least increasing the premiums for people unnecessarily. It's interesting to note that in 2024-25 there was $31.1 billion paid in private health insurance premiums.

That is a lot of money that is being paid by families across the country in order to get the health cover they need. Sadly, for many of them, on top of that, when they do need some kind of medical support or treatment, they usually find themselves being out of pocket to the tune of hundreds of dollars if not thousands of dollars. That is a terribly sad thing.

I particularly feel for the people who have chronic conditions—conditions whereby not only is their own lifestyle changed and affected each and every day because of the chronic condition they have, but in most cases a person with a chronic condition will also be someone who probably has to regularly see a specialist of some sort or another. So they not only have to deal with other increased costs in their lives because of their condition, but the constant treatment that they need from the specialist must surely be a burden that many of them would find difficult to face.

I know, from speaking to people in my electorate, that has often been the case. People are really struggling to pay for the treatment they need if it means going to see a specialist. In wrapping up, this legislation is good legislation.

It provides information out there in the marketplace that people will access, and ultimately that will reduce the cost of health services for people who need them throughout this country. I commend the legislation to the House.