Private Health Insurance Amendment (Modernising the Private Health Insurance Rebate) Bill 2026

Dr FREELANDER (Macarthur) (12:53): I've worked in the healthcare system for over half a century. The Private Health Insurance Amendment (Modernising the Private Health Insurance Rebate) Bill 2026 is about equitable access to health care, as really all of the government's healthcare policies are, and it's a very important bill. I should point out also that I'm affected by this bill.

I'm well over the age of 65. I've paid private health insurance since I was 18, as did my parents, my grandparents and, I suspect, also my great-grandparents. I strongly believe in taking responsibility for your own health care and your family's health care if you can afford it.

It's a very important, fundamental practice in a country like Australia. It's an important bill because it goes to the fundamental question of how we fund health care in Australia. It asks us to consider not simply what governments spend but whether the way we spend taxpayers money is fair, equitable, sustainable and delivering the greatest benefit to the Australians who need care.

The Labor Party is the party of health care. That's one of the reasons that I'm a member of the Labor Party and why I stand here in this parliament. It's a party of health care and always will be.

We will always defend equitable access to health care. We believe in the importance of public healthcare initiatives, such as Medicare, the PBS system and urgent care clinics. We believe in the importance of public hospitals; hence, our record of investment in them across the nation, as well as access to primary care and specialist care.

We're aware of the importance of private health insurance. We believe in the hybrid model that we've had in health care in Australia for many years. I've worked in the public hospital system for many years, and our hybrid model of care is the envy of the rest of the world.

We also believe strongly in the equitable access to care. At present, Australians aged 65 and over receive a higher private health insurance rebate than younger Australians, and I don't think that's fair. I don't think it's fair that my private health insurance is cheaper than my kids' private health insurance with their young families.

I just don't think that's fair. As an older Australian, I know that I will need to use more of our health system, particularly our public hospital system, than younger people. I don't think it's fair that I should pay less for that, and that is what this bill is all about.

This bill removes the age based uplift which I don't believe is fair. From 1 April 2027, the rebate will be calculated on the same basis for Australians aged 65 and over as it is for people aged under 65, which is only fair, with income remaining the basis for determining the rebate. I think that is fair.

This is a reform about fairness and impartiality. It's about making sure that every dollar we responsibly redirect from one part of the health system can do more good somewhere else. It's important to know that we also live with an ageing population, so the demands on health care will be greater.

It's up to us as a government to make sure that every dollar of healthcare spending is spent in the most efficient way. It's important to be clear that this bill does not abolish the private health insurance rebate, as some from the opposition are saying, nor does it abolish private health insurance. In fact, it encourages private health insurance.

Because we have community rating, younger people don't have to continue to overly subsidise the health insurance of older people. It does not undermine the role that private health insurance plays alongside our public health system. As I've said, that hybrid system has worked well for generations.

As I've said, it's the envy of the rest of the world. I've examined health systems throughout the developed world, and ours is probably the best. It doesn't undermine the role that private health insurance plays alongside our public health system in providing the best possible care in the 21st century.

The private health insurance rebate remains. What we are changing is the additional age based loading that currently means an older Australian can receive a higher rebate simply because they've turned 65. We also need to be clear about the choices confronting our healthcare and aged-care systems.

The money saved by this reform is not disappearing, nor is it being used to fund tax cuts for the wealthy. Our government has made a clear commitment that these savings will be reinvested in aged care. We are living with an ageing population that continues to grow older and we do need to increase the funding in the aged-care system.

There's no question about that, and that's what our government is doing. This measure is expected to save $3 billion over four years and about a billion dollars every year after that. That is $3 billion that can be put towards more residential aged-care beds, more home-care support and better care for older Australians.

That's a very important distinction. This is not simply a savings measure. This is a way of getting better, more equitable access and more efficient use of the health dollar.

It's a reprioritisation. It is taking money currently used to provide a higher rebate on private health insurance premiums for older people and redirecting it towards a more fundamental need—making sure older Australians can access the care they need when they need it. The reality is that Australia is ageing and more Australians are living longer, and, as they are living longer, their healthcare needs are increasing.

That's something that we should celebrate: amongst the developed world, we have one of the highest life expectancies—far higher than the United States, for example, that spends almost twice what we spend on health care. We should celebrate this and we should celebrate the fact that our healthcare and aged-care systems support older Australians. With longevity, however, there are responsibilities, and that means we should be responsible, as older Australians, for paying our fair share of health costs.

It means that we need to make sure that we take responsibility when we can for our own health care. We do need more aged-care places. We do need more aged-care workers.

We do need more home-care packages. There's no question about that. We all know that our offices are often contacted by people needing access, either for themselves or their aged relatives, to aged care.

We need to make sure that an older Australian who can no longer safely live independently is not left waiting, and we need to make sure that an older person who is medically ready to leave hospital has somewhere appropriate and dignified to go to. It's not simply an aged-care issue; it's also a hospital issue. Every hospital bed occupied by someone who is clinically ready to leave hospital is a bed that cannot be used for another patient who needs acute aged care.

We need to make sure that we can provide that, and I think every member of this House would agree with that. These sometimes are difficult choices to make, and we have a government that is willing to make those hard choices to support our healthcare system. We've seen that with increased Medicare rebates for GPs.

We've seen it with higher bulk-billing rates. We've seen it with better hospital access. This investment in aged care is also an investment in our hospitals.

That's why the Albanese government's record on public hospitals matters so much and why we have done so much to increase our hospital funding. When Labor came to government in 2022, we inherited a health system that was under enormous pressure and hadn't changed for many years. Bulk-billing had been declining.

Patients were waiting longer to get care. Our elective-surgery waiting lists were getting longer and longer. Emergency departments were under a lot of pressure, and they still are.

Our public hospitals were dealing with years of inadequate Commonwealth funding growth. We have turned that around and we've changed that trajectory completely. Under the new, 2026-2031 National Health Reform Agreement, the Commonwealth is providing an additional $25 billion for public hospitals.

That takes Commonwealth funding for state run public hospitals to a record $220 billion over five years. That's an extraordinary investment in Australia's public health system. It's three times the additional funding provided under the previous five-year agreement.

We have done an enormous amount and will continue to do so. There are still concerns in our public hospital system; we know that. State governments have underfunded the public hospital system persistently for years, and the Commonwealth government is having to pick up a lot of that slack.

Our emergency departments continue to be terribly stressed, and waiting times to be seen in our emergency departments are not acceptable. It demonstrates that there are continuing concerns, and the federal Labor government is really dealing with that by getting more extra supports and more funding for our public hospital system than there have ever been. It demonstrates that there's something fundamental about the Labor Party's health policies, and we continue to make sure that we do the very best we can to make sure health spending is equitable across the system for everyone.

We believe in Medicare. We believe in our public hospital systems, and we fund them. At the present time, as chair of the House of Reps health committee, we are undertaking now a deep look into access to specialist care in the 21st century, and that will again provide more support for our public health system.

We believe in it and we fund it, and we are doing our best to make sure we're making our health system fit for purpose for the 21st century. We believe in it and we fund it, and we are doing our best to make sure we're making our health system fit for purpose for the 21st century. Part of that is redirecting health spending, as we've said, and this bill is an important part of it.

We believe in public hospitals, and we don't just say it; we do something about it. We invest in them. And we believe that older Australians deserve dignity and quality care, not just in the healthcare system but also in the aged-care system, and we're doing something about it.

We're prepared to make difficult decisions. The health system is made up of a whole lot of vested interests, and some people will not be happy with this decision, but I am convinced it's the right one. It's the right one for our community and for our country.

We believe in what we are doing. In contrast, the coalition, unfortunately, really has no effective public health policy. I just have to mention their policy on tobacco excise.

It's really a terrible public health policy, and I hope that we never see it implemented. We have a health minister and a government who believes in public health and in public health policy, and this is part of it. We've seen what happens when public hospitals are treated as someone else's problem, and we don't want that.

We've seen the consequences of funding cuts with the Abbott government, for example, cutting back on healthcare costs in the public system. It was terrible. We've seen the consequences of shifting costs onto the states and territories and allowing pressure to build throughout the health system.

Labor's approach is very different. It is something that I deeply believe in. I know we are doing the right thing, and I recognise that it is our responsibility to make those difficult decisions.

We recognise that public hospitals are an essential part of Australia's universal healthcare system, and we recognise that aged care is not just an optional extra; it's an essential service. That's why we need to make sure our health funding costs take that into account. It's part of the social contract that we have between the generations and with our community, and we want to make sure that people feel confident in our health system as we evolve into the 21st century.

There are many more challenges. Health treatments are changing. We need to change our system.

The Medicare system was designed a long time ago. We need to make sure that we take into account some of the new treatments—for example, the infusion based treatments for autoimmune disease, which sometimes require hospital admission to have that take place. We need to make sure we fund that properly.

The new CAR T targeted cancer treatments require both Commonwealth and state support to make them happen. Some of the new treatments for genetic disorders, such as we've seen for cystic fibrosis and spinal muscular atrophy, require ongoing support from both the state and federal health systems. These are changes that are dramatically changing our health system.

We've heard recently about the mRNA cancer treatments developed by Moderna and the first clinical trial occurring in Australia, with the Melanoma Institute at the Mater Hospital at Sydney. It has really changed the whole playing field for cancer treatments. Melanoma will now be a cancer that can be managed, not a universally fatal death sentence.

These are dramatic changes, but they need to be accommodated by changes in our healthcare system that it's never had to deal with before. These things will be happening as we evolve into the next century, and we need to make sure that our health system is fit for purpose for this. The private health insurance system now has to deal with things like Hospital in the Home treatments, which weren't available until recently.

These changes are dramatic. They're changing our health system. We have a government that supports it.