INDUSTRY PERSPECTIVE
State of private healthcare in Australia
Australia’s healthcare system is often described as a mixed system, with a combination of public and private providers. While public healthcare through Medicare provides universal coverage for essential services, private healthcare offers additional options and amenities for those who can afford them.
Private Healthcare Australia (PHA) is the Australian private health insurance industry’s peak representative body that currently has 21registered health funds throughout Australia and collectively represents 98% of people covered by private health insurance. PHA member funds today provide healthcare benefits for over 14 million Australians.
Dr. Rachel David is the CEO of Private Healthcare Australia, which is a policy, advocacy and research organisation that represents Australian health insurance funds and their members.
Australian Health Journal spoke with Dr David on the trends seen in private healthcare in Australia, including the impact to private specialist consultations from workforce issues in primary health. In rising costs of living pressures to household budgets, she comments on how the industry is showing the value of private healthcare.
According to Dr. David, the services that private health insurance policyholders use are related to their age and the availability of particular services in the public hospital system.
In recent years, some procedures that were once performed in the public sector have been almost entirely shifted to private healthcare. For people under the age of 50, the predominant claim for private health insurance is mental health, followed by reproductive health and obstetrics. For men, another group claims for sporting injuries and other accidents that cannot be fixed quickly. For people aged 55-65 and 70, most claims are in the orthopaedic space, including hip replacements, knee replacements, and procedures for back pain. These are the big drivers for people to have private health insurance due to the long wait times in the public sector. As people get older, into the frail aged group, claims are related to heart disease and vascular disease, such as stents in the heart for coronary artery disease, or more major procedures like valve replacements for heart failure.
Private health insurance also covers services provided by allied health under extras cover for people seeking care in the community. The biggest claims under extras cover are for dental care, with people seeking low-cost or free dental care for things like scale and clean basic dental services and checkups.
Dr. David notes that there are a number of trends in private health insurance that have been enhanced as a result of the pandemic and the impact on the Australian economy. There have been a number of quarters of growth in private health insurance since March 2020, which is when the pandemic kicked off in Australia. This growth is due to skilled migration, more women entering the workforce, and younger people remaining on family policies until the age of 31.
On the provider side, Dr. David notes that there is a rapid return of procedural medicine into the private hospital system after the lockdowns. However, in some particular health areas, particularly mental health and rehabilitation, doctors are preferring to manage patients out of the hospital and in the community. Private health insurance providers are hoping to move with this disruption and encourage regulators to permit them to fund more care in the community and shorter stays in hospitals for people with mental health conditions and short-stay surgeries.
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Family biz succeeds in vaccine approval & distribution
It’s been 10 years since Jenny and Karl Herz started in business. Over the past 10 years they’ve launched Biointelect and Biocelect businesses to help secure approval and distribution for new medicines into Australia.
In this Australian Health Journal interview, Jenny and Karl talk about the journey the husband and wife team took to get the Novavax COVID-19 vaccine (Nuvaxovid) approved and distributed in Australia. The journey didn’t just include talented and diverse skilled staff but also their children working in both organisations.
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Using human skin hair follicles to treat Alzheimer’s disease
Professor Michael Valenzuela is a science opinion leader, innovator and creative thinker with a career-long commitment to the prevention and treatment of dementia.
Following that he completed graduate medicine and medical training at the Prince of Wales Hospital. In 2012, he established the Regenerative Neuroscience Group at the University of Sydney, and in 2017 became the university’s first Professor of Regenerative Medicine.
Professor Valenzuela’s group discovered a new cell type with potential for regenerative medicine, a rare neural precursor cell found deep within the human hair follicle. He is the main inventor on several related patents and is the Founder and Chief Scientific Officer of Skin2Neuron – a biotech company developing the first neurorestorative cell therapy for Alzheimer’s disease based on this work.
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Diary of a Paramedic in a primary health care clinic
Alecka Miles is a lecturer at Edith Cowan University and works as a paramedic in a multidisciplinary team at Dianella Family Medical Centre in Metropolitan Perth, Western Australia.
Community paramedic roles have a history in Australia, dating back to 2007 in New South Wales and followed by similar initiatives in South Australia and New Zealand. Alecka’s position emerged after she sought to evaluate how paramedics could integrate into general practice, ultimately leading to a job offer post-COVID lockdown in 2020. Her skills, particularly in cannulation, proved valuable as healthcare shifted towards primary care.
