MICHAEL PASCOE. Profit-rich private health insurers burning billions on non-health costs
May 18, 2018
Australian capitalisms sheltered workshop, the private health insurance industry, is burning billions of dollars a year unrelated to Australians health.
Thursdayslatest statisticsfor the year to the end of March show the industry increased its gross margin to 14.4 per cent, up from 13.6 over the previous corresponding period.
Premium revenue rose 4 per cent, to $23.75 billion, while the insurance companies benefits payments increased by 3 per cent to $20.1 billion.
The resulting health insurance gross margin of $3.65 billion went on expenses of $2.21 billion, tax of $441,000, state ambulance levies of $226,000 and net profits of $1.38 billion.
Thus private health insurers spent $3.65 billion on stuff other than the medical needs of their customers. Thats money that didnt pay for hospitals, doctors, nurses, drugs, prostheses or even the sundry ancillary benefits that are a dubious insurance proposition for customers dental, physiotherapy, optical and chiropractic.
This is an industry that enjoys the federal government acting as its enforcer, pushing customers through its doors, using the cattle prod of tax penalties. It then blows 14.4 per cent of the money customers pay on things other than health care.
Some of that money goes on lobbying the government to ensure the perpetuation of two-class health care. The private insurance companies need at least the perception of the public system being second-rate as part of its sale pitch.
Despite the governments tax carrots and sticks, most Australians 54.5 per cent didnt have hospital treatment cover on March 31. Thats up from 53.1 per cent five years ago. The general treatment sales effort has been more successful 54.6 per cent of us buy it, similar to the 54.7 in 2013.
The numbers on private cover vary widely, but many Australians dont have any. Source: APRA
The industrys grand ambition was spelt out last year by the CEO of one of the two ASX-listed insurers, NIB. Mark Fitzgibbon told the AFR he wanted to bring back the days before Medicare.
We need to be thinking about how do we create a future in which 70 per cent of the population have health insurance, as it did before Gough Whitlam introduced Medicare, he said.
If we spend all our time defending what weve got, well never get that 70 per cent of the population. So what kinds of policy changes and settingsdo we need to incite consumers to that level of participation?What else can we do to give people another reason for having health insurance, particularly young people?
Shamelessly propped up by the tax system, the double act of private hospitals and private health insurance push the line that public hospitals couldnt cope without them, ignoring the inefficiencies of maintaining two systems and what the money spent on private hospitals and insurance could achieve if added to the public hospital budget. Just for a start, theres that $3.65 billion of health insurance premiums that went nowhere on health in the latest year.
Australias mishmash of state-run public hospitals and private hospitals effectively funded by federal government policy has inherent inefficiencies, but is something weve become used to.
It also is a system with massive vested interests that enjoy the power, connections and money to fight to preserve and expand those inefficiencies.
This article first appeared in New Daily

Michael Pascoe
Michael is the contributing editor for The New Daily. Journalist, commentator, speaker, rugby follower, would prefer to be skiing. His book, The Summertime of Our Dreams, is published by Ultimo Press.