Increased private health fund involvement in Australia's primary health care

Implications for health equity

Bibliographic Data

ID11228196
AuthorsAlice Windle (0000-0002-5968-2910, Southgate Institute for Health Society and Equity Flinders University Adelaide SA Australia, corresponding author), Matthew Fisher (0000-0003-3756-1146, Southgate Institute for Health Society and Equity Flinders University Adelaide SA Australia), Toby Freeman (0000-0002-2787-8580, Southgate Institute for Health Society and Equity Flinders University Adelaide SA Australia), Franziska Baum (0000-0002-2294-1368, Southgate Institute for Health Society and Equity Flinders University Adelaide SA Australia), Fran Baum, Sara Javanparast (0000-0002-0388-5524, Southgate Institute for Health Society and Equity Flinders University Adelaide SA Australia), Adrian Kay (0000-0002-5854-4516, Crawford School of Public Policy Australian National University Canberra ACT Australia), Martin Kidd (0000-0002-0221-1245, University of Toronto), Michael Kidd (0000-0001-7800-1810, Faculty of Medicine University of Toronto Toronto ON Canada)
Year2018
Volume53
Issue4
Pages338-354
Publication date2018-12-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueAustralian Journal of Social Issues (JOURNAL)
Journal identifiersISSN: 0157-6321 • E-ISSN: 1839-4655
PublisherWiley (PUBLISHER • GB)
DOI10.1002/ajs4.45
OpenAlexW2887196681
LanguageEN
Citations received2
References cited14

This study identifies current practices of private health funds ( PHF s) in Australian primary health care ( PHC ), including areas where their involvement is increasing, and examines the risks and benefits of these practices for quality of, and equity of access to PHC . The paper draws on research to investigate equity implications of current PHF involvement in PHC in Australia. We reviewed literature, analysed documents relating to a Senate Committee inquiry and interviewed stakeholders and experts in private health insurance policy from government, private sector and nongovernment organisations. Involvement of PHF s in the PHC sector in Australia is increasing, presenting risk of increased inequities in access to PHC based on insurance status, which could undermine the universality of PHC under Medicare. However, some stakeholders think these risks can be managed within current policy arrangements. There are also risks for quality of PHC services arising from greater involvement of PHF s in service delivery and “preferred provider” models. Differing stakeholder views on equity implications of PHF involvement in PHC are associated with different views on desirable policy action. We conclude that there is a risk of increased involvement of PHF s in PHC risks exacerbating existing inequities in the health system, but this is moderated by public support for Medicare

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