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Australians’ poor perceptions of the public health system and surgery waitlists are driving them to take out private health insurance in growing numbers, despite cost-of-living pressures.

Private health funds say they have been surprised by the latest data from the Australian Prudential Regulation Authority that reveals 13 straight quarters of membership growth, even as rising interest rates strain household budgets.

Significant waitlists of tens of thousands of people remain in both the NSW and Victorian public hospital systems.Credit: iStock

Just over 45 per cent of Australians had hospital insurance in the September quarter and 55 per cent had general cover for extras like dental, optical and physiotherapy – the highest membership rates in more than five years.

Rachel David, the chief executive of industry peak body Private Health Australia, said numbers began to turn around during the COVID-19 pandemic and the decline that preceded it had now been reversed.

“We haven’t seen this growth trajectory in an inflation environment before and it’s important for us to understand what’s going on,” she said, noting that industry research commissioned by her organisation showed declining confidence in the public health system and demographic factors were driving the uptick.

The pandemic created long backlogs for elective surgeries and while they have since shortened, recovery has been slow. Significant waitlists of tens of thousands of people remain in both the NSW and Victorian public hospital systems.

“There is a perception that public hospitals are struggling and you might not get the best care when you need it. It [membership growth] is down to increased surgery waiting lists but also the stories about ambulance ramping, and as a result of that, poor care in emergency departments,” David said.

“That’s even holding strong in areas where demand is elastic and expensive, like maternity care, which was declining in popularity for some time because of the cost. Now it’s rising in spite of the cost.”

Parents taking out insurance for their financially stretched adult children – enabled by a new rule that last year allowed under-30s to be added to family packages – was another factor behind growth.

The greatest surge in hospital cover in the 12 months to September was in the 20- to 29-year-old age group, where membership grew by 5.4 per cent.

David said the other two demographic factors helping drive memberships were higher incomes for professional women, who tended to prioritise health for themselves and their families, and the arrival of skilled migrants who worked in the health sector.

The statistics mirror commentary from health insurers during the year. Medibank chief executive David Koczkar told investors last week that the cost-of-living crisis was an issue for customers, but they were choosing to cut back on other areas to preserve their health insurance.

“People are continuing to prioritise their health and wellbeing. The ongoing challenges in the public system have only amplified this … Customers are more likely to cut back on discretionary areas of spending like entertainment, dining out and holidays rather than drop their health cover,” he said.

nib boss Mark Fitzgibbon made similar comments after his company’s full-year results announcement in August.

“We don’t celebrate the fact that you may wait three years for a joint replacement in the public system, but it’s clearly driving the level of increased participation in private health insurance,” he said.

Morgan Stanley analyst Sean Laaman said there was a record number of hospital-insured Australians; more than 12 million now had hospital cover.

“[Private health insurance] membership continues to be stickier than thought,” he said.

Consumers Health Forum chief executive Dr Elizabeth Deveny said she was also hearing that elective surgery waitlists were leading people to keep their cover.

“Private health insurance for many people isn’t cheap and you would think with a cost-of- living crisis the rates would start to drop off. But we aren’t seeing that,” she said.

“We do have a concern about people taking private health insurance, getting the health care they need and then cancelling their insurance shortly afterwards. We have heard anecdotally that this is happening, which could raise a sustainability issue with private health in the future.”

Deveny said there were concerns that people would lose continuity of care by moving between the private and public hospital system, and that the trend would exacerbate inequality issues in healthcare.

At the same time as private health membership has increased, a record proportion of Australians also said they delayed or cancelled GP appointments they needed because of the cost.

“It is important, though, for people to remember that Australia has an excellent public hospital system and whether you have insurance or not, you will receive medical attention, especially in an emergency,” Deveny said.

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