Authors
Jeffrey Cl Looi, Stephen Allison, Tarun Bastiampillai, Steve Kisely, Wai-Man Liu
Published in
Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists. Pages 10398562261474429. Aug 02, 2026. Epub Aug 02, 2026.
Abstract
The viability of the Australian private healthcare sector, and hence, private psychiatric care, is determined by a range of complex, inter-related factors. The private health insurance industry and Medicare reimbursement partially underwrite the costs of procedures, private hospital care and some allied healthcare. Psychiatric hospital cover sits almost entirely within the most expensive private health insurance Gold tier cover. Private outpatient fees are set by medical specialists, and patients receive a Medicare reimbursement for these consultations. There has been increasing concern regarding out-of-pocket costs for patients accessing private psychiatric hospital and outpatient care. A substantial 15% of all health expenditure in Australia is paid directly by individuals as out-of-pocket costs - almost double the share contributed by private health insurers. It is estimated that 72% of these out-of-pocket costs is attributable to individual-physician fee variation. Instead of focussing on providers or payors, a systemic private healthcare regulatory approach is needed to address the overall costs issue.
PMID:
42543611
Bibliographic data and abstract were imported from PubMed on 03 Aug 2026.
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