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Why payment integrity matters for every health insurance member

Opinion pieces
By Dr Rachel David When Australians pay their health insurance premiums, they expect that money to be there when they need healthcare. It sounds obvious. But it means health funds have a responsibility to make sure that money is being used for its intended purpose. In the year to March 2026, health funds paid more than $27 billion to hospitals and other healthcare providers, including dental, optical and physiotherapy services. When you are responsible for managing that much of your members’ money, you cannot simply pay every claim without checking that it is legitimate, the service was provided and the…
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Who really has health insurance in Australia? The answer might surprise you.

Opinion pieces
By Dr Rachel David One of the biggest misconceptions about health insurance in Australia is that it’s mainly something for wealthy people. The latest Australian Taxation Office data tells a very different story. More than 9.3 million Australians who lodged a tax return in 2023–24 had health insurance. When you look at who those Australians actually are, you find that health insurance is held by a remarkably broad cross-section of the community. More than one-third of insured Australians reported annual taxable incomes below the national median taxable income. Three in five had taxable incomes of $90,000 or less, and more…
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Private Healthcare Facts

Why Private Health Insurance Matters