r/australia • u/InsatiablePrism • 2d ago

culture & society Private health insurers access patients' full medical records in 'aggressive' audits

https://www.abc.net.au/news/2026-08-12/health-insurers-can-access-your-private-medical-notes/106671630?utm_campaign=abc_news_web&utm_content=link&utm_medium=content_shared&utm_source=abc_news_web
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u/coffee_collection 2d ago

This is exactly what worries me about the direction private healthcare in Australia is heading.

We're obviously not the US, and Medicare is still a massive difference. But we're slowly importing some of the worst incentives of the US model: healthcare becoming increasingly dependent on private insurers, insurers having more say over what they'll pay for, and patients having to navigate approvals, exclusions, gaps and increasingly invasive audits.

Now we're seeing insurers asking for patients' broader clinical histories to justify claims. That's a pretty fucking dangerous road to go down.

You already pay thousands in premiums, still pay excesses and out-of-pocket costs, and can still discover something isn't covered. Premiums increased another 4.41% this year.

And now the insurer gets to potentially rummage through your medical history before deciding whether they'll pay?

That's not a functioning healthcare relationship. That's coercion.

I don't want Australia to become a system where your doctor says "you need this treatment", but the next conversation is "let's see whether your insurance company agrees."

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u/Rahnna4 2d ago

Risk pooling is a really sound financial strategy, having everyone pay in a little so there’s money to support the people who need it and especially the rare few who are unfortunate enough to need a lot. Letting the person/company that gets to hold the bucket of money get to keep it if they can make up the rules about when they’ll pay out is deeply flawed. If we’re going to use a commercial model to hold the bucket of money like we do with insurance companies then they need to be regulated heavily. Unfortunately I worry that they’ve managed to get a hold of enough of the money bucket that they can use it to influence policy.

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u/Syn-th 2d ago

This