The public view of private health insurance, CHERE Discussion Paper No 45

Until the 1996 Federal election, the Liberal Party remained committed to the repeal of Medicare. In that election the Liberal platform endorsed the continuation of Medicare, and support for private health insurance. Since then the Government has pursued a strategy of support for private health insurance involving three stages: one, rebates for the poor and penalties for the well-off; two, universal rebates; and three, departure from community rating to what has been described as ?lifetime health cover?. This paper reviews the coverage by the quality media of the private health insurance issue from the beginning of 1996 (prior to the beginning of the formal election campaign) to the end of 1999 (after the announcement of lifetime health cover). Over 500 articles were reviewed. Federal elections and budgets are most likely to trigger articles on private health insurance. The topic has become newsworthy, with stories now appearing which report only changes in insurance coverage. Most articles report differing perspectives on the issue; however, opposing views are frequently given little column space and appear at the end of the article. While many articles report events in a factual way, there are a significant number which provide only one perspective or viewpoint. The media rely heavily on authoritative experts and these are usually spokespersons for the private sector and the organised medical profession. When independent figures are quoted, there has been no disclosure of any financial or other links with the private health sector. The story angle was generally conflict between the various stakeholders, although the politics of health policy was also a major theme. The editorials, in contrast, urged a view of what was good for the country, rather than the winners/losers in a political conflict. The Age and the Sydney Morning Herald (SMH) took quite different stances on the issue of access, hospital costs and the importance of community rating. Clearly, the media has a role to inform. Many articles are a means of disseminating new policies, or explaining their detail, or advising individuals of the implications for them. However, the media has also defined what and why private health insurance is a problem, floated unpopular policy responses, defined the solution and popularised it. For those concerned to see public debate on private health insurance, to promote information and evidence as a basis for policy, and to see community values inform health policy, there is little here to encourage.