Welcome to your October newsletter
There’s been plenty of discussion this month about the future of Australian healthcare, and some increasingly pointed questions about how we pay for it. Rising out-of-pocket costs, the debate over the private health insurance rebate, and reform proposals from Bupa, Ramsay and HCF all reflect a system under pressure. There’s broad agreement that things need to change, although the views on what should change, who should pay and who should take responsibility look quite different depending on where you sit.
Alongside those immediate debates, the longer-term forces keep gathering momentum. An ageing population will need more care, while workforce and affordability pressures will make it harder to keep delivering that care in the same ways. To me, that strengthens the case for earlier intervention, better support at home and more deliberate investment in keeping people well. The challenge is turning those ambitions into services that members can access, providers can deliver and funds can sustainably support.
These are also the conversations I’ve been having with PHI leaders. Recent PHI FACTORS™ Leadership Labs with multiple funds gave their teams space to explore the forces reshaping healthcare, challenge their assumptions and consider what different futures might mean for their organisations and members. I’ve shared their generous feedback below. What I particularly enjoy about these sessions is seeing a conversation move from “what might happen?” to “what does that mean for the choices we’re making today?”
A question I keep coming back to is how far health funds want to extend their role in members’ lives, and what it will take to earn that role. Helping someone navigate care, manage their health at home or avoid a future hospital admission requires different capabilities and relationships from paying a claim. It also raises some important choices about where to build, where to partner and how to demonstrate value along the way.
That thread runs through this month’s articles and my Innovation Insider conversation with Joey Colandra, which explores why promising healthcare ideas so often struggle to scale. It’s also central to my work on the 2026 PHI Innovation Report, examining how the five largest funds are responding to the forces reshaping the sector. Registrations are now open, and I’m looking forward to sharing what’s emerging.
Thanks, as always, for reading. I hope this month’s edition gives you something useful to bring into your own conversations about what comes next. Don’t forget to subscribe to stay updated with the future of private healthcare 👇🏻.