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Private health transparency legislation is progressing in Australia, with the Senate Committee recommending the Health Legislation Amendment (Improving Choice and Transparency for Private Health Consumers) Bill 2026 be passed.

RACS has strongly advocated for a model that reflects the realities of surgical care. The Committee acknowledged the concerns raised by RACS and other medical colleges, and identified these as matters to be addressed through consultation during implementation.

A narrow focus on practitioner fees risks misleading patients and overlooking key drivers of out-of-pocket costs, including private health insurance rebates and hospital charges.

RACS is now focused on the implementation phase, working with government to ensure strong clinical input, accurate data, and appropriate safeguards, while continuing to advocate for targeted amendments.

RACS position: support for transparency, with critical safeguards

RACS supports reforms that improve transparency and strengthen informed financial consent. We also support measures that enhance system integrity, including action to address inappropriate practices in private health insurance such as product 'phoenixing'.

However, transparency must apply across the full patient cost pathway, including not only practitioner fees, but also private health insurance rebates and benefit design, which are also drivers of out-of-pocket costs.

We have been clear that the current design of practitioner-level fee transparency requires further development.

Key issues identified by RACS

1. Oversimplification of surgical care
Surgical services cannot be reduced to a single price point. Costs vary based on clinical complexity, patient factors, procedural approach and care setting. Simplified fee reporting risks misleading patients and creating false equivalence between practitioners.

2. Attribution of cost drivers
Out-of-pocket costs are significantly influenced by insurance design, MBS rebates, practice costs and hospital charging. A practitioner-level lens risks misattributing these broader system drivers and obscuring where costs are actually incurred.

3. Data integrity and verification
The Bill enables publication of practitioner-level data derived from administrative sources, including without practitioner input. This raises material concerns regarding accuracy, timeliness and the ability for clinicians to verify or correct information prior to publication.

4. Procedural fairness and accountability
The legislation includes protections limiting civil liability for the publication of data.  This reinforces the need for strong safeguards, transparent methodologies and clear review mechanisms.

5. Expansion to clinical outcomes data
The Bill enables future expansion of datasets. Individual practitioner clinical outcomes should not be published unless they are clinically validated, appropriately risk-adjusted, and interpreted within a robust clinical governance framework. Administrative data alone is not sufficient and risks misrepresenting quality and discouraging care for complex patients.

Risk of unintended consequences

Both RACS and other stakeholders have also highlighted the potential for unintended system impacts, including:
• price convergence, which may increase rather than reduce costs 
• distortion of referral patterns towards price over clinical suitability
• reduced access for patients with complex or higher-risk conditions. 

Broader system context

It is critical that transparency reforms are considered alongside the structural drivers of cost, including the growing gap between Medicare rebates and the cost of delivering care; variation in private health insurance rebates and product design; and the importance of maintaining a sustainable private sector to support system capacity. 

A narrow focus on practitioner fees risks obscuring these underlying factors.

Next steps

The legislation is expected to proceed. The focus will now shift to implementation design, where the detail will be critical.

RACS is actively engaging with the Department, with further meetings underway, to ensure:
• transparency across both fees and insurance contributions 
• clinically appropriate design 
• robust data governance and accuracy 
• fair and transparent processes for practitioners 
• appropriate limits on the use of clinical outcomes data 
• meaningful consultation with the profession. 

Our position

RACS will continue to advocate strongly that transparency reforms must be clinically informed, methodologically robust, procedurally fair, and must reflect the full funding pathway of care, not just practitioner fees.

Without this, there is a risk the reforms will misrepresent care, distort decision-making, and undermine both patient understanding and system performance.

You can view our full submission to the committee.