T

he Health Legislation Amendment (Improving Choice and Transparency for Private Health Consumers) Bill 2026 has moved a step closer to becoming law in Australia, following the release of a report by the Senate Community Affairs Legislation Committee recommending that the Bill be passed.

The Royal Australasian College of Surgeons (RACS) contributed to the inquiry and raised a number of concerns shared by medical specialists and other colleges. While these concerns were acknowledged in the Committee’s report, it concluded they could be addressed during the implementation phase.

RACS will now focus its advocacy on ensuring strong clinical input into how the reforms are designed and delivered.

Supporting transparency, with the right safeguards
RACS supports measures that improve transparency and strengthen informed financial consent for patients.

We also support action to improve system integrity, including addressing inappropriate practices in private health insurance.

However, transparency must reflect the full cost of care. Out-of-pocket costs are not determined by practitioner fees alone. They are significantly influenced by private health insurance rebates, benefit design and hospital charges.

A narrow focus on practitioner fees risks giving patients an incomplete and potentially misleading picture.

Key issues raised by RACS
RACS has identified several areas where the current design of the reforms requires further development.

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

Attribution of cost drivers
Out-of-pocket costs are shaped by multiple factors, particularly insurance design and rebates. A practitioner-level view risks mi-sattributing where costs arise.

Data accuracy and verification
The Bill enables publication of practitioner-level data drawn from administrative sources, including without clinician input. This raises concerns about accuracy, timeliness and the ability for practitioners to verify or correct information.

Procedural fairness and accountability
Provisions limiting civil liability for published data reinforce the need for strong safeguards, transparent methodologies and clear review processes.

Potential expansion to clinical outcomes data
The legislation allows for future expansion of datasets. RACS maintains that individual clinical outcomes data should only be published where it is clinically validated, appropriately risk-adjusted and interpreted within a robust clinical governance framework.

Risk of unintended consequences
RACS and other stakeholders have also highlighted potential unintended impacts, including:
• price convergence, which may increase rather than reduce costs
• changes in referral patterns driven by price rather than clinical need
• reduced access for patients with complex or higher-risk conditions.

The broader system context
Transparency reforms must be considered alongside the structural drivers of cost in the health system.

These include the gap between Medicare rebates and the cost of delivering care, variation in private health insurance products and benefits, and the need to maintain a sustainable private sector to support overall system capacity.

Next steps
With the legislation expected to proceed, attention now turns to implementation.

RACS is actively engaging with government to support a model that includes:
• transparency across both practitioner 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 for transparency reforms that are clinically informed, methodologically robust and procedurally fair.

For patients to make genuinely informed decisions, transparency must reflect the full funding pathway of care not just one part of it.
Without this, there is a risk of misrepresenting care, distorting decision-making and undermining both patient understanding and system performance.

Read our full submission to the committee. [link]