Private health insurance regulation: Ethical implications for rural residents

Helene Jacmon1, Fiona MacDonald2,3

1 Monash University, Wellington Road & Blackburn Rd, Clayton VIC 3800,
2 Australian Centre for Health Law Research, Queensland University of Technology, C Block, Gardens Point Campus, GPO Box 2434 Brisbane Queensland 4001
3 Department of Bioethics, Dalhousie University 5849 University Avenue, Room C-315, CRC Bldg, PO Box 15000 Halifax, NS  B3H 4R2, Canada

The Australian Government uses positive and negative incentives in legislation to encourage people to take out private health insurance. The stated purpose of this regulatory framework is to contribute to the sustainability of the public health system through reducing public hospital utilisation. Government also claims that individuals will directly benefit through affordable access to private healthcare. This regulatory framework applies to individuals regardless of their ability to access private healthcare services, and there is no way to freely opt-out. This presentation will focus on two ethical issues arising from the regulatory framework. The first issue is potential constraints on an individual’s autonomy. The presentation will identify if and how autonomy may be constrained, and explore whether this approach may be justifiable by the intended outcomes of the regulatory framework. The second ethical issue relates to the regulatory framework’s application to rural residents. Rural residents have, as a group, significantly less access to private healthcare services, and experience poorer health outcomes compared to their urban counterparts. This raises ethical concerns regarding equitable access to the benefits of private health insurance, and the fair distribution of associated burdens between urban and rural residents. The presentation concludes that the regulatory framework as it is currently applied to rural residents raises significant ethical concerns.


Helene Jacmon is currently studying towards a Master of Bioethics at Monash University. Prior to returning to study Helene worked for the Australian Taxation Office in a variety of roles in administrative policy, law interpretation, and project management. Helene is interested in ethical issues arising from health/social policy and is passionate about justice.

Dr Fiona McDonald is a Senior Lecturer at the Australian Centre for Health Law Research at the Queensland University of Technology and an Adjunct Associate Professor at the Department of Bioethics, Dalhousie University, Canada. She is a co-editor of Health Law In Australia (Thomson 2014), Health Workforce Governance (Ashgate 2012) and a co-author of Ethics, Law and Health Care (Palgrave 2014). Interested in regulation and healthcare, her research interests currently focus on the governance of health systems, including health professionals, health facilities and health technologies, and rural bioethics.

About the Association

The Australasian Association of Bioethics and Health Law (AABHL) was formed in 2009.

It encourages open discussion and debate on a range of bioethical issues, providing a place where people can ask difficult questions about ideas and practices associated with health and illness, biomedical research and human values.

The AABHL seeks to foster a distinctive Australasian voice in bioethics, and provide opportunities for international engagement through its membership, journal and conferences.

Members come from all the contributing humanities, social science and science disciplines that make up contemporary bioethics.

Many members have cross-disciplinary interests and all seek to broaden the dialogues in which all members of the wider community ultimately have an interest.

The AABHL is a supportive, creative and challenging community that provides a rich source of continuing academic refreshment and renewal.

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