Health insurance design: choices, consumer behavior and policy challenges

ARC Future Fellowship

The challenge​

Rising health costs are a global challenge. Creating an efficient health insurance system is a key policy concern in all developed countries. This project aims to study choices, consumer behaviours, and policy challenges in two health insurance markets: Australian private health insurance (PHI) and US Medicare prescription drug insurance.

Expected outcomes include new evidence needed to develop a new framework for PHI, new knowledge on how consumers respond to complex pricing structures and new policy proposals to improve the overall efficiency of the health system. The research will benefit the redesign of PHI and the health system, to improve Australians’ health while reducing health costs.

The research​

This project investigates consumer choice, behaviours, and policy challenges in health insurance markets. Specific aims are:

  • To evaluate factors affecting recent changes in the take-up rates of PHI among different age groups;
  • To evaluate the effectiveness of key government incentive regulations on the uptake of PHI;
  • To evaluate the effects of PHI on the expansion of hospital use and the substitution between public and private care;
  • To investigate the effects of PHI on the quality of care and waiting time in public hospitals.
  • To develop alternative policies to fund private and public care.
  • To study how consumers respond to complex price structures in their demand for medicines and how consumers anticipate price changes to change their current consumption

The impact​

Professor Zhang has made significant contributions to the field of private health insurance (PHI) research in Australia, substantially influencing both policy and public understanding. Her work has provided crucial insights into the complex interplay between public and private healthcare financing within Australia's universal healthcare system.

Zhang and her team have conducted comprehensive evaluations of major government incentive policies on PHI uptake and utilization. Their research has shed light on the effects of policies such as rebates, the Lifetime Health Cover and Medicare Levy Surcharge. Notably, their findings suggest that the government should reduce public support and regulations in PHI.

Professor Zhang has been invited to provide feedback on PHI reforms to Australian and international government bodies, including the Department of Health and Aged Care. She has organised and led discussions with policymakers, facilitating direct dialogue between researchers and decision-makers in the health insurance sector. Her team's research has had tangible policy impacts. For instance, when the government was considering requiring people to buy more expensive plans to avoid the Medicare Levy surcharge, this proposal was dropped after considering the team's research, which did not support the change.

To bridge the gap between academic research and public understanding, Professor Zhang has written several articles in The Conversation, reaching over 400,000 readers, and has been interviewed numerous times by journalists and reporters. Through these efforts, she has played a crucial role in educating the general public about government tax and rebate incentives related to PHI, helping to demystify complex policy issues for a broader audience.

Our researcher

Melbourne Institute - Yuting Zhang.

Our partner

Australian Research Council Future Fellowship

Publications

Media