1. The ACCC & Private Health Insurance Sarah Court ACCC Commissioner Private Health Insurance Code of Conduct Code Seminar July 2015

2. Outline The ACCC - who we are and what we do Why the ACCC is relevant to the private health insurance sector The private health insurance reportQuestions??

3. Who we are and what we do Competition & Consumer Act 2010 Lawful Competition Consumer Protection & Product Safety Regulated Infrastructure Making Markets Work

4. The Commission Chairman Rod Sims Deputy Chair Consumer Delia Rickard Deputy Chair Small Business Michael Schaper Commissioner Jill Walker Commissioner Roger Featherston Commissioner Sarah Court Commissioner Cristina Cifuentes

5. Compliance & Enforcement Strategy Takes about 30 matters to court + 15 court enforceable undertakings + 20 infringement notices 130 in-depth 500 investigated 200,000 contacts

6. Cartel conduct Anti-competitive agreements and practices Misuse of market power Product safety issues 2015 Priorities Truth in advertising; claims made by big businesses Competition & consumer issues in the health and medical sectors Cartel conduct impacting on government procurement Compliance with new or amended industry codes of conduct Product safety through minimising the supply of unsafe goods Emerging systemic consumer issues online Competition & consumer issues in highly concentrated sectors Disruption of scams that rely on building deceptive relationships Carbon tax cost savings being passed through to consumers Consumer protection issues impacting on Indigenous consumers Older consumers and people who are newly arrived in Australia Enforcement Priorities

7. Why the ACCC is relevant to the private health insurance sector

8. We have received allegations about attempts to limit access to products, patients, procedures or facilities

9. The ACCC is focusing on misleading or unconscionable conduct... we are looking at efficacy claims that are not supported by scientific evidence

10. Benefits of Industry Codes of Conduct TransparencyConfidenceCompliance Marketing advantage FlexibilityLess intrusive Ownership Quality control Complaint handling

11. Criteria for an effective Code Stakeholder consultation Measurable objectives Complaint handling procedures Independent review Consumer awareness Data collection Monitoring & evaluation Regular reviews & reports Performance indicators

12. The private health insurance report The ACCC reports to the Australian Senate on ‘any anti-competitive or other practices by health insurers or providers which reduce the extent of health cover for consumers and increase their out-of-pocket medical and other expenses’.

13. 2013-14 Private Health Insurance Report The ACCC is interested in understanding whether there are problems relating to information provision in the health insurance industry. Report published August 2015 Consumer survey Meetings with industry 50 submissions received ACCC invites submissions

14. Issues raised in submissions Code sanctions Standardised models Communicating policy changes Out of pocket expenses Information statements

15. Questions?