Croakey recently linked to the four volumes of the Federal Department of Health and Ageing’s brief to the incoming government, which were released following FOI requests.
It struck me at the time that there was a striking lack of reference to the widespread concerns that have been raised around the equity and cost of private health insurance incentives. But I also acknowledged that I may have missed any such mention, given my quick scan of these hefty tomes.
And this is why I so enjoy the online world. A Croakey reader took up where I left off. This reader not only searched the documents properly for all references to private health insurance (you can read them below) but created a single, searchable document that others can now search.
The Croakey reader (who wishes to remain anonymous) wrote:
With respect to private health insurance, I don’t think you missed anything earth-shattering: out of curiosity, I optical character read (OCRed) all four of the scanned AGDoHA FOI documents (via the excellent and free Google Docs service) to make them searchable, and looked for all instances of “private health insurance”. The relevant excerpts are below (the OCR process is rather imperfect, hence the many spelling errors).
Other readers can access the OCRed version of the AGDoHA documents at http://goo.gl/waTq2 – it is a 100MB PDF file which needs to be downloaded, but then Acrobat Reader or other PDF viewers can be used to search it for arbitrary words, phrases or names. The full (non-free) version of Adobe Acrobat will also perform OCRing on scanned text in PDF documents, and may do a better job than Google Docs, but I don’t have access to it.
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Major Australian Govt health and ageing programs 2009-10
Estimated actual expenses 2009-10 accural basis ($ billion) and percentage of Aust. Govt health, ageing, sport and recreation estimated annual actual expenses
Medicare benefits: $16.2B (25.5%)
National Healthcare Agreement: $12.0B (19%)
Aged care and population ageing: $11.0B (17.3%)
Pharmaceutical benefits: $9.5B (15%)
Private Health Insurance Rebate: $4.6B (7.3%)
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Private health insurance (PHI) can be used by an individual to partially or fully cover the out-of-pocket costs of treatment as a
private patient in hospital, and a range of ancillary medical services. Government support for access to private health services has been through Medicare benefits and the PHI rebates.
As of December quarter 2009, 44.7 per cent of Australians were covered for private hospital treatment. Private sector hospitals
provided 40 per cent of the 8.1 million hospital separations (episodes of care) in 2008-09. Private hospitals provide the majority of procedures in some areas of acute care, such as major procedures for obesity, knee procedures, and chemotherapy.
The majority of the health workforce is employed in the private sector, and corporatisation is increasingly becoming a key
organising factor for delivery of services such as general medicine (by GPs), pathology and diagnostic imaging.
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Appendex A1.17 to Key Decisions brief
Private Health Insurance Administration Council (PHIAC)
17 Sep 2010 Indicate the Minister’s
preference for appointing two PHIAC Members.
The terms of two PHIAC Members expire on 16 March 2011 and the Minister will need to indicate whether they wish to:
reappoint the incumbents; test the ñeld through an open recruitment process; or appoint candidates of the Minister’s own
choosing.
A critical date of 17 September 2010 was identified to allow time for a recruitment exercise to be undertaken if this is the
Minister’s preferred approach, seek the approval of the PM or Cabinet, and appoint the PHIAC Members by 16 March 2011.
If necessary, the Minister may appoint the two PHIAC Members for a further three months under the provisions of the Cabinet
Handbook without
Subject to the Minister’s preference, the Department will undertake the necessary recruitment and/or consultation process for
appointments. Once the recruitment and/or consultation processes are finalised, the Department will prepare a Minute and
the required Cabinet documentation to allow Prime Ministerial or Cabinet approval of the appointments. On approval, the
Department will prepare a Minute to the Minister and Instruments of Appointment for the Minister’s signature to give effect to
the appointments
Mr Richard Bartlett A/ g First Assistant Secretary, Medical Beneñts Division (Telephone: (02) 6289 1016)
Contact: Mary McDonald, First Assistant Secretary, Regulatory Policy and Governance Division,
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Private Health Insurance Administration Council (PHIAC)
W28 Sep 2010
Decide two PHIAC member appointments that are currently vacant.
A merit based selection process has also been conducted for two PHIAC member roles that are currently vacant and
recommendations are ready to forward to the Minister for consideration. The previous appointments ceased on 28 August 2010,
When the new appointments are finalised, one of the four PHIAC members will need to be appointed as Deputy Commissioner.
While the Private Health Insurance Act 2007 does provide for the Council to operate with a Commissioner and at least two other members, as it is operating now, this is neither optimal or usual practice. It may draw criticism that the regulator is not operating effectively because it does not have a full complement of members.
Mr Richard Bartlett A/ g First Assistant Secretary, Medical Beneñts Division (Telephone: (02) 6289 1016)
Private Health Insurance Administration Council (PHIAC)
28 sep 2010
Decide the PHIAC Commissioner
has been conducted for the
Conunissioner role. The Minister’s recommendation for Cabinet Secretariat, however the appointment process was not finalised prior to the commencement of the caretaker period.
A merit-based recruitment process appointment was forwarded to the
Arrangements are in place for David Learmonth to act as the Commissioner from 29 August 2010 for a period not exceeding
three months (28 November 2010).
If the incoming Minister does not support the recommendation that is currently with the Cabinet Secretariat, the appointment
process may not be ñnalised by
Mr Richard Bartlett A/ g First Assistant Secretary, Medical Beneñts Division (Telephone: (02) 6289 1016)
Contact: Mary McDonald, First Assistant Secretary, Regulatory Policy and Governance Division,
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28 November 2010.
It should be noted that under the Private Health Insurance Act 2007(the Act), the PHIAC must consist of a Commissioner and at least two, but not more than four, other members. There is provision under section 27010
of the Act for the Minister to appoint a person to act as Commissioner for up to 12 months during a vacancy in the office. However, an extension of the current shortterm arrangements would require the approval of the Prime Minister or, at her/his discretion, Cabinet.
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PRIVATE HEALTH INSURANCE 2011 PREMIUM ROUND Action Required
0 Approval of the 2011 private health insurance premium round timeline. Critical Date 17 September 2010 Background
0 Under section 66-10 ofthe Private Health Insurance Act 2007, private health insurers must apply to the Minister for Health and Ageing for approval of premimn changes.
0 Under an informal agreement between the Government and insurers, premium applications are submitted in November, a
decision by the Minister occurs in February, and increases take effect in April.
0 The Department is proposing that the closing date for insurers’ applications for the 2011 premium round is 18 November 2010.
0 Private health insurers require confirmation of the closing date for applications in order to prepare applications in the approved form and to allow scheduling of Board meetmgs to approve applications.
0 The key dates in the proposed timeline are:
18 November 2010: Deadline for premium applications from insurers;
19 November 2010 22 December 2010: Assessment of applications by Minister, Department, Private Health Insurance
Administration Council, and where relevant, the Australian Government Actuary;
23 December 2010 7 January 2011: Resubmissions prepared by insurers; 8-21 January 201 1: Assessment of resubmissions;
22 January 2011 – 4 February 201 1: Further resubmissions prepared by insurers; 5-23 February 2011: Assessment of further
resubmissions;
24 February 2011: Insurers notiñed of Minister’s decision and public announcement of premium changes; and
1 April 2011: Premium changes to take effect.
Handling Strategy
0 A Minute to the Minister seeking your approval of the timeline will be provided as soon as possible.
Contact: Richard Bartlett, A/g First Assistant Secretary, Medical Benefits Division, (02) 6289 1016
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IN-CONFIDENCE A3.21
KEY DECISION BRIEF
PRIVATE HEALTH INSURANCE RULES – AMENDMENT Action Required
0 Approval of amendments to the Private Health Insurance Rules. Critical Date 25 October 2010 Background
The Department has prepared amendments to the Private Health Insurance (Prostheses) Rules 2010 to create a new Part C to
the Prostheses List, as enabled by the Private Health Insurance Legislation Amendment Act (N0. I) 2010. The new Part C will
require health insurers to beneñts for devices which are not surgically implanted, but provide cost effective clinical outcomes for patients, including insulin pumps and cardiac loop monitors.
The new Part C of the Prostheses List needs to be actioned by the end of October to ensure that there is sufficient time for the
transfer of products from Part A of the Prostheses list to the new Part C before the February 2011 Prostheses list is made. This
transfer will require consultation with a large number of medical device sponsors.
The Department has also prepared amendments to the Private Health Insurance (Benefit Requirement) Rules 2010 to restore the ability of hospitals and insurers to negotiate agreements relating to the payment of private health insurance beneñts for hospital aecommodation costs at a fate below the legislated minimum benefit payable for an episode of hospital treatment. The legislated default benefit would only apply when there was no negotiated agreement in place.
Handling Strategy
0 A Minute to the Minister will be provided in September seeking approval ofthe necessary
subordinate legislation.
Contact: Richard Bartlett, A/ g First Assistant Secretary, Medical Benefits Division, (02) 6289 1016
A4 Key Decisions Three to Four Months (cont’d)
Programs (cont’d)
Indigenous Tackling Smoking and Healthy Lifestyle Workforce – Approval of remaining thirtyseven
regions for New Coordinated Care for Patients with Diabetes program – Program implementation arrangements Mental Health – Taking Action to Tackle Suicide – Proposed implementation strategy Strong Fathers Strong Families – Program Guidelines Legislation,
Regulation And Review
Personally Controlled Electronic Health Record – Approval of policy components of legislation and release of exposure draft for
public consultation
Review of Overseas Students Health Cover Deeds – Authorise new deeds of agreement Tobacco Advertising Prohibition Act
1992 – Restrict Internet Advertising at Point of Sale Midwife Professional Indemnity (Commonwealth Contribution) Scheme Act
2010 Amendments
Private Health Insurance (Complaints Levy) Rules – Amendments to recover Private Health Insurance Ombudsman costs
Private Health Insurance Rebate – Means Test Legislative changes
Personally Controlled Electronic Health Record Approval of policy components of legislation and release of exposure draft for
public consultation
Other Social Marketing Research Publishing Online – Public Release General Practice Education and Training Ltd (GPET)
Company Constitution
World Health Organization Collaborating Centre for Reference and Research on Influenza – Approval to move Centre to new
Peter Doherty Institute for Infection and Immunity
16th NHMRC Embryo Research Licensing Committee – Biannual Report Tabling IN-CONFIDENCE
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Portfolio Outcomes
The services of the Health and Ageing portfolio are delivered through the following outcomes:
Outcome 1: Population Health
A reduction in the incidence of preventable mortality and morbidity in Australia, including through regulation and national
initiatives that support healthy lifestyles and disease prevention.
Outcome 2: Access to Pharmaceutical Services
Access to cost-effective medicines, including through the Pharmaceutical Beneñts Scheme and related subsidies, and assistance for medication management through industiy partnerships.
Outcome 3: Access to Medical Services
Access to cost-effective medical, practice nursing and allied health services, including through Medicare subsidies for clinically
relevant services.
Outcome 4: Aged Care and Population Ageing
Access to quality and affordable aged care and carer support services for older people, including through subsidies and grants,
industry assistance, training and regulation of the aged care sector.
Outcome 5: Primary Care
Access to comprehensive, community-based health care, including through ñrst point of call services for prevention, diagnosis
and treatment of and for ongoing management of chronic disease.
Outcome 6: Rural Health
Access to health services for people living in rural, regional and remote Australia, including through health infrastructure and
outreach services.
Outcome 7: Hearing Services
A reduction in the incidence and consequence of hearing loss, including through research and prevention activities, and access to hearing services and devices for eligible people.
Outcome 8: Indigenous Health
Closing the gap in life expectance and child mortality rates for Indigenous Australians, including through primary health care,
child and maternal health, and substance use services.
Outcome 9: Private Health
Improved choice in health services by supporting affordable quality private health care, including through private health
insurance rebates and a regulatory framework.
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Private Health Insurance Administration Council _ Outcome 1: Prudential safety and competitiveness of the private health
insurance industry 1n the interests of consumers, including through efficient industry regulation.
Private Health Insurance Ombudsman Outcome 1: Public confidence in private health insurance, including through consumer and provider complaint and enquiry investigations, and performance monitoring and reporting.
Private Health Insurance Penny Shakespeare
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Medical Benefits Division
Key Contact Name: Richard Bartlett È Position: A/ g First Assistant Secretary Contact numbers ‘ Work: (02) 6289 1016
Divisional Description The Division has responsibility for providing policy advice to Government on the Medicare Beneñts
Schedule (MBS) and its use and costs, new and emerging technologies, and funding for: ° GP allied health, nursing and
midwifery services, and specialist services including pathology, diagnostic imaging and radiation oncology; ° health care services through private health insurance arrangements; and special access programs such as medical treatment overseas and disaster health care assistance. It is also responsible for private health insurance and associated policy.
The Division has the lead role in the delivery of Outcome 3: Access to Medical Services; Outcome 9: Private Health; and is
responsible for a small component of funding under Outcome 5: Primary Care.
Branch Descriptions Medicare Benefits Branch The prime responsibility of Medicare Beneñts Branch is to develop and
implement programs resulting in affordable access to quality health care for all Australians through the MBSfunded
arrangements. ‘
The main objectives of the Branch are to: provide policy advice on: eligibility
for Medicare, including the Medicare safety nets and funding for private medical services including nondiagnostic
specialist and general practice services; electronic claiming of Medicare benefits and service delivery reform relating to the payment of Medicare benefits; compliance issues including legislative changes as they relate to Medicare and participates in whole of government compliance activities; and eligibility
of people for Medicare, covering the Australian population, annual migration program, refugees, foreign workers and visitors. The Branch also: ‘ provides policy oversight in relation to the Professional Services Review Scheme and the Medicare
Participation Review Committee; manages schemes to assist victims of disasters with health care costs, in cooperation with the
Office of Health Protection; ° negotiates and administers reciprocal health agreements with foreign countries; ° provides policy
advice to Medicare Australia in relation to the Cleft Lip and Cleft Palate (CLaCP) Scheme; ° monitors billing trends relating to
the Medicare safety nets; and manages the production of the MBS and MBS Online, including legislative requirements.
Pońfolio Guide September 2010 C13
Private Health Insurance Branch The Private Health Insurance Branch is responsible for ensuring that Australians have a choice of health care services within a world class health system, by supporting the private health sector to provide affordable, quality care. The Branch: manages the private health insurance rebates; ° develops policy and provides advice in relation to private health and private hospital services; ° manages legislation establishing minimum private health insurance benefits for hospital treatment, including prostheses beneñts; ° provides advice to the Minister about insurers’ applications for premium increases; and provides information to consumers and health insurers about Lifetime Health Cover.
Portfolio Guide – September 2010 C15
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Ombudsman
Private Health Insmmce
PHIO
Ms Samantha Gavel
Statutory Agency under Public
Service Act 1999
Private Health Insurance Act 2007
Ms Samantha Gavel (02) 8235 8777
Administration Council
The Private Health Insurance Administration Council (PHIAC) is a statutory authority established under the Private Health
Insurance Act 2007 (the Act). PHIAC is a body corporate, legally separate from the Commonwealth and subject to the CAC Act.
PHIAC is governed by a board of directors (the Council) and is ultimately accountable for the policy outcomes and expenditure
and the CEO is responsible to the Council for the day-to-day running of the authority.
The Council consists of the Commissioner and at least two but no more than four other members. The Commissioner and Council members are appointed by the Minister responsible for the Act.
The CEO is appointed by the Council. Functions
PHIAC’s central functions are to monitor and regulate the private health insurance industry and to provide information to the
Australian Government and other stakeholders, for example on private health insurance and utilisation.
Other main functions of PHIAC set out in the Act include to: administer the Risk Equalisation Trust Fund; ° establish a solvency standard and a capital adequacy standard to be complied with by private health insurers; ° give solvency directions and capital adequacy directions to private health insurers; ° undertake the supervisory functions in relation to private health insurers, including the appointment of inspectors and administrators; ° collect and disseminate ñnancial and statistical data, including tabling of an annual report to Parliament on the operations of private health insurers; ° levy private health insurers for the general administrative costs of the PHIAC; ° produce membership and coverage statistics quarterly. These statistics detail the proportion ofthe population with private health insurance. The gap statistics provide information about the out-of-pocket costs and availability of cover to consumers with private health insurance; and collect and disseminate information about private health insurance to allow consumers to make informed choices about the product.
Responsibility The Medical Beneñts Division in the Department has policy responsibility for PHIAC.
Chief Executive: Mr Shaun Gath Commissioner: Mr Peter Armand (acting until Aug 28, 2010)
Portfolio Guide – September 2010 D20
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Ombudsman The Private Health Insurance Ombudsman (Ombudsman) is a statutory office holder
established under the Private Health Insurance Act 2007 (the Act). The Ombudsman exercises his or her statutory responsibility independently. The Ombudsman and staff are prescribed under the FMA Act, and constitute a statutory agency for the purposes of the PS Act.
The Ombudsman is appointed by the Minister responsible for the Act.
Functions
The main role of the Ombudsman is to deal with complaints about private health insurance arrangements and acts as the umpire in dispute resolution at all levels within the private health insurance industry.
Other functions in the Act include: publishing the State of the Health Funds Report to provide comparative information on the
performance and service delivery of health insurers; ° publishing aggregate date on complaints; ° making recommendations
to the Minister or the Department of Health and Ageing; ° reporting to the Minister or the Department about the practices
of particular private health insurers, private health providers and private health insurance brokers or other related parties; °
collecting and publishing information about complying health insurance products (i.e. manage the consumer website at
wWW.PrivateHealth.gov.au <http://www.privatehealth.gov.au/> ); and promoting a knowledge and an understanding of the Ombudsman’s functions. Responsibility
The Medical Benefits Division in the Department has policy responsibility for the Ombudsman.
Ombudsman: Ms Samantha Gavel
Portfolio Guide – September 2010 D21
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Australian Health insurance Association (AHIA)
CEO: Dr Hon Michael Armitage
Unit 17G, Level 1, 2 King St Deakin ACT 2600 02 6202 1000
Private health insurance industry peak representative group.
Represents open/non-restricted Health Insurers throughout Australia.
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Administration Council (PHIAC)
Statutory
PHlAC’s central ñmctions are to monitor and regulate the private health insurance industry. PHIAC provides information to the Government and other stakeholders on private health insurance membership and utilisation, risk equalisation and gap cover.
Penny Shakespeare Assistant Secretaly Private Health Insurance Branch (02) 6289 9490
Acute Care
Private Health Insurance Ombudsman (PHIO)
Statutory I
The Ombudsman is an independent body which resolves problems relating to private health insurance, and acts as the umpire in dispute resolution at all levels within the private health insurance industry.
Penny Shakespeare Assistant Secretary Private Health Insurance Branch (O2) 6289 9490
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Prostheses and Devices Committee Non-Statutory
The Committee was appointed by the Minister in May 2004 as part of the implementation of reforms to how private health
insurance funds pay benefits for surgically implanted prostheses. The role of the Committee is to make recommendations to
the Minister (or the Minister’s delegate) about: (a) the listing of prostheses and devices; and (b) the benefits payable for items
recommended for listing on the Prostheses List.
Penny Shakespeare Assistant Secretary Private Health Insurance Branch (O2) 6289 9490
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IN-CONFIDENCE C9 PROGRAM OVERVIEW
PRIVATE HEALTH INSURANCE
Portfolio Outcome: 9 Private Health Improved choice in health services by | An affordable and sustainable I 2010-11 | 4,4406
supporting affordable quality private health | private health insurance sector | 2011-12 | 3,4984 care, including through
sustainable private lmprovod regulatory 2012-13 3,556.7 health insurance rebates and a robust framework 2013-14 3,556.7
regulatory framework. | . Improved information for | Total | 15,052.4
Pfogfam V | Key Outputs | Fin Years | Sm* An affordable and sustainable 2010-1 1 private health insurance sector 201 l-12
Improved regulatory 2012-13 framework 2013-14 Improved information for T0131 consumers
*As budgeted, actual expenditure will depend on legislative outcomes (see below) Program Administration
The Private Health Insurance Act 2007 is the overarching legislation that governs private health insurance. This contains
provisions regulating health insurance to ensure: 0 consumer interests are protected (for instance, through regulation of minimum benefits insurers have to pay for hospital treatment, and requiring insurers to provide standard information statements about all insurance policies); 0 affordability (through the regulation of premium increases by Government, by providing Government rebates and encouraging more people to take out insurance at an earlier age rather than Waiting until they are more likely to claim); and 0 insurers remain solvent and can meet their claims obligations (through provisions relating to prudential regulation by the Private Health Insurance Administration Council).
The following initiatives are ftmded under Private Health Insurance:
30 per cent Rebate – People with a private hospital or general treatment policy receive a rebate on the total cost of insurance
premiums. To claim the rebate, people need to be eligible for Medicare and have a complying health insurance product. This
can be received as an upfront deduction on the cost of their premium with the insurer collecting the rebate on their behalf, or the consumer can pay the premitmi cost in full, then claim the rebate at a later stage.
The proposed means testing of the rebate and increase in Medicare Levy Surcharge rates for higher income earners are forecast to take effect from 2011-12 onwards.
Lifetime Health Cover (LHC) – LHC is designed to encourage people to purchase private hospital insurance at a younger age
and maintain their membership throughout their lifetime. For every year after age 31 that a person does not hold private hospital insurance, a loading of 2 per cent is applied to the cost of their insurance, to a maximum of 70 per cent. The loadings do not apply to people born before 1934 or for those who joined private health insurance prior to July 2000. The LHC loading is removed following 10 consecutive years of maintaining hospital cover.
Community Rating – Policies are priced by health insurers based on community rating. Community rating ensures everybody
pays the same price for the same policy, regardless of age, gender, health or size of a family. Private health insurance is different from trauma and disability insurance. This insurance is “risk rated” rather than “community rated” and is not a substitute for private health insurance.
Risk Equalisatíon – This supports community rating. Insurers contribute a portion of the benefits paid for a member to the aged based risk equalisation pool using specified criteria (e. g. 82 per cent of the hospital benefits paid for a member aged over 85). At the end of each quarter, insurers may receive money from the pool if they had to pay out benefits in excess of the average amount according to the age profile of their membership, or contribute to the pool if benefits paid were less than the industry average. This means that insurers are not disadvantaged if more older people or sick
people join their fund, but does mean there is less incentive for insurers to invest in improving the health of their membership, for instance, through chronic disease management programs.
Annual Premium Round The Minister must approve premium increases submitted by insurers unless satisfied the proposed
increase would not be in the public interest. The Department and PHIAC provide advice about Whether increases sought are the minimum necessary, taking into consideration insurer solvency requirements, forecast benefit payments and capital requirements.
Minimum Benefits Legislation The
legislation sets out the minimum beneíits insurers must pay for hospital treatment. The Department has recently investigated allegations NIB has been paying hospital benefits below the legislated rate. NIB has
reviewed its beneñt payments, and approximately $15,700 has been underpaid. NIB has undertaken to repay this amount to the hospitals concerned.
Prostheses List As
part of the minimum hospital beneñts framework, insurers are required to pay minimum beneñts
for surgically implanted prostheses. The Minister determines the products included on the Prostheses List, based on
recommendations from a ministerially appointed expert committee. The Prostheses List is produced twice each year. The costs of administering the Prostheses List are recovered from prostheses manufacturers.
Medicare Levy Surcharge (MLS) Under taxation law, the MLS encourages people with higher incomes to purchase private health insurance. In 2010/ 1 1, individuals earning $77,000
or more and families/couples earning $154,000 or more without private hospital insurance pay an extra l per cent of income in tax (in addition to the normal 1.5 per cent Medicare Levy). These thresholds are indexed each year. The levy is administered by the
Treasury and the Australian Tax Office (ATO) under taxation legislation.
Program Background
There are many private health insurance policies (over 20,000) and 35 health insurers to choose from. Policies cover (to varying extents) hospital treatment and specialist’ costs in hospital. Health insurance may also cover general treatments or services not covered by Medicare. These include, but are not limited to, dental treatment, optical goods and services, physiotherapy, ambulance transport and podiatry. As at March 2010, 9,912,887 persons (44.5 per cent of the Australian population) were covered by hospital treatment policies. 11,449,950 persons (51.4 per cent of the population) were covered by general treatment policies.
Summary of Government initiatives in relation to Private Health Insurance
July 1997 | Meanstested
Private Health Insmance Incentive Scheme
July 1997 | 1% Medicare Levy Surcharge
Janualy 1999 | 30% Rebate
July 2000 | Lifetime Health Cover
August 2000 I Gap Cover scheme
April 2005 Í Higher Rebates for older Australians
April 2007 | Commencement of new Private Health Insurance Act 2007
October 2008 I Increased Medicare Levy Surcharge thresholds Contact:
Richard Baltlett, First Assistant Secretary, Medical Benefits Division, (02) 6289 1016
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Type I Diabetes Insulin Pump Program
Announced in the 2008-09 Budget, the Program commenced on l November 2008. The Program is intended to increase the
affordability of insulin pumps and associated consumables for families with children under 18 with type 1 diabetes who do not
have access to other means of reimbursement, such as private health insurance.
Following low uptake, in February 2010 the Program was revised to increase the subsidy from a maximum of $2,500 to a
maximum of $6,400. Pumps typically cost up to $8,000. Provisions were also made for eligible families with two or more
children with type l diabetes to automatically be eligible for the maximum subsidy available for subsequent children, once they
receive the means tested subsidy for their first child.
