Private Healthcare Australia Conference 2015

Click here to download the PHA Conference 2015 Program. (119 KB)

The 2015 Annual Conference of Private Healthcare Australia, “Private Health Insurance: The Best Care at the Right Price”, was held in Adelaide on March 4, 5 and 6. It presented the chance for Industry participants and colleagues to hear a range of interesting speakers including FBI Special Agent Michael Badolato, who is an expert in Healthcare Fraud; Diana Dennett, Senior Counsel for America’s Health Insurance Plans (AHIP); Phil Stern from Port Jackson Partners; Macquarie Bank, who will present an updated analysis of how the market views our sector and how investors see the future of Healthcare; and Professor Judith Sloan, one of Australia’s best known economic and political commentators, whose column appears regularly in The Australian.

Key topics which the conference addressed included ways in which the Industry can promote Integrated Care to deliver better health outcomes at lower cost; how funds in America utilise Government programs to enhance both their business models and the care they provide; the political environment prevailing at the time; responding to the challenges of a heavily regulated business environment; thought provoking addresses from leading Australian Social Thinkers; and improving health outcomes.

International Keynote Speakers, Biographies & Presentations

David Abernethy, Health Policy and Government Relations Consultant, Washington, DC
Download Presentation – Private Insurance Solutions in the US, Social Insurance System for the Aged and Disabled   (659 KB)
David Abernethy

David S. Abernethy is a health policy and government relations consultant in Washington, DC.

He was formerly Senior Vice President of EmblemHealth, the parent company of HIP Health Plan of New York, Group Health Incorporated, and ConnectiCare in a variety of positions. He was SVP, Operations, responsible for claims, billing, customer service, grievance and appeals, and enrollment. He was executive director of HIP of Florida, and SVP Government Relations, responsible for all issues relating to Federal and State government for the health plans and for directing the company’s Washington office. He was with EmblemHealth and with HIP in these positions from 1996 until 2013.

Mr. Abernethy worked from 1987 to 1996 for the Committee on Ways and Means of the U.S. House of Representatives in a variety of positions including Staff Director of the Subcommittee on Health. As such he was the Committee’s principal staff person for Medicare and for health reform. He was particularly involved in the design of legislation concerning comprehensive health insurance, hospital payment policy, managed care, tax treatment of health care organizations, reorganization of rural health care and related topics.

Prior to joining the Committee on Ways and Means, Mr. Abernethy was Deputy Commissioner of Health for Planning, Policy, and Resource Development for the New York State Department of Health. In that capacity from 1982 through 1987, he directed the Department’s health planning and policy development division, developing a range of initiatives affecting long-term care financing, hospital reimbursement and capital investment, ambulatory surgery, primary care in underserved areas, maternal and child health, and preventive health services in the State of New York.

Mr. Abernethy is the author with David A. Pearson of Regulating Hospital Costs: The Development of Public Policy as well as a number of articles on health policy. He is the former President of the American Health Planning Association (AHPA) and a recipient of the Richard H. Schlesinger Achievement Award given by AHPA and the American Public Health Association (APHA). He is formerly a member of the Governing Council of APHA. He has held teaching positions in health policy at the School of Hygiene and Public Health of the Johns Hopkins University and the School of Public Health of the University of North Carolina at Chapel Hill. He is former Chair and current member of the board of the David Winston Health Policy Fellowship. He has also served on the boards of the New York and Florida Health Plan Associations.

Mr. Abernethy has also worked for the Subcommittee on Health and the Environment of the House Committee on Commerce (1977-1980) and as the Administrator of the Haight-Ashbury Free Medical Clinic in San Francisco (1974-1976). He holds a Master’s degree in Public Health (Health Services Administration) from Yale University and a Bachelor of Arts degree from Claremont Men’s College, cum laude in History.


Michael Badolato, FBI Special Agent, Federal Bureau of Investigation
Michael Badolato

Michael has worked with the FBI in Baltimore, Maryland; Atlanta, Georgia; and St. Louis, Missouri, USA as a Special Agent. For the past 11 years his efforts with the FBI have focussed on health care fraud investigations.

Previously he worked with Express Scripts, Inc. in St. Louis where he was a Clinical Programs / Account Manager and St. Luke’s Hospital also in St. Louis as a Medical Coder / Utilization Review.

Michael has a Master of Business Administration (MBA) from Lindenwood University, as well as a Master of Health Care Administration (MHA) from St. Louis University and a Bachelor of Science (BS), Health Information Management also from St. Louis University.


Donna Lynne, Executive vice president Kaiser Foundation Hospitals and Health Plan, Inc.; Group president, Kaiser Permanente Colorado, Northwest and Hawaii; President, Kaiser Foundation Health Plan of Colorado.
Download Presentation – Leveraging Primary Care and Population Health Management to Create Value   (2 MB)
Donna Lynne
Donna Lynne, DrPH, is the executive vice president of Kaiser Foundation Hospitals and Health Plan, Inc. and a group president for Kaiser Foundation Health Plan, Inc. and Kaiser Foundation Hospitals and is responsible for its Pacific Northwest and Hawaii regions.

In addition, she is the president of Kaiser Foundation Health Plan of Colorado. There are more than 623,000 Kaiser Permanente members in Colorado and 725,000 in the other two regions she oversees, with a combined total revenue base of more than $7 billion.


Invited Speakers, Biographies & Presentations

Wednesday, 4 March (Day One):


Professor Des Gorman, Executive Chair, Health Workforce New Zealand, Professor of Medicine and Associate Dean, Faculty of Medical and Health Sciences, University of Auckland
Download Presentation – The challenge of clinician and health system leadership   (730 KB)
Professor Des Gorman

Professor Gorman holds a BSc, MBChB and MD from the University of Auckland, as well as a PhD from the University of Sydney. The two doctorates were awarded for in vivo research into brain injuries. Professor Gorman’s primary research and clinical interests are brain injury, diving medicine, occupational medicine and toxicology. His research career includes more than 250 publications.




Ian Laughlin, Deputy Chairman, Australian Prudential Regulation Authority (APRA)
Download Presentation –
Introduction to APRA as the new regulator of Private Health Insurers from 1 July 2015
 (185 KB)
Ian Laughlin

Mr Laughlin was appointed as a Member of APRA on 1 July 2010 for a three-year term, and was reappointed Member and appointed Deputy Chairman for a two-year term commencing 1 July 2013.

Mr Laughlin is APRA’s representative on the Executive Committee of the International Association of Insurance Supervisors and on the Financial Reporting Council. Mr Laughlin has extensive experience in the financial services industry. He has been a non-executive director of AMP Life Limited, serving as Chairman of its Board Audit Committee, Managing Director of the United Kingdom life insurance subsidiaries of AMP (Pearl, London Life and NPI), director of HHG plc and non-executive director of Diligenta Ltd in the United Kingdom. Before then, he held senior management positions in AMP, Suncorp and National Mutual in Australia, New Zealand and Hong Kong. Mr Laughlin has also served on the Council of the Institute of Actuaries of Australia.


Thursday, 5 March (Day Two):


Martin Bowles PSM, Secretary of the Department of Health
Martin Bowles

Martin Bowles PSM was appointed as Secretary of the Department of Health as of 13 October 2014.

Previously Mr Bowles was the Secretary of the Department of Immigration and Border Protection, overseeing the management of migration, humanitarian, citizenship and visa policy and programmes, managing the lawful entry, stay and departure of people crossing the Australian border and managing the Immigration Detention network and regional processing centres.

Prior to this role Mr Bowles held the positions of Deputy Secretary in the Department of Climate Change and Energy Efficiency and the Department of Defence respectively.

In 2012 Mr Bowles was awarded a Public Service Medal for delivering highly successful energy efficiency policies and remediation programmes for the Home Insulation and Green Loans programmes.

Prior to joining the Commonwealth Mr Bowles held senior executive positions in the education and health portfolios in the Queensland and New South Wales public sector.

Mr Bowles has a Bachelor of Business degree, a Graduate Certificate of Public Sector Management and is a Fellow of the Australian Society of Certified Practicing Accountants.


Stephen Duckett, Director of the Health Program, Grattan Institute
Download Presentation – Questionable care: what to do about things which shouldn’t be done   (283 KB)
Stephen Duckett

Stephen Duckett is Director of the Health Program at Grattan Institute. He has a reputation for creativity, evidence-based innovation and reform in areas ranging from the introduction of activity-based funding for hospitals, to new systems of accountability for the safety of hospital care. An economist, he is a Fellow of the Academy of the Social Sciences in Australia.




Professor Paul Glasziou, Professor of Evidence-Based Medicine, Bond University
Download Presentation – Overdiagnosis: its rise, causes and possible cures   (8.01 MB)
Professor Paul Glasziou

He was a part-time General Practitioner for many years, and the Director of the Centre for Evidence-Based Medicine in Oxford from 2003-2010. His key interests include identifying and removing the barriers to using high quality research in everyday clinical practice. He has authored over 250 peer-reviewed journal articles – with a total of over 18,000 citations, and 7 books related to evidence based practice: Systematic Reviews in Health Care, Decision Making in Health Care and Medicine: integrating evidence and values, An Evidence-Based Medicine Workbook, Clinical Thinking: Evidence, Communication and Decision-making, Evidence-Based Medicine: How to Practice and Teach EBM, and Evidence-Based Medical Monitoring: Principles and Practice.

He is the recipient of an NHRMC Australia Fellowship which he commenced at Bond University in July, 2010. He is Chair, RACGP Handbook of Non-Drug Interventions Project Team, and a member of the Medicare Services Advisory Committee.


Tim Lawson, Director, Australian Insurance and Diversified Financial market research, Macquarie Securities

Tim Lawson is Division Director of Australian Insurance and Diversified Financial market research at Macquarie Securities. Macquarie Securities is a division of Macquarie Group. Tim’s responsibilities include research coverage of the listed private health insurance funds Medibank Private and nib.


Noel Pearson, Chairman, Cape York Group (CYG)

Note: Mr Noel Pearson’s video presentation has been made available only to the PHA conference 2015 delegates at the request of Mr Pearson.

Noel Pearson
Noel Pearson is one of the most influential indigenous lawyers and activists who has, for many years, campaigned tirelessly on behalf of the Aboriginal people.

A member of the Guugu Yimidhirr community of Hopevale on South Eastern Cape York Peninsula, Noel studied Law and History at the University of Sydney, and was involved in the establishment of the Cape York Land Council, Cape York Partnerships, Apunipima Cape York Health Council and Balkanu Development Corporation.

He is now Chair of the Cape York Group and has been Executive Chairman of Cape York Partnerships and the Director of the Cape York Institute for Policy and Leadership, a body that drives new directions in public policy on indigenous issues working closely with the Queensland and Commonwealth governments.

Since 1999 Noel has campaigned for Welfare Reform in indigenous communities. In 2008 the Welfare Reform Project, driven by Cape York Institute and Cape York Partnerships, was implemented in four pilot communities in Cape York.

Noel continues to work in close association with all Cape York regional organisations and the philanthropic sector on issues of economic development, education, health and justice. His end goal is to enable Cape York’s indigenous people to have the capacity to choose the life they have reason to value by reinstating the rights of Aboriginal people to take responsibility for their lives.

Descriptions of these ideas can be found in Noel Pearson’s monograph Our Right to Take Responsibility (self-published, 2000) as well as his recent papers.


John Pollaers, CEO and Managing Director, Pacific Brands
John Pollaers

As CEO and Managing Director of Pacific Brands, Australia’s largest listed home ware, consumer apparel, industrial apparel and footwear business, John led 5000 employees across 6 markets with revenues in excess of $1.3Bn.

Returning the company to consecutive years of top line growth, John conceived and led the well‐documented turnaround plan for the business through a revitalisation of the company’s culture and is recognised as simplifying and transforming the business model, while successfully driving the performance of each key business division. 
Prior to that he was Chief Executive Officer of Global Brewer Foster’s Group Limited with beer brands are available in 45 countries and CUB as Australia’s largest brewer with annual revenues of c.$2.4 Bn and sales of almost 110 million cases.  

Prior to joining Foster’s, John had a distinguished career in the consumer products sector. He held senior executive roles at Diageo plc including President, Asia Pacific and Managing Director, Australasia, and was a member of the Diageo Group Executive Committee.

John’s career has been marked by repeated turnaround performances, motivating and building confidence among his teams and in his companies’ brands; resilience in the face of commercial challenges and economic volatility; and an innate knack for forging strong partnerships. This success is characterised by his ability to set a clear strategic direction, matched with a sharp focus on operational delivery, and supported by a strong commercial conscience.

John is Chairman of the Australian Advanced Manufacturing Council, Co‐Chair of the National Breast Cancer Foundation Council, Fellow of Melbourne University Faculty of Business and Economics, and Director on Melbourne University Center for Workplace Leadership, and past member of Expert Advisory Committee of the National Preventative Health Agency. He holds an MBA from INSEAD and Macquarie University, as well as degrees in Electrical Engineering and Computer Science.


Phil Stern, Director, Port Jackson Partners
Phil Stern

Philip Stern is a Director of Port Jackson Partners, which he joined in early 1992, shortly after the firm was founded. He has helped drive its growth and development since that time, serving clients on strategic and organisational matters in a diverse range of industries. His contributions to the firm’s intellectual development include research into the evolution of Australia’s Top 100 companies and his involvement in a review of Australia’s energy reforms on behalf of the Business Council of Australia.

Prior to joining Port Jackson Partners, Philip was a consultant with McKinsey & Company and with Cresap (a division of Towers Perrin), where he gained extensive international management consulting experience.

In over 30 years of consulting, Philip has assisted clients to address fundamental issues of strategy, organisation, operational effectiveness and governance. He has served clients in industries including financial services, airlines, agribusiness, energy, resources, professional services, healthcare, telecommunications, building and construction materials and insurance.

His work includes serving member-based organisations in insurance, health care, financial services, exchange-traded markets, and agribusiness.

Philip has also assisted a number of not-for-profit organisations on matters of strategy and governance. He served on the Council of the Cranbrook School from 1998 through 2014, and served as Treasurer from 2000 through 2008. He was on the Council of the Harvard Club of Australia for more than 10 years, and was President of the Club from 2000 to 2002. He served as a Director of the Sydney Futures Exchange following its demutualisation.

Philip holds a Bachelor of Science degree (cum laude) in Mechanical Engineering from Rensselaer Polytechnic Institute in New York, as well as a Masters degree in Business Administration (with Distinction) from Harvard Business School. He has lived in Australia since 1986 and is an Australian citizen.


Friday, 6 March (Day Three):


Suzie Dale, Regional Director of Brand & Customer Experience, The Nielsen Company
Download Presentation – Messages that make a difference   (2 MB)

Suzie Dale

Suzie Dale is a Director and leads the Brand and Customer Experience Practice at Nielsen. Appointed to this role in March 2013, Suzie is responsible for Nielsen’s customised research in brand health, consumer insights, and customer experience.

Prior to this role, Suzie was the Head of Nielsen’s New Zealand Consumer Insights department, leading all customised research across a wide range of industries and studies, including strategy, brand, shopper, customer experience work. In her long research career, Suzie has worked across most industry sectors and a vast array of research topics, and is an experienced workshop facilitator. Suzie also led the Qualitative Research team in New Zealand from 2004 until her Australian shift in 2013.

Suzie joined Nielsen in 2004 from Phoenix Research. Suzie has been involved in customised research for more than 20 years and has had prior roles in New Zealand with Colmar Brunton and Heylen Research. Suzie has also worked in management consultancy and change management for the WinWin Group and the health and social services consultancy, Synergia.

Suzie is a regular contributor to marketing magazines on the topic of Brand and has published multiple research papers. She has won the 2012 TVNZ Marketing Awards with her brand work for Z Energy and four Gold Awards from the NZ Market Research Society Award for:

  • 2012 FMG Customer Partnership
  • 2011 Media Engagement with APN
  • 2010 The Future of Fitness with Les Mills
  • 2008 Didymo Pest Campaign with MAF Biosecurity


Russell McGowan, Former Consumer Commissioner, Australian Commission on Safety and Quality in Health Care
Download Presentation – A role for Private Health Insurance in Health System Reform?   (3 MB)

Russell McGowan

Russell McGowan is a bone marrow transplant survivor who has been active in the healthcare consumer movement since the early 1990s and is now retired from the workforce on health grounds. His working life had included teaching, field work, program management and policy development, mainly involving employment, education and training programs for indigenous people.

Russell lives in Canberra and participates in numerous community and consumer healthcare organisations in the ACT. He served as president of the Health Care Consumers Association of the ACT for ten years and deputy chair of the ACT Health Council.

Nationally he is a board member of the Public Health Association of Australia and secretary of the Australian Health Care Reform Alliance. He is also a member of the Consumer eHealth Alliance and the Patients and Citizens ISG of HTA International.


Associate Professor Brian Owler, President of the Australian Medical Association

Brian Owler

Associate Professor Brian K Owler is an Australian trained neurosurgeon. Associate Professor Owler is a Consultant Neurosurgeon at the Children’s Hospital at Westmead, Westmead Private, Sydney Adventist Hospital at Wahroonga and Norwest Private Hospital.

Associate Professor Owler has a PhD from the University of Sydney and spent 18 months performing research at the Academic Neurosurgery Unit at the University of Cambridge. He is Associate Professor of Neurosurgery at the University of Sydney.

Associate Professor Owler is a member of the Australian Medical Association (AMA) Council representing surgeons and is also the surgeon representative on the Council of Federal AMA. He is a member of the COAG Expert Panel on Emergency Department and Elective Surgery Performance.

Associate Professor Owler was elected as President of the AMA NSW on 29th May 2012. He was elected Federal President on 25th May 2014.

Associate Professor Owler has a particular interest in public health advocacy. He worked with the Roads and Maritime Service to develop the “Don’t Rush” advertising campaign targeted at reducing speed-related road accidents in NSW.

Associate Professor Owler is leading the AMA in campaigns with a number of key organisations and the State Government to reduce the incidence of preventable deaths and injuries in children, primarily in the areas of pool safety and falls from residential buildings in NSW and alcohol related violence.


Associate Professor Morton Rawlin, Chair of Victoria Faculty and the National Faculty of Specific Interests
Associate Professor Morton Rawlin

Morton is a GP practising in Melbourne and is the Chair of the Victoria Faculty and the National Faculty of Specific Interests. Morton has extensive experience in general practice medical education at all levels, including as a general practice supervisor and medical educator. His past professional appointments include Medical Director of Dianella Community Health, RACGP National Manager of Fellowship Programs and RACGP Director of Education.

He is currently Adjunct Associate Professor in General Practice at the University of Sydney. Morton has a long standing interest in competency assessment and training. His research and teaching interests are in standards and teaching in general practice, dermatology and mental health. Morton is a RACGP nominee on the Board of General Practice Education and Training Ltd (GPET).


Laura Tingle, Political Editor, Australian Financial Review
Laura Tingle

The Australian Financial Review’s political editor Laura Tingle has reported politics from the Canberra press gallery for over twenty five years, after beginning her career in Sydney reporting on the financial markets and economics.

She is the author of Chasing the Future – a book about the recession of the early 1990s – and a 2012 Quarterly Essay Great Expectations: Government, entitlement and an angry nation. She has won two Walkley Awards for Journalism and the Paul Lyneham Award for Excellence in Press Gallery Journalism.



Mark Valena, Chief Executive Officer GMHBA
Mark Valena
Mark Valena is an experienced Business Executive. He came to the helm at GMHBA in early 2008 following seven years as the CEO of Medical Defence Association Victoria. MDAV was Victoria’s largest medical professional indemnity insurer (with an 18% national market share) and as a not-for- profit organisation, in a highly regulated insurance market operating in the health sector, provided a sound experience base for his current role at GMHBA. Mark has significant experience in the negotiation and implementation of mergers and business transitions at MDAV, NRMA and Fortis Insurance. Through these transitions Mark was able to create an environment of goodwill and navigate through many complex agendas leading to retention of members and employees. Mark is an Australian Chartered Accountant who has a Bachelor of Business and a Graduate Certificate in Innovation & Service Management.

Mark is on the Board of Private Health Care Australia, the Australian Health Services Alliance, the Victorian Managed Insurance Authority and the Committee for Geelong.

In the past seven years GMHBA has:

  • Grown at 3 times the industry average
  • Significantly improved its margin and capital
  • Won multiple best value and outstanding service awards
  • Created a high performance culture in the top decile of the survey benchmarks
  • Defeated a hostile takeover bid from a listed health insurer
  • Acquired the portfolio of a smaller health fund
  • Implemented a range of community and member based health prevention, wellness and disease management initiatives
  • Announced it’s plans to take a leadership position in investing in regional health and aged care infrastructure and to make a transition from health funder to become a heath funder and provider.


Senator Nick Xenophon
Senator Nick Xenophon

Nick first became involved in politics in the 1997 South Australian election, where he campaigned on a ‘No Pokies’ platform. He ran to simply make a point. Nick scraped in with a little under three per cent of the statewide vote due to a large number of preferences being directed to him. Nick was re-elected to the State’s Upper House in 2006 with just over 20.5 percent of the state’s vote.

Over the next eight years, Nick worked to fight the spread of poker machines. He also campaigned on issues where individuals and communities weren’t getting a fair go, including asbestos victims, victims of crime and land tax.

Some of Nick’s biggest achievements to date is negotiating the fast tracking of $900 million in funding for the Murray Darling Basin, river communities and stormwater harvesting as part of the 2009 stimulus package; his campaign for victims of Scientology; consumer rights; and the many Private Senator’s Bills he has introduced on gambling, consumer law and water management.