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Private health insurers are only a few years away from folding or being forced to merge as young people continue to shun private cover, an APRA official has warned.

A review of Australia’s private health insurance industry is needed to stop its decline, Australian Prudential Regulation Authority executive board member Geoff Summerhayes has told an audience in Sydney

“We’ve reached the point where some hard decisions need to be made if private health insurance is to remain an essential part of the Australian health system,” he said on Tuesday.

The number Australians with hospital cover is at its lowest level – 44.1 per cent – since 2007.

Many young people have abandoned private cover, which they say is unaffordable.