Public hospital revenue raising leaves patients stranded on waiting lists


The latest data from the regulator offers little hope for patients stranded on public hospital waiting lists, as increasing numbers of private patients are put ahead of them in the elective surgery queue, says Australian Private Hospitals Association (APHA) CEO Mr Michael Roff.

This quarter’s private health insurance statistics, released by the Australian Prudential Regulation Authority (APRA), show a four percent jump in the number of private patients treated in public hospitals during the period.

Mr Roff said the data shows more than 800,000 episodes of care were funded through private health insurance in the last 12 months.

“These episodes of care led to private health insurers paying out $1.1 billion to public hospitals, forcing premiums up,” he said.

According to Mr Roff, the steadily increasing number of privately-insured patients in public beds shows public hospitals are prioritising revenue raising over providing care, leaving public patients stranded on waiting lists.

“It’s devastating news for anyone on a public hospital waiting list.

“It means more people without the ability to pay for private health care will be left waiting for their surgery. We know that public hospitals let private patients jump the queue, with public patients waiting twice as long for treatment compared to insured patients. So the more private patients they treat, the longer public patients have to wait,” said Mr Roff.

“The public health system was designed to provide health care to all Australians regardless of their capacity to pay. Now we see more and more public hospitals revenue raising through privately insured patients rather than delivering on their core objectives under Medicare.

“Unfortunately, the public hospitals are making a rod for their own backs – and penalising their patients – by continuing to choose private health insurance revenue over patients’ clinical care needs,” Mr Roff said.

The APRA data also showed decreasing participation in private hospital health insurance cover overall. About 45 percent of Australians held the cover during the period, a drop of 0.1 percentage points. While the quarter did see a slight increase in uptake (10,481), this did not balance out the 36,743 Australians who had dropped it over the last 12 months.

Another worrying figure is the number of Australians choosing to take out policies with service exclusions, Mr Roff said.

“Comparing this quarter to the same time last year, this figure has increased from 39.3 to 42.9 percent. This means people will often miss out on cover for private hospital services they may need, based on a guess about what their future health needs will be. Unfortunately, it falls to the private hospital to tell vulnerable, and often very unwell, patients that their health insurance does not cover them for a procedure,” said Mr Roff.

Private hospitals provided more than a million episodes of care in the quarter and more than 4.6 million in the year ending Saturday 31 March 2018, an increase of 1.4 percent.

Read more: Private in public growth needs a cure.


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