Public hospitals put cash ahead of patient need

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Australians are stuck languishing on public elective surgery waiting lists while privately insured patients jump ahead of them in the queue, new data from the Australian Institute of Health and Welfare (AIHW) has shown.

The AIHW report Admitted patient care 2015-16: Australian hospital statistics revealed damning statistics about public hospital’s rorting of private health insurance – showing the wait for surgery in a public hospital can be up to seven times longer than privately insured patients. For example, coronary artery bypass graft waiting times are twice as long for the uninsured – which could be the difference between life and death.

Australian Private Hospitals Association (APHA) CEO Mr Michael Roff said it was unconscionable that public hospitals were putting patient care at the bottom of their priority list to make a quick buck from private health insurance.

“The data is very clear, insured patients get to jump the queue in public hospitals while public patients are losing out. This is the exact opposite of what Medicare was supposed to do – provide access to health care for those who can least afford to pay for it.

“Access to public hospital services is supposed to be on the basis of clinical need, not the ability to pay. The fact that private patients are jumping the queue in public hospitals is certainly against the spirit, if not the letter, of the National Healthcare Reform Agreement.

“These long waits will have a flow on effect on people’s quality of life. Waiting more than four months, the median wait time for hip surgery, will mean patients are living with pain and limited movement, while public hospitals push the insured through the system in little over a month,” said Mr Roff.

The data was further underlined by March quarter figures from The Australian Prudential Regulation Authority (APRA) which shows an increase in episodes of private patients treated in public hospitals.

The APRA data shows 18.6 percent of episodes paid for by private health insurance were treated in public hospitals for the March quarter. This is up by 1.4 percentage point on December data, and 0.2 percentage point higher than March 2016.

Mr Roff said he was aware of patients being coerced into using their private health insurance in public hospitals.

“Public hospitals employ teams of people to encourage privately insured patients to use their insurance as a ‘favour’ to their public hospital. Of course people want to help out, but they don’t realise their ‘help’ to the hospital might be hindering someone else’s access to care.

“We also hear from many privately insured patients that their requests to be transferred to a private hospital are denied or delayed while additional tests and procedures are performed in an effort to exhaust private health insurance benefits. Very often patients are outright lied to and told the private hospital is full,” Mr Roff said.

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