Reform deal brings fairness back to public hospitals

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The new National Health Reform Agreement will potentially stop public hospitals “harvesting” privately-insured patients, says Australian Private Hospitals Association (APHA) CEO Michael Roff.  

APHA has long campaigned against the practice of public hospitals targeting insurance benefits to bolster their revenues, thus pushing up premiums and pushing public patients down the waiting lists.

The $131 billion agreement for 2020-25, signed by all states and territories, includes a commitment to remove any financial benefit accruing to public hospitals for treating private patients.

Mr Roff congratulated Health Minister Greg Hunt for his collaborative work in sealing the “significant” deal, which he said would have “genuine impact” on how Australians can access care.

“APHA has been advocating for this change for a long time. We know the practice has driven up premiums, and disadvantages public patients who are pushed further down public hospital waiting lists. 

“It undermines the principle of Medicare – that treatment in a public hospital should be on the basis of clinical need, not ability to pay,” he said.

Mr Roff hoped the agreement would end the current situation of almost 14 percent of public hospital beds being tied up with private patients, while public patients wait twice as long to get into a public hospital compared to those with insurance. 

“Our hope is that patients in public hospital Emergency Departments are no longer coerced or harassed into handing over their private health insurance details when they are vulnerable and in need of urgent treatment,” he said. 

“It should also reduce costs for public hospitals who will no longer need to employ so called ‘private patient liaison officers’ to undertake this coercion,” he added. 

Mr Roff said the agreement should mean improved access to care for those Australians who cannot afford private health insurance – and APHA will “closely monitor” its implementation after Wednesday 1 July to ensure public hospitals are not offering preferential access to insured patients. 

“Public hospitals must now concentrate on what people expect them to do: treat public patients. This has never been more important to ensure that public patients are not left languishing on waiting lists that have grown even longer due to the surgery restrictions imposed during the COVID-19 pandemic,” he said. 

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