More private insurers are using public hospitals

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Private health insurance funding of stays in public hospital has grown twice as fast as admissions to private facilities, a new Australian Institute of Health and Welfare (AIHW) report reveals.

In 2015-16, about one in five admissions that were privately funded occurred in public hospitals. This was up from one in seven nearly a decade ago, according to the report, Private health insurance patients in Australian hospitals, 2006-07 to 2015-16.

The study also showed that patients aged 75 and over were more likely to be placed in a public hospital by a private fund than any other demographic.

“When looking at the types of admissions and services provided, medical care was the most common type of service provided for private health insurance-funded admissions in public hospitals, and surgical care was the most common in private hospitals,” it reported.

Additionally, privately funded patients appeared to be treated more favourably, for example their waiting times for elective surgery was shorter than it was for public patients.

 On average, privately funded patients waited about 20 days compared with 42 days for public patients and 18 days for other patients.

“When looking at knee replacement surgery, the median waiting time for private health insurance-funded patients was 76 days, compared with 203 days for public patients,” said AIHW spokesperson Jenny Hargreaves.

“Private health insurance-funded patients were more likely to be categorised as needing this surgery relatively urgently, with 43 per cent requiring knee replacement surgery within 90 days. This compared with 25 per cent of public patients.”

Opinion: think before you bank on this insurance advice

The statistical analysis conducted by the Australian Institute of Health and Welfare (AIHW) should silence the detractors who are increasingly bashing health insurance for the wrong reasons.

Last week, esteemed investment bank Morgan Stanley said in a lengthy report for clients that buying health insurance was a waste of money because … wait for it … the free public hospital system was the bees’ knees.

News Corp, which obtained the report, quoted Morgan Stanley Executive Director Daniel Toohey as writing that “the private health industry had become lazy and the Government should refuse any premium (rises) until the industry sorted itself out”.

It’s true, there is much to begrudge health insurers – their steadily rising premiums that seem to cover fewer and fewer treatments, for one – but for the silvertail bank to champion sitting among the sick and wounded for hours in emergency before seeing a doctor, like most users of public hospitals do every day, is a bit rich.

In a “nothing to see here” assertion, the bank said: “The picture is not as dire as the media would suggest (of a public system at breaking point, evidenced by crowded emergency departments and ballooning elective surgery wait times).”

And it advised: “People who are grudge purchasers of health insurance will be better off paying the Medicare Levy Surcharge than buying insurance.”

But its most incredulous claim was that the public sector could right now feasibly absorb the excess demand caused by an ageing population and falling private hospital admissions.

Really, Mr Toohey? If you were very ill, would you stoop to rub shoulders with the masses in a smelly, overcrowded and noisy admissions waiting room?

If he took his firm’s advice and ditched paying for private health care, it wouldn’t be long before he would likely regret it if he needed a new knee. According to AIHW, if he were a private patient in a public hospital, he would likely wait just over two months before being wheeled into theatre. If he went for the procedure as a public patient, his wait would be closer to eight months.

Thankfully, Private Healthcare Australia chief Rachel David wasted little time in dismissing some of the bank’s conclusions as incorrect and very naïve.

 “Wait times for elective surgery in public hospitals extend to years and the public system can’t quickly treat disabling sporting injuries, eating disorders, weight-loss surgery, chronic severe anxiety and depression,” Ms David was reported to have said.

Sounds like Mr Toohey et al have been schooled.

Would you ditch your private health cover if you have any? Do you have as much faith in the public hospital system as you do in the private sector?

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Written by Olga Galacho

80 Comments

Total Comments: 80
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    “On average, privately funded patients waited about 20 days compared with 42 days for public patients and 18 days for other patients.

    This is a quote from the article. I know we have private patients and public patients, but I don’t know who the” others ” are. Does anyone?

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      Others is the third tier of our medical system that the wealthy use. There are many treatments available but are not covered by Medicare or private health insurance. Most doctors wont tell you about them as they assume you can’t afford them and they are thus wasting their time.

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      Indeed – Lang Hancock flew to the US to get an immediate heart op that he couldn’t get here… didn’t work for him, unfortunately for him, but fortunately for his inheritors….

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      We have a strange system where two patients needing the exact emergency care will be treated equally until the one who has been paying Private cover for decades is hit with a massive excess gap fee.
      Its only the threat of delays and waiting periods that makes a lot of people stay with private health.
      Its certainly not for dental and optical cover!

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      Rosret, you ought to know by now that all insurance is a SCAM.

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      I agree Rosret and that is why I quit paying for hospital and medical insurance.
      If you live in a small town or in a rural area there is often no choice of hospital or surgeon etc. so you get the same treatment in the public system as you would as a private patient – apart from the horrendous amount of dollars demanded before admittance and the many “gaps” that are not covered by the insurance even though they should be.

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      Rosret, my husband needs new glasses. He will put the frames on his private cover this month and next month he will put the lenses on thus claiming for his new glasses but in a sneaky but legal way.
      More than three quarters of our recent dental bill was covered by our our private health insurance. Between the two of us $800 was coughed up by our private health insurer.
      A few months ago I needed an in hospital procedure. The whole lot was fully covered by my private health insurer in the amount of a couple of grand. There was no excess or copayment required to be paid by us.
      Going back a year or so I was in an emergency department of a public hospital because I had severe vertigo. I was asked to swipe my private health card to help them out. I was happy to do so. The hospital was given $400 to help with the costs. It was not obligatory but voluntary.
      We are way ahead but I shop for the best deal from the private insurers and my specialist never charges me. I was his first patient as a specialist 11 years ago but I believe he does that for everyone. There are good people like him who are not money hungry and accept the base fee.
      The key is to shop around personally

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    Other could be user pay for treatment as needed.

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    A friend recently injured his finger at home doing outdoor building work. Went to private hospital close to home in Brisbane. Initial consultation and minor surgery, he a holder of top private cover was out of pocket $1750.00 a week later.

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      And that is why I gave up private medical. Every time I had something done it was at least 1000.00.

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      But what excess did he have Jo? Was it to minimise his fees? susyq looks like she had her excess set at $1000.

      My dear old dad told me 50 years ago that medical benefits were a waste of money, particularly after the government forced friendly societies out of the market. i.e. When there was no such thing as a gap. He said I should put the fees I would pay into a bank account and let it accumulate and pay any medical costs out of that account.

      Being young and about to be married the advice fell on deaf ears but I now wonder if I had adopted his advice what the balance of the account could have been. I guess it would be in the tens of thousands of dollars if not more. I have been blessed with good health up to now but I’m starting to feel the effects of my sporting days and working environment. So next time I review my benefits, I might consider a cost benefit analysis and see what avenues are available to minimise my costs.

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      Doctors are often financially rapacious – particularly specialists and surgeons.

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      That is why so many are not saying they have private insurance and going public. If rushed in as an emergency it does not pay to say you have private…you are treated the same as public but you are nearly always out of pocket. So why would you say you have private insurance.
      It is not illegal…you have every right to be treated as a public patient.

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    I have been paying for health insurance for most of my life, the problem I have with it is, if I have a need to go to hospital etc I would not have the money to pay the gap so for this reason will be cancelling my health insurance as I see it , it’s only for those that have the money gets up my nose that I have to cancel after all these years but it is just wasted money

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    2 yr wait for knee replacement in Adelaide on public.
    But I have nothing but praise for public everything when I was diagnosed with breast cancer.

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      I aught to move to Adelaide.

      3 years wait to even see a specialist for a knee replacement in South East Queensland. Over a year & 3 appointments, with a wait of 8 weeks to get scans done, to be finally put on the list for surgery.

      That was 4 months ago, still waiting for a date.

  6. 0
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    I have top cover but would not use it unless absolutely needed because of the very large out of pocket expenses.

    The twice I we needed to use specialist services they were provided in the rooms and not covered by that $2500 a year insurance anyway.

    I regret not just putting the money in an account all these decades.

    If times became very hard my medical insurance would be one of the first things I stop. In fact if they keep raising it 8% every year I’ll be gone even sooner. That is a lot of money to keep throwing into a bottomless pit with no return and no loyalty attached to it.

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      If you read my comments below, Rae – I posted those before I read anyone else’s – that’s a policy of mine, so that I don’t become a sycophant to someone else’s ideas….. and I agree 1000% with you.

      (aye, man moost ‘ave integrity of own ideas an
      ‘ not be kow-towin’ to every passing fad!!!)….

  7. 0
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    I’ve long stated that I find it unconscionable on the part of doctors to place private people first rather than working on a needs basis. It’s a bit like that final scene in the movie Fargo – there’s more in life than a little money.

    That said – I’ve had some top people work on me very quickly and without my spending a dollar, so it comes down to the individual surgeon etc. In any case, private patients, in my eyes, are taken for a ride, since they pay in advance and then they still pay for ‘extras’ such as anaesthetics (that’s an ‘extra’ in an operation – wow – you live and learn!), meaning they are out of pocket three way – they pay the fees, they pay the Medicare levy, and then they pay out of hand for ‘extras’. Ludicrous.

    So – to me – that means the entire medical procedure industry and the private health schemes need a thorough review and a lot of tightening up.

    As for taking up space – – well – I addressed that one in my first paragraph – put simply, how does a doctor abiding by the Hippocratic Oath dump a suffering person to the bottom time after time in order to fit in some filthy lucre?

    Don’t they already get paid enough? And for the ‘righties’ here – the AMA is probably the most recalcitrant and frankly obnoxious Union in this nation.

    There’s more to life than a little money………………………..

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      Yes, you’re right, Trebor.

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      Yes Trebor well said.

      I find it appalling that we have doubled our population over 30 years but built very few hospitals. It is mismanagement by State Governments and should have had Federal Funding increased per head of population including the millions of visa holders and tourists using the facilities.

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      The Hippocratic Oath has become the Hypocrites’ Oath.

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      Agree Trebor, the entire Medical Industry – Insurance, Suppliers and AMA need to be reviewed and strict controls put on their quality (including inclusion) of services and prices. The whole industry is collaborating to rip off the consumers, with the Govt watching like impotent dopes.

  8. 0
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    Probably the same “silver tails” that can afford private health insurance who are also creating the demand for housing that has put young families out of home ownership!!!!!!!! GREED and selfishness!!!!!

  9. 0
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    Private health insurance ia an expensive waste of money. Don’t forget that it is propped up by the taxpayer. So even if you don’t have the insurance you still pay for it through your taxes. A perfect example of inequality where the poor pay for the rich without getting any benefit. Choice of doctor is of course a con since few people know who to choose. They rely on their GP like everyone else. Items and salaries in private health are far more expensive. In knee replacements just the metal part is in private health far more expensive than in public health. Pure profit making. If all the government subsidies for private health went into the public health and we increased the medicare levy a bit we could have an equal and world class health system.. Now we are slowly but surely drifting to the American system. Health care for the rich only.

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      “Don’t forget that it is propped up by the taxpayer”.

      And Public health costs are paid 100% by the taxpayer.

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      You seem to be forgetting that people who have private health insurance are tax payers too. I pay for private health insurance and this year my insurer has paid out over $100,000 for me without a quibble. That is $100,000 that other taxpayers are not having to fork out,hence more money for those who are unable to afford private insurance. I am really happy about that.

      Another thing – have you any idea how many years specialists study for and have you any idea what they have to pay back to the government for their study loans?

      Have you any idea the sort of hours they have had to work in public hospitals during their training? I don’t think they are as greedy as you would like to think.

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      You mean nobody pays interns and registrars and such, Maggie? Well I never!

      I had no idea that graduated medical students worked in hospitals to hone their skills for free………….

      I was supposed to be a quack myself… but my Patch Adams kind of nature didn’t fit with the then establishment…. once went to a nurse’s party and was swamped with fine females…… the only thing they wanted to know was what my specialty was…..

      Nowadays my approach would be a heartsong for many a very sick patient, but I still criticise the AMA and many of its Unionists for their rapacious nature, like politics, just another way to good money.

      I’d be doing heaps for free….. but that’s me.

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      Maggie As far as I know and see, I never mentioned “greedy” doctors. Even though some of them are very greedy. I am fully aware of the studies they do as I am in the field myself. You were obviously unforunate enough to require $100,000 worth of treatment. That’s not the amount of saving for the taxpayer though. it’s far less than that. And those people you talk about that are not as priveleged as you are in being able to have insurance. Yes they paid towards your $100000. In addition you made a claim from the public purse as well. Claiming $100,000 in one year is not average though. Rather than having people like yourself who feel a certain entitlement. I am all for an equal health care system where people are treated according to real need and not according to the insurance they can afford and not what dr tells them they need because it gets Dr another rip off fee. That last one is the American system.

  10. 0
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    People are going to Govt Emergency Depts, not private because it costs a mininum of $220 for a pensioner or $260 for a non-pensioner. It used to be free if you were admitted but that hasn’t been the case for a few years. You can not claim against Medicare or private health for that at all.

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