Article

The patients who are waiting four times longer for surgery

Wednesday, 6th December, 2017

Public patients have to wait significantly longer than private patents for elective operations at public hospitals. Photo: Louie Douvis

THE rules are simple. It doesn't matter whether you're a public patient or a health fund member, if you're a patient in a public hospital, treatment should be delivered based on clinical need not insurance status.

But the latest figures in the Australian Institute of Health and Welfare's Private Health Insurance Use in Australian Hospitals report tell a very different, and worrying, story.

Public patients, for some elective operations such as a cataract extraction, are waiting four times longer than privately insured patients in public hospitals – 113 days compared to 29 days.

Waiting for a tonsillectomy? Public patients have to wait three times longer – 138 days compared to 49 days.

The Waiting Game

Public patients are being forced to wait as much as four times longer than privately insured patients at Australia's public hospitals, despite rules that say cases should be prioritised based on clinical need.

graph 1

In violation of Medicare principles enshrined in Australian health care agreements, public patients had a median waiting time of 42 days for elective surgery in 2015-16, compared to 20 days for patients who had opted to use their health insurance to cover all or part of their admission.

Health Minister Greg Hunt holds "real concerns" that the practice of public hospitals' "harvesting" private health insurance is driving up the cost of insurance premiums and pushing out waiting lists.

And the situation is getting worse. The number of privately insured patients in public hospitals has doubled in the past decade to 872,000 admissions in 2015-16.

"Data also shows that private health insurance premiums would be around 2.5 per cent lower if this practice wasn't running rampant," a spokesman for Mr Hunt said.

More Patience

Private health insurance-funded hospitalisations at public hospitals are increasing by 9.6% on average each year, while hospitalisations at private hospitals are at half the rate - 4.9% on average each year.

graph 2

Hospitals are in their rights to treat privately insured patients as a means to raise revenue. However, they shouldn't be giving a certain group of patients preferential treatment.

They've long insisted that the money raised is ploughed back into services, benefiting everyone.

NSW, compared to all other states and territories, had the highest proportion of privately insured patients in public hospitals, 19.9 per cent, compared to the national average of 13.9 per cent.

"The government will continue to work with the states on how we can fix this problem because nobody wins with longer waiting times," Mr Hunt's spokesman said.

On the Rise

The proportion of privately insured patients at public hospitals in NSW is gradually going up each year.

The graph compares the proportion of privately insured patients and public patients at public hospitals in 2006-07 and 2015-16.

graph 5The Sydney Morning Herald


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