Double whammy leaves private and public patients short

Australia’s health system is turning into an increasingly inequitable mix of high health fund profits while public patients wait longer for care in public hospitals.

“New figures have delivered a double whammy for patients.  Public patients are waiting much longer for elective surgery than privately insured patients in public hospitals.

“Meanwhile health fund profits have risen by 18 per cent after tax at a time of widespread dissatisfaction with continuing premium increases and shrinking cover,” the CEO of the Consumers Health Forum, Leanne Wells, said.

“The stark differences in public hospital waiting times while heavily subsidised health funds generate accelerating profits reveal a dire need for reform, the Consumers Health Forum said today.

“The new Australian Institute of Health and Welfare figures show that public patients typically wait for twice as long to have elective surgery as privately insured patients do in public hospitals.

“This undermines a fundamental tenet of Australian health care - that everyone should be treated according to their medical need,“ the CEO of the Consumers Health Forum, Leanne Wells said.

“These figures raise serious questions about how and why people with private insurance should get access to costly care ahead of public patients who depend on public hospitals as provided for under Medicare for their treatment.

“We need much more transparency and accountability about how decisions are made about elective surgery priorities.  How can the public be assured that there is integrity in the processes to ensure that patients in public hospitals are treated on the basis of clinical need rather than wallet size?

“The fact that these figures have been released just as latest health insurance numbers shows a slight but continuing fourth quarterly decline in members is a further indication that Australia’s public-private system is in urgent need of a shake-up.  

“Separately the APRA financial figures for health funds show that total premium revenue earned by health funds at $22.8 billion is $3.4 billion ahead of what they paid out in benefits in the 12 months to March.

“The private health insurance rebate, costing taxpayers at least $6 billion a year, was introduced on the grounds that it would take the pressure off public hospitals.

“The AIHW data suggest the opposite outcome:  private patients in effect getting preferred access to public hospital surgery indicates the opposite is happening.

“Disturbingly when the elective surgery rates are measured in terms of socio-economic background, the picture illustrates a two-tiered health system.

“To have their vision restored by means of cataract surgery, Indigenous Australians waited significantly longer for a median 151 days compared to other Australians. Overall, those from the lowest income areas wait a median 137 days, double the 63-day wait of those from well-off suburbs.  And this is happening in our public hospitals. Whether it be hip and knee replacements or tonsillectomies, poorer people wait significantly longer. 

“The revelation of these figures demands a much more thorough inquiry into the health system than the limited private health insurance review currently underway. We know state governments are urging their public hospitals to encourage private patients in order to gain revenue. This is happening with apparently little concern for the impact on the majority who do not have hospital insurance.

“If Australia is to continue claiming it has a national health system that provides equitable access to health care, we need to see a turnaround in these figures,” Ms Wells said.


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Mark Metherell
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