Private health sector fires back on cost-shifting

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The private health sector has leapt on a new report from the Australian Institute of Health and Welfare confirming a substantial jump in the number of public hospital separations funded by private insurers.

According to the report, private health insurance-funded hospitalisations increased from 8.2 per cent of hospitalisations in 2006–07 to 13.9 per cent in 2015–16 - an average annual increase of 9.6 per cent.

"We note a significant growth in privately funded public hospitals admissions by state, particularly Queensland. We don’t think it’s the best use of the health dollar for public hospitals to game the system," said Dr Rachel David, CEO of Private Healthcare Australia.

Australian Private Hospitals Association CEO, Michael Roff, said the increase was a direct result of hospital staff pressuring patients while in the emergency department.

“These data are clear evidence of public hospital staff trawling though emergency departments, triaging patients by their insurance status, not their need for treatment," he said.

"A public hospital emergency department should be solely focussed on the clinical care of the patients who present there, it is not the place for hospital administrators to pressure and blackmail patients in an unseemly cash-grab.

“The AIHW figures also provide more information on the unconscionable practice of allowing private patients to jump the queue for elective surgery while public patients are forced to wait longer, often with conditions that affect their quality of life, mobility or capacity to work.”

Defence Health CEO, Gerard Fogarty, said, "Firstly, the fact private patients are pushed up the waiting list is unethical and a violation of Medicare rules and every health agreement in the country. Secondly, as a private patient in a private hospital, the surgery would take place almost immediately. In such a case, the public hospital setting provides no value or comfort for a private patient. 

"Private health insurance is a vital element of our health system. But the 'harvesting of private patients by public hospitals' is pushing $1.1 billion in costs each year onto insurers. That’s why we continue to call on the government to reform this practice and remove further cost pressures on the privately insured."