Private hospital admissions soar despite insurance price hike: Report

While private health insurance premiums rose by an average of 3.25 per cent last month, an alarming number of Australians are still opting for private hospital care.

New statistics show that despite private health insurance participation declining by 0.1 percentage points to 44.5 per cent in the first quarter of 2019, more than 70,000 more people accessed private hospital care in the same period. The results appeared in new Australian Prudential Regulation Authority (APRA) data on Tuesday.

“The ability to choose when and where you have your surgery, choose which doctor performs the procedure and have access to a private room makes private hospital care a priority for many,” Michael Roff, CEO of Australian Private Hospitals (APHA) said in a statement.

APHA hopes the government’s move to improve clarity and comparability around insurance through the Gold/Silver/Bronze/Basic tiered model increases people using private health insurance. The new model is intended to make it easier for customers to compare policies in the long run and there are minimum standards for hospital services and treatments that are covered under each tier.

The data shows some Australians with private health insurance are still being treated in public hospitals, but people who are privately insured want to be treated in private hospitals when given the choice.

“The first priority for the next Health Minister is to finalise a Heads of Agreement with the states. Hopefully, the two recalcitrant states that have not yet signed the Heads of Agreement, New South Wales and Victoria, will now come to the party so the process can move forward,” Roff said. “The Heads of Agreement includes a framework for addressing the issue of public hospitals ‘harvesting’ private patients, particularly in emergency departments.”

With the introduction of the Gold/Silver/Bronze/Basic tiered structures, services previously offered to customers may be covered under different tiers and some people may find that services that weren’t previously offered now are.

Read more: Dozens of natural therapies no longer available under new private health rules

“Only ‘Gold’ products will cover everything, so people should be extremely cautious about the low-cost, low-value products in the bottom categories to avoid the shock of not being properly covered,” Roff said.

All Silver policies now include treatment for the heart and vascular system, lung and chest, blood, back, neck, and spine, plastic and reconstructive surgery (medically necessary), dental surgery, podiatric surgery (provided by an accredited podiatric surgeon) and implantation of hearing devices. Gold includes all this as well as treatment for cataracts, joint replacement, dialysis for chronic kidney failure, weight loss surgery, insulin pumps, pain management with device and sleep studies. Both Gold and Silver also include all the benefits of the Bronze and Basic policies.

The news follows the release of the Australian Medical Association’s Public Hospital Report Card in April which shows people are waiting longer than ever for care at public hospitals and that they’re failing to cope with ever-increasing patient demand.

Read more: ‘A depressing picture’: Report shows public hospital wait times increasing

According to the AMA, the report “paints a depressing picture of overstretched hospitals and patients waiting longer for their care”.

While private hospital care is ideal, it’s not affordable for all Australians and the AMA’s report also shows that emergency times for “urgent” patients have gone backwards in all Australian states and territories since the last report.

Are you surprised that private hospital admissions have increased? Are you covered by private health insurance?

IMPORTANT LEGAL INFO This article is of a general nature and FYI only, because it doesn’t take into account your personal health requirements or existing medical conditions. That means it’s not personalised health advice and shouldn’t be relied upon as if it is. Before making a health-related decision, you should work out if the info is appropriate for your situation and get professional medical advice.