Health funds offer help with birth fees
BRIDGING THE GAP
HEALTH funds have offered to pay the massive obstetrician booking fees to stop the stampede of women moving back to public hospitals to have their babies.
The offer comes as new research shows the medical bills for having a baby have skyrocketed more than 1000 per cent above inflation in the past 24 years, leaving mums facing an average $264 bill to visit an obstetrician.
In addition, new mums face an average $781 gap fee for a hospital delivery, a 77 per cent rise above inflation since 1992-93, new research shows.
The research published in the Australian New Zealand Journal of Obstetrics and Gynaecology today does not include the upfront booking fees of between $2000 and $13,000 charged by many private obstetricians.
These massive fees are not covered by Medicare or health funds and health-fund data shows they can be as high as $13,000.
Private Healthcare Australia chief Rachel David said low wage growth and women facing a period off work after having a child could no longer afford these fees, so they were deciding to give birth in a public hospital.
The proportion of women giving birth in private hospitals dropped from 28.2 per cent in 2006-07 to 24.5 per cent in 2015-16.
Private hospitals are losing business and it is hard for newly qualified obstetricians to build a private practice, it also means young families never take out health cover, Ms David says.
In a bid to stem the tide, insurers have held formal meetings with doctors and offered for the first time to cover reasonable obstetrician booking fees.
Exorbitant booking fees of $13,000 will not be covered but funds would be prepared to pay a set amount to cover a modest booking fee, she said.
Patients of doctors who charged above this limit would not be entitled to any rebate to contain inflation in the area, she said.
Doctors have yet to agree to the offer, citing fears it amounts to managed care but Ms David says there would be no pre-approval needed from a fund and insurers would not dictate the type of care women received.
The exorbitant obstetrician’s charges add to mounting pressure on the Government to force doctors to publish their fees so consumers can make a more informed choice about the bestvalue doctors.
Health Minister Greg Hunt has set up a committee to examine why doctors are charging out-of-pocket medical and find ways consumers can be better informed of fees before agreeing to treatment.
The number of medical services that attracted a gap payment has increased from one in nine to one in seven between 2014-15 and 2015-16.
Australian Medical Association president and obstetrician Michael Gannon said antenatal care was now more complex and many obstetricians now employed midwives on staff and this had to be paid for.
The AMA is opposing any attempt to make doctors publish their fees on a website to help patients choose a better value doctor.
Dr Gannon said he charged 16 different fees for delivering a baby depending on the health fund a woman belonged to.
Doctors like himself who participated in no gap schemes had to set their fees within the parameters set by the funds and this meant there was no uniform charge, he said.
However, Ms David says modern technology meant these problems were easy to overcome.
“If the medical profession continues to have their head in the sand then technology will overtake them and medical directory services like Healthshare and White Coat will do it anyway,” she said.
“We don’t want the health funds to own the process, it would be ideal if the medical profession owned it,” she said.
Experts have warned publishing doctor’s fees could be inflationary, with lower charging doctors increasing their fees if they see their colleagues charge more than they do.
Health fund enrolment has plunged by 50,000 members and insurers are desperate to drive down the out of pocket costs faced by their members.
TAS .......... $655 (in hospital) .......... $123 (out of hospital) NSW................................................... $788 (in) $328 (out) VIC ..................................................... $780 (in) $395 (out) QLD.................................................... $683 (in) $163 (out) SA ........................................................ $912 (in) $197 (out) WA ......................................................$928 (in) $183 (out) NT ......................................................$302 (in) $340 (out) ACT ................................................... $698 (in) $260 (out)