Aussies abandoning private hospitals over large fee gaps Patients go public
NOT- FOR- PROFIT he a l t h insurance funds paid 90c of every dollar received from premiums back to members last year, compared with just 84c by for- profit funds, a new survey has found.
Despite the significantly higher payout rate, more than a quarter of Australians do not know that non- profit health insurance funds exist, the finder. com. au survey found.
The report comes as Australia’s largest private hospital owner Ramsay Health Care this week said patients were opting out of treatment in private hospitals because of the large out- of- pocket fees not paid by their health insurance.
“The more Australians turn away from private hospitals, the more weight that places on the public system,” Finder spokeswoman Bessie Hassan said yesterday.
“Unfortunately, the reality is that with growing livingcosts many people have no choice but to rely on the public system, leaving the larger healthcare providers at risk,” Ms Hassan said.
The latest quarterly health insurance statistics found that out- of- pocket hospital costs increased 8.6 per cent during the three months to March 2018. However, on an annual basis, out- of- pocket costs were unchanged compared with March 2017 at $ 316 per treatment.
The Australian Prudential Regulation Authority statistics also found out- of- pocket costs for ancillary treatments, known as extras on most policies, were $ 48 per treatment, down 2 per cent during the quarter but also steady compared with March last year.
The biggest gap in payments was for plastic and reconstructive surgery where patients had a shortfall of 38 per cent of the total costs. This was followed by urology treatments were patients had a shortfall from their health in- surance of 25 per cent, orthopaedics 25 per cent, neurosurgery 20 per cent, general surgery 18 per cent, anaesthetists 15 per cent and obstetrics 11 per cent.
“Controlling what type of fund they sign up to, whether it’s a commercial fund or notfor- profit, could have a big impact financially,” Ms Hassan said.
“The research shows just how many Australians are paying for a product they know very little about,” she said.
The survey of almost 2100 people also found that more women than men were in the dark about not- for- profit funds, 32 per cent said they did not know they existed, compared with 23 per cent of men, she said.
In 2016, not- for- profit funds paid out 89c in the dollar, increasing to 90c last year. This compared with for- profit funds which paid out 85c in the dollar in 2016, decreasing to 84c last year.
There are 24 not- for- profit health insurance funds in Australia and 12 for- profit funds.
On Thursday, Ramsay Health Care was forced to downgrade its profit forecast because of reduced patient numbers at its hospitals. The company said it believed the decline was caused by higher out- of- pocket costs.