Submission to DOH on private patients in public hospitals

Older Australians remain strong subscribers of PHI (with 52.6% of people over the age of 65 retaining coverage)1 despite generally much lower incomes and greater difficulty meeting premiums and out-of-pocket costs after retirement.

However, it is also important to note that nearly as many older Australians do not have PHI as do, and there are strong variations in coverage amongst older people depending on factors such as marital status, cultural and linguistic background, incomes and where a person lives. Therefore, COTA is very interested in and concerned about the interaction between the public and private health systems, as well as having a strong interest in their separate operation and delivery within a publicly supported mixed system.

COTA has for some time been concerned about the issue of private patients in public hospitals, based on anecdotal information both from older Australians and from health practitioners. Older Australians report being pressured to declare as private patients , and offered inducements to do so, including that they will receive faster treatments if they do so.

As the government is aware this repeated anecdotal evidence over some time has now been validated with the release of deeply concerning figures by the Australian Institute of Health and Welfare (AIHW) in May showing the growth in numbers of patients who used private health insurance to fund all or part of their admission to public hospitals and the simultaneous finding that:

Public patients had a median waiting time of 42 days for elective surgery in a public hospital, while it was 20 days for patients who used private health insurance to fund all or part of their admission.

COTA joined with other stakeholders (including the Consumers Health Forum3 and Catholic Health Australia4) to call for immediate action by governments to ensure that private patients in public hospitals do not receive preferential treatment ahead of public patients.

COTA believes that the patient’s clinical need must be the only factor for prioritising treatment in public hospitals. This used to be a principle in the Medicare Agreements between the Commonwealth and States, and it should be reinstated.