Putting members’ health before profit

Tasmanian Public hospital waiting lists under even more pressure

Public hospital waiting lists under even more pressure if private health insurance affordability is not resolved: full restoration of the Australian Government Rebate a must.

With more than 2000 Tasmanians languishing on public hospital waiting lists for more than 12 months, alarm bells should be ringing.

“The official data suggests that waiting lists are out of control. 12.9% of all patients on Tasmanian elective surgery lists have been waiting over a year for common procedures like cataract surgery, knee replacements and hip replacements, and there are no signs the situation will improve any time soon,” said hirmaa CEO Mr Matthew Koce.

“Delays in treatment can result in disastrous consequences for patients and their families. Aside from the obvious long term health effects, it can result in lost income through time off work, going through months of pain and suffering and missing out on quality time with loved ones.”

“It is positive that the Tasmanian Government is taking ownership of this issue and their establishment of a panel to prioritise elective surgery cases is necessary to help those patients that have been waiting the longest,” said Mr Koce, “but the official government statistics are unambiguous, quick access to high quality care can only be guaranteed through the private health system”.

Having health insurance opens up access to the private hospital network and is the only way to ensure fast treatment and avoid long waiting lists in the public system.

“Patients in a private hospital have the right to choose the doctor of their choice and they will not be left stuck on long waiting lists, wondering if they will ever receive treatment,” said Mr Koce “Too often we take our good health for granted and only realise the importance of health insurance once something goes wrong.”

According to the Australian Institute of Health and Welfare (AIHW), the number of patients treated from Tasmanian public hospital waiting lists has decreased fairly consistently since 2009-10. In 2014-15 there was a small increase in admissions, but the waiting list still grew, with additions outpacing removals.

In 2014-15, 41% of all patients admitted for elective surgery were not done so in the clinically recommended time frame. 27.2% of urgent ‘Category 1’ patients and a whopping 57.2% of less urgent ‘Category 2 patients’ were not treated in a clinically acceptable time-frame.

Urgent ‘Category 1’ patients that were not admitted in the clinically recommended time-frame had to wait on average an additional 21 days for surgery. Semi-urgent ‘Category 2’ patients had to wait on average an additional 182 days, and non-urgent ‘Category 3’ patients, an additional 247 days.

470 patients could not be contacted for surgery, including patients that have died whilst left on waiting lists.

The AIHW data reveals that Tasmanians on elective surgery waiting lists waited an average of 273 days for a cataract extraction, 274 days for a hip replacement and 374 days for a knee replacement. 51.8% of all patients requiring a knee replacement had to wait more than 12 months for surgery and many waited more than two years.

While around 45% of Tasmanians have private hospital cover, growing affordability pressures are causing more and more to reconsider their cover. This could have a devastating impact on public hospital waiting lists by blowing them out even further.

“Cuts to the government rebate combined with tough means tests are hurting the hip-pockets of ordinary Australians trying to do the right thing by themselves and their families, with many being forced to downgrade their private health cover or drop it altogether.”

Two thirds of all elective procedures are performed in private hospitals. Therefore, even a small decline in the number of families with Private Health Insurance could have overwhelming consequences for Tasmania’s already overstretched public health system.

hirmaa’s analysis shows that a family on a combined income of $180,000 with no member over 65 years of age, would pay almost $500 less annually for a top-cover policy if they were still receiving their full, non means-tested rebate.

Cuts to the rebate added on average another 1.7% to the cost of a policy this year, and 1.4% the previous year. By 2020, it is estimated that the full 30% rebate will be slashed to just 23%.

“The ongoing sustainability of the health system is dependent on a viable private health sector. Therefore it is of critical importance that the Federal Government make haste and end means testing while restoring the full 30% rebate for private health insurance,” said Mr Koce.

“It is quite clear that public hospitals are struggling and just would not cope with a greater volume of elective surgeries.”

In the 2014 calendar year private health insurers paid $17.2 billion in benefits that would otherwise have to be paid by government. For every dollar paid to private health insurers in premiums, on average almost 90 cents are paid back to members in benefits.

hirmaa is the peak industry body for eighteen health insurers which are community based, member- owned and not-for-profit. In all, the hirmaa funds provide private health insurance for well over one million Australians.

A complete list of hirmaa funds is available at https://membershealth.com.au/our-funds/.