" Public " Health !

Analysis of the way public hospitals in New South Wales are serving the public disclose a curious anomaly of how the charges are allocated.   Every Australian is entitled to free care in a public hospital, but on presentation they are asked if they wish to be treated as a " public " or a " private " patient !

It all depends if the patient has private health insurance - and if they wish to use that for any extra benefits it may deliver.  A public patient will be treated by whatever doctor the hospital rosters but a private patient may select a doctor of his or her choice - and receive a bill for that persons  services.  That will be a separate claim on the patient's health fund insurance.

Some hospitals are able to offer private patients a private room instead of the usual shared ward, but in the majority of minor cases both public and private patients receive precisely the same treatment in our public hospital system.  In fact, many patients with health insurance opt to be classed as " public " because they fear getting bills for items that are not covered by their insurance - and by going public the entire service is guaranteed to be without charge.

This analysis indicates that public hospitals in New South Wales have the highest percentage of patients billing their health insurance for their hospital stay.   Royal North Shore bills 35%, Sutherland hospital 41% and St Vincents another 35%.   It is evident that this state's hospitals are more meticulous in persuading insured patients to avail themselves of their insurance cover to keep costs down.

This comes at a time when the premium for health insurance is steadily rising and there is fear that many families may discontinue their cover.  The bean counters estimate that if the rules changed to prevent insured patients billing hospital stays to their health funds the annual premium would drop by $250 a year - and this would deliver a saving of a billion dollars.   It would - of course -  also deliver a sharp increase in the cost of running the hospital system.

Initially, the whole point of private health insurance was to elevate health care for those who could afford it.   The thinking was that such patients could select a leading surgeon of their choice and avoid the spartan conditions of a public hospital for the luxury provided in the private hospital system.   To some extent, that choice exists in major cities but in lesser centres the choice is to receive basically the same care in the local public hospital, hence many choose to avoid any extra bills and opt for " public " care.

This seems to be a conundrum that will face health care providers in the future.   We are making great strides in the treatment of diseases and the wonder medical equipment that delivers miracles cost a mint of money.   The public purse is not bottomless -  and insurance seems the obvious way to share costs between the public and private sectors.   The sticking point seems to be leaving the decision in the hands of the patient.

If the health providers fail to get their sums right, that may resolve itself.  If the cost of private health insurance moves out of reach the vast majority will automatically become " public " patients !