Out-of-pocket costs and the future of private health insurance
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Why are Australians losing confidence in private health insurance?
Hello and welcome to this week's health report with me, Norman Swann. Today, how men with prostate cancer may not be monitored as well as they should. Cities and mental health, are they bad for your mind? Are they good? Or does it depend on the city? And a glimpse into this week's Four Corners.
You know, you're sitting there with someone telling you that you've got a a reasonably aggressive cancer. And I think the other factor that played into our mind, my wife and I's mind, is our son was getting married in November. This is September. And I actually wanted to be there.
So then presumably a conversation about cost came up?
Yes it did. So my comment to him was, would I have to mortgage the house to have this surgery? And the answer was no. It's competitive to other cities and uh t uh sixteen thousand was the figure.
And your reaction to that?
Um, a bit gobsmacked. But I think I was thinking at the time, oh well, I'm in health fund.
John Dunn, one of the patients on this week's Four Corners, and you can see that on ABC IV. There are constant headlines about how people are losing confidence in private health insurance. One reason is rising premiums, but another is the gap between what doctors charge you and what you get back from Medicare and your health fund. We asked you to send in your bills if you were upset about your out of pocket expenses, and hundreds of you did. It was extraordinary and actually shocking. A urologist in Canberra charging twenty seven thousand dollars for a prostotectomy that could have been done in Melbourne for a fraction of that, a potentially illegal under the counterfee of six thousand dollars, and so it went on.
One of the commentators on the program is Professor Stephen Duckett, who runs the health group at the Grattan Institute. I thought I'd give you a chance to hear what he had to say that we didn't have time to play on Four Corners, because we're just beginning to see significant cracks in private health care. In addition to issues around private health insurance, at least one major private hospital group is struggling. Out of pocket may be killing the goose that lays the golden egg. Stephen Ducket.
I think what we're seeing are are problems in the in the private health insurance and the private hospital system generally. It's not an immediate thing that's just happened yesterday. It's something that's been accumulating over the years. And though the number of people with private health insurance has been basically stable at a little bit of a dip recently, what's been happening is people have been dropping the level of cover. So as private health insurance premiums have gone up, people have kept their private health insurance, but they've dropped. They've started taking out products with copayments and they've started taking out products with exclusion clauses. So they're not covered for orthopedics or they're not covered for maternity or they're not covered for something else.
To what extent do people realise that?
One of the criticisms there's been a vast increase in the number of complaints to the uh private health insurance ombudsman. And one of the things uh people complain about is the small print that they don't realise what they're not covered for. I'd say they front up to a private hospital and they suddenly discover that they're not covered or they're not fully covered for the operation they are about to have. And so I think this is leading to real increase in dissatisfaction for the insurance they have got. believe.
that the public sector has become much more of a competitor for the private system.
So over the last twenty, thirty years there's been a much greater focus on waiting times in the public sector, and waiting times are um improving in many states. And of course, one of the reasons people took out private health insurance in the past was they wanted to bypass the public sector waiting list. And so now the waiting times are much better. Public hospitals are in a sense much more competitive. And there's been this massive infrastructure investment.
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Chapters
4 chapters
1
Why are Australians losing confidence in private health insurance?
0:00–4:56
2
What do the submitted medical bills reveal about out‑of‑pocket costs?
4:56–8:11
3
How does Professor Stephen Duckett explain the strain on the private health system?
8:11–18:41
4
What future trends could reshape private health insurance over the next 20 years?
18:41–28:20
Speakers
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