Sooner or later the government is going to need to revisit the gaping holes in our healthcare system. Picture: iStock
Sooner or later the government is going to need to revisit the gaping holes in our healthcare system. Picture: iStock

Patients, be sure to mind the gap when falling ill

THERE'S been much tearing of political hair and gnashing of media teeth over the recent bed shortage afflicting public hospitals in Queensland.

A colleague recently wrote on the impact of rapid population growth having a habit of rearing up and snapping, like a wrecking-yard dog, at the face of governments - in this case the Queensland Government, though this isn't an issue confined to the Sunshine State.

There's little doubt governments are quick to pocket the proceeds of any economic growth generated by more people milling about, but often slow (or too incompetent?) to respond to the challenges an enlarged mob also presents.

Challenges like increased pressure on hospitals and schools, roads and public transport, housing and so on.

God knows, politicians all over country but especially the ones in Canberra seem to have sat on their hands as migrants have continued to pile in, largely in accordance with Commonwealth immigration quotas, while failing utterly to fund and build the infrastructure to accommodate us all. And then, when everything's pretty much chocka and Joe and Sally Whitebread-Taxpayer are getting ornery, they pull one of their hands out from under their bums and point at Sanjiv and Fatima Newbie and join the chorus chanting "It's their fault".

Well, it isn't. It's yours and don't point, it's rude.

There’s been much tearing of political hair and gnashing of media teeth over the recent bed shortage afflicting public hospitals in Queensland. Picture: iStock
There’s been much tearing of political hair and gnashing of media teeth over the recent bed shortage afflicting public hospitals in Queensland. Picture: iStock

But I'm not swallowing the failure to catch up with population growth as the only explanation for hospital bed shortages, which occur from time to time and not just in Queensland.

Nor am I buying, in toto, the line put out by Australian Private Hospitals Association CEO Michael Roff that the Queensland shortage was created by Queensland Health "prioritising" privately insured patients at the expense of the uninsured.

Commenting on the "cruel irony" of the State Government stumping up $3 million in March to pay for the treatment of public patients in private hospitals to clear the backlog, Roff was reported as saying "the reality is if public hospitals weren't so blinded by the idea of making an extra dollar or two out of the privately insured, there would be enough beds for everyone".

That's pretty much the same song sheet, Health Minister Greg Hunt's sung from and not just this year and not just about Queensland.

Questioned about a "massive bed shortage" in South Australia on Adelaide radio last year, he said patients in that state were "being harvested out of private hospitals to public hospitals".

Harvested? Is it just me with a mental picture of public hospital administrators breaking into private hospitals in the dead of night, kidnapping frightened but well-insured patents, strapping them to gurneys and running up the road with them to the nearest public hospital? About 134,000 of them in Queensland in 2018 if the Australian Institute of Health and Welfare figures are correct.

But given the body snatching isn't actually happening, the $3 million question is why are people with private health insurance going public?

The $3 million question is why are people with private health insurance going public?
The $3 million question is why are people with private health insurance going public?

I think I can offer one pretty sound reason - out-of-pocket costs which I have banged on about in so many previous columns about our supposedly universal but ramshackle health system that I feel I should apologise for the cracked record.

But just how significant these can be was rammed home to me again, in February, when my 95-year-old mum fell backwards through a window in her aged care home.

Badly cut, terribly shaken but with no immediate sign of things like broken bones and with top level private health insurance and mindful that if we presented at the Royal Brisbane's ED she might be faced with a stressful wait, we arranged for the ambulance to take her to a large private hospital with an ED, where she was admitted.

The out-of-pocket costs associated with her treatment there totalled $984.05. A week or so later she was taken back to hospital out of sorts and with suspected heart issues. These settled down and she wasn't admitted. But the out-of-pocket costs for this sojourn were $230.15 bringing the grand gap total for the two incidents to $1224.20 - a dirty big outgoing for anyone but particularly an aged pensioner.

That gap encapsulates the dilemma faced by many with private health insurance.

Can insured people really be blamed for going public to avoid such severe hip pocket pain and should public hospitals really be roundly criticised for taking advantage of their insurance?

Can insured people really be blamed for going public to avoid such severe hip pocket pain? Picture: iStock
Can insured people really be blamed for going public to avoid such severe hip pocket pain? Picture: iStock

Since 2013, Mum's private health premiums have increased nearly 60 per cent. This year she will pay $2680.20 for her renamed "Gold" Top Hospital and Blue Ribbon Extras cover with Medibank Private.

The impact of the Gold, Silver, Bronze, Basic "tier" reforms the Coalition Government has introduced ostensibly to try to make insurance more affordable and relevant to consumers' needs and so halt the health cover exodus is, as yet, unknown.

But, surely, unless this issue of gap payments is addressed the system will continue to be regarded by many as unfair, not good value for money and therefore will continue to add to the pressures on the public system.

What is required, cue cracked record, is a thorough review and updating of the Medical Benefits Schedule fees for services and procedures on which rebates are based (and for the MBS to then be regularly updated).

Also, the medical profession needs to address the issue of gouging by some medicos and imaging and pathology companies.

Finally, the Medicare levy, stuck at 1.5 per cent for 25 years and counting, must be increased to pay for the higher rebates associated with a fairer fee schedule.

In the meantime a warning to all private health policy patients: be sure to mind the glaring gap.

Margaret Wenham is the Courier Mail's opinion editor.