Victorian public hospitals targeting private patients to raise revenue
A shock investigation has busted open controversial “targets” set by the Victorian Government to recruit privately insured patients to pay for their public hospital care.
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Exclusive: A special News Corp investigation has busted open controversial “targets” set by the Victorian Government to recruit privately-insured patients to pay for their public hospital care.
In the 14 Melbourne health districts the state government has set an expectation that 143,400 services for 2018-19 would be billed to health funds or patients themselves.
This represents almost one in three services in some public hospitals in Melbourne that were to be billed to health funds, care that should be free under Medicare.
The investigation found:
* Melbourne’s premier cancer hospital Peter MacCallum was set a target of billing 30.9 per cent of the care it provided to health funds.
* The Royal Victorian Eye and Ear Hospital’s target was 24.4 per cent.
* The Royal Children’s hospital had a target of billing 23.6 per cent of services to health insurers.
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The investigation also discovered the practice had been going on for eight years and in documents obtained for the past two financial years, the “target” rate had remained steady.
The revelation comes as federal Health Minister Greg Hunt has delivered an ultimatum to the state’s health minister demanding public hospitals stop pressuring patients to be treated privately.
Mr Hunt has written to the state’s health minister Jenny Mikakos demanding she stop the practice.
“I seek a guarantee that you will entirely cease practices of pressuring patients to be treated privately in public hospitals,” he said in the letter obtained by News Corp Australia.
Health Minister Jenny Mikakos said “patients who have private health insurance have the right to be treated as a public patient or a private patient in our hospitals and have a right to use the insurance they’re paying for if they wish”.
“If only Greg Hunt cared about Victorian patients and public hospitals as much as he cares about private health insurance companies and their shareholders,” she said.
Victoria denies the number of expected private services it sets are “targets” and insists they are merely budgetary estimates and says the rate of private patients using public hospitals has fallen from 12.9 per cent in 2012-13 to 12.1 per cent in 2017-18 across all hospitals.
News Corp Australia revealed last week that one in five patients at Melbourne’s biggest public hospitals are having their health fund billed under a practice that is pushing up health fund premiums by $92 a year.
Dozens of patients contacted the Herald Sun after the article to reveal how public hospitals refused to take no for an answer when they refused to bill their health fund for public care.
One patient said they were asked three times including when they were stressed and being prepared for surgery.
Others were sent letters styled as invoices after they were discharged asking them to retrospectively bill their health fund for their care.
“The letter was quite confronting and was guilting us into sending our health fund details”, one patient told the Herald Sun.
An auditor general’s report into the private use of three of Victoria’s public hospitals uncovered a slew of problems including double dipping where Medicare was billed.
It also found private patients at one hospital got treated eight times faster than public patients in breach of hospital funding rules.
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A spokesman for Mr Hunt said the National Health Funding body and the Department of Health is undertaking analysis to identify if there are instances of double payments being made.
The Australian Government intends to discuss initial findings on a small subset of data at the upcoming COAG Health Minister’s meeting in November.
“If double payments are found the Department of Health will work with State and Territory Governments to discuss the findings and any proposed compliance activities. A focus on how to avoid these payments in the future would be a key part of these discussions,” the spokesman said.
Health fund Bupa said patients should not be pressured into using their private health insurance in public hospitals.
“Patients should know in advance what they will be charged for a procedure, how that compares to other specialists’ fees, if the procedures is covered under their health insurance policy, and what (if any) out-of-pocket costs they may face,” a spokesperson for the fund said.
Medibank said if patients opted to use their cover “they get the benefits of using their health insurance, such as having access to the doctor of their choice”.
“If any of our customers are ever feeling pressured to use their health insurance in a public hospital, we encourage them to contact us so we can support them through this process,” the fund said.