Wait times are blowing out – How can private health insurance help?
If you’re looking to undergo surgery, you may expect to wait over a year for the procedure. But there’s a simple way you can avoid the delay.
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The waiting list for elective surgeries has increased across Australia as long patient backlogs continue to intensify demand on hospitals.
From 2020 to 2021 around 754,600 patients were admitted for surgery from public hospital elective surgery waiting lists, according to the Australian Institute of Health and Wellness.
However, the proportion of patients waiting more than 365 days for the surgery also increased in the 2020-2021 period from 2.8 per cent to 7.6 per cent.
Australian Patients Association CEO Stephen Mason said after speaking with doctors and nurses working in public hospitals, there’s ‘no doubt in most states there is a pressure on the health system’.
“There’s been a long waiting time for elective surgery since the start of the pandemic, and wait times have roughly doubled prior to pandemic times,” he said.
The greatest increases in median waiting times were for tonsil removal at 123 days, treatment for varicose veins at 94 days and a total knee replacement leaving patients waiting 85 days for treatment.
“Private hospitals are having the same issues during the pandemic as there were delays because there were limits on elective surgery,” Mr Mason said.
Could you save on your health cover?
Why are wait lists for elective surgery increasing?
According to the AIHW, the reason behind wait times increasing for most procedures was thanks to the restrictions from 2019-2020 on elective surgery due to COVID-19.
Mr Mason said while hospitals continued with category one surgeries, most category two and three were cancelled.
“Hospitals already have reduced capacity, and the available capacity went to Covid patients,” he said.
“When surgery resumed, it only ran at 50 per cent for a while before increasing to 75 per cent, which led to a big backlog that we haven’t reduced yet.”
How long are people waiting?
While wait times are increasing for elective surgery, Mr Mason said the longest waiting time is for category three surgery because they’re not life threatening.
However if the surgery is life-threatening, patients can usually expect a short wait time.
“Anything relating to the heart, cancer, stroke, that usually has to be done in 30 days,” he said.
“For those categories of surgery, if you wait too long it can become urgent.”
“When you get into category three, they’re not life threatening, but they do impact your quality of life.
Elective surgery is classified into three categories with estimated times for operation, depending on their seriousness.
Category 1 elective surgery:
Urgent and can potentially deteriorate where the issue may become an emergency and should be performed within 30 days.
Category 2 elective surgery:
Semi-urgent and is causing patient dysfunction or disability but is unlikely to become an emergency. Recommended performance time for the surgery is within 90 days.
Category 3 elective surgery:
Not life threatening but impacting your quality of life. The recommended performance time is within 365 days.
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Can taking out private health insurance help reduce wait times?
Private Health Insurance Australia CEO Dr Rachel David said a record 14.116 million Australians have taken out private health insurance during the pandemic to “avoid catastrophic delays in essential non-emergency surgery.”
“Improving affordability and access to private health insurance is the key addressing the current hospital crisis and ensuring Australians can access the healthcare they need,” she said.
Ms David said private health insurance is the “most effective way to clear the backlog of surgery and take pressure off the public hospital system.”
“Public hospitals across the country are facing higher patient loads and waiting times for surgery have exploded during the pandemic,” she said.
“That’s why Private Healthcare Australia is calling on an incoming government to restore the PHI rebate to 30 per cent for low and middle income families.”
While the rebate is currently less than 25 per cent, many Australians have been hit hard by inflationary pressures and rely on the PHI rebate to keep their health insurance affordable.
“Without the rebate, Australians with health insurance would face higher health bills every year, leading to many families opting out of private hospital cover and relying on the already overburdened public hospital system,” she said.
“Any future Government must ensure the private health system remains sustainable and affordable in order to provide world-class services and access that 14 million Australians rely on.”
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