Public hospitals being bled by foreign tourists

Tens of millions of dollars in public hospital debts are being run up by tourists each year.

NSW Health Minister Brad Hazzard. Picture: Adam Yip

Tens of millions of dollars in public hospital debts are being run up by tourists, foreign workers and international students each year, prompting a renewed bid to make them pay their way.

However, a NSW proposal to require all visitors to take out health insurance, separate to any travel insurance they might have, has served only to highlight the complexity of the problem.

When NSW Health Minister Brad Hazzard put the proposal on the agenda for the Council of Australian Governments Health Council, he received the cautious backing of several states and his federal counterpart, Greg Hunt.

“Regardless of who they are, if you are sick you should be able to access healthcare,” Mr Hunt told The Australian.

“However, there is a cumulative effect when temporary visa holders, who are often here on holiday, access our public health system, incur costs, and then leave the country with debts unpaid.”

A ministerial advisory committee has since been asked to recommend options to “ease the burden on Australia’s public health system” without jeopardising the tourism, skilled worker and education sectors.

Mr Hazzard said about $30 million worth of public hospital treatment for Medicare-­ineligible patients in NSW was left unpaid each year. Most of that was for hospital accommodation.

NSW has highlighted the case of an uninsured patient from China who spent two months in hospital recovering from a brain haemorrhage and was unable to pay the $250,000 bill.

In some cases, visa holders give birth in public hospitals, leading to speculation trips are being planned to allow mothers to access Australia’s health system.

Western Australia has previously complained of mining workers using public hospitals to obtain expensive HIV drugs, while emergency departments frequently have patients arrive with pre-existing conditions that have gone untreated.

Last financial year, it is estimated $16.5m in debts were incurred at Victorian public hospitals. More than half of the 13,000 foreign ­patients were treated following emergency admissions.

As of October, Queensland had a total outstanding debt of about $11m for Medicare-­ineligible patients. “Queensland’s doctors and nurses save lives first,” a Queensland Health spokeswoman said. “How those services are paid for comes second.”

While some visa classes ­already require health insurance, there are often out-of-pocket ­expenses left to be paid by the ­patient, which may lead them to go public instead. Some visitors complain of having to pay thousands of dollars ­upfront for policies with insufficient cover. The Private Health Insurance Ombudsman’s office recently noted that “the financial impact on visitors who have hospital claims refused by health insurers are usually much greater than they are for Australian residents who can access Medicare”.

The NSW proposal comes as the federal government seeks to crack down on states billing insurers for public hospital treatment Australian citizens are otherwise entitled to without charge.

Private Healthcare Australia head Rachel David said the success of the NSW proposal would depend on the problem ministers were trying to solve. She said travel insurance was meant to cover emergency treatment, whereas health insurance covered elective surgery, admissions for chronic mental health problems and basic dental care.

“If the issue they are concerned about is that ageing travellers may not be covered for pre-existing conditions, may be admitted to public hospitals and then create a complex cost-recovery issue as well as occupying needed beds, then the health insurance solution makes sense,” Dr David said.

Australia has reciprocal health­care agreements with 11 countries, but in 2017 moved to restrict ­access to assisted reproductive services to cut costs.