How Melbourne’s public hospitals push up health fund premiums

Public hospital care should be free but three hospitals in Victoria are tricking patients into billing their health funds which is pushing up costs. SEE IF YOUR HOSPITAL IS ON THE LIST

Exclusive: Almost one in five patients at Melbourne’s biggest public hospitals are having their health fund billed for their care under a practice that is pushing up health fund premiums by $92 a year.

Austin Hospital, Royal Melbourne Hospital and Box Hill Hospital are billing health insurers for public treatment at twice the rate of some other public providers in Victoria.

Annual reports show they are earning between $30 million and $50 million a year by charging patients and their insurers for their care.

Health service annual reports show around 25 per cent of the patients treated at these hospitals were privately funded either by health insurance or other means in 2017-18.

A recent Auditor General’s report found at three other Melbourne hospitals — Latrobe Regional Hospital, St Vincent’s Hospital Melbourne (SVHM) and Western Health- earned over $200 million from private patients in the past two years and that patients did not always consent to having their health fund billed.

It also found hospitals were breaking the rules by double dipping and charging both Medicare and insurers for the same service.

If you’ve had an experience of a public hospital trying to get you to bill your care to your health fund contact [e-mail]

Some patients end up paying gap fees for care that would be free if they had not billed their health fund. Picture: iStock

Health funds have warned the practice of public hospitals encouraging patients to bill their care to their health fund is adding $1.6 billion a year to premiums and pushing up the average annual premium bill by $92.

And health fund membership has plunged to its lowest level in more than a decade despite major government reforms as premiums continue to rise above inflation.

News Corp revealed last month that some public hospitals in NSW were pursuing people beyond the grave and demanding relatives billed their deceased loved one’s private health fund for their treatment.

Others were asked multiple times to bill their health fund including even just before they were put under an anaesthetic for surgery.

Many people faced massive out of pocket expenses after electing to use their health fund to pay for treatment they were entitled to for free in a public hospital.

Some were being sent letters after they were discharged asking them to allow the hospitals to bill their health fund.

Free public hospital care is a fundamental right for all Australians, it’s guaranteed under Medicare and Clause 5 and G19b of the National Health Reform Agreement (NHRA) but health fund members are being tricked into thinking they have to pay.

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A Herald Sun investigation has found cash strapped Victorian public hospitals are also engaged in the practice.

Two of the state’s biggest hospitals are actually advertising for staff whose job description is to chase patients for private health insurance money.

Austin Health — Job ad for staff in Victoria where the job description is to chase people to get them to bill their health fund for their care

A job advertisement for a patients Accounts Officer at Austin Health in November 2017 stated the person would be “responsible for election of private and compensable patients, billing patients, receipting and debt management”.

Another job advertisement for a revenue services officer at Melbourne Health in May 2016 stated: The Revenue Services Officer “assists in growing the private practice profile at Melbourne Health with a focus on private and compensable patients”.

Austin Health’s annual report shows it raised $39.8 million from patient and residents fees in 2018, Melbourne Health earned $42.2 million, Eastern Health earned $48.7 million from patient and residents fees in 2018

Private Healthcare Australia chief Dr Rachel David said Victorian public hospitals have increased their private health insurance income by 75 per cent over the past 10 years.

“That’s more than a quarter of a million dollars in 2016-17 for families with private health insurance ($256m in 2016-17),” she said.

Austin Health said “patients have the right to use their private health insurance in public hospitals if they choose to. Our staff ensure that patients are informed of their rights and that they have the option to use the system as a public or a private patient.”

Melbourne Health said “privately insured patients can choose to be treated as a public or a private patient — that is their decision alone”.

“Melbourne Health receives funding from a range of external agencies including the Department of Health and Human Services, Transport Accident Commission (TAC), private health insurance companies, Medicare and donors,” a spokesman said.

Originally published as How Melbourne’s public hospitals push up health fund premiums