AMA (NSW) President: Medibank risks harm to regional patients

Medibank Private’s ongoing feud with Calvary hospitals is driven by money, is to the detriment of patients and is derived from an obstinate misunderstanding of how medicine works.

“This is particularly going to be a problem in rural centres like Wagga Wagga, where the Calvary Hospital is unable to take Medibank Private patients beyond the 31st of August.

“Medibank is threatening to cancel its arrangement with the hospital, meaning that it will not cover costs for its members who seek treatment there,” AMA (NSW) President, Dr Saxon Smith, said.

“This means that unless urgent action is taken, from September 1, Medibank patients will need to travel to Sydney, another centre or go to the public hospital,” AMA (NSW) Councillor and Wagga Wagga Surgeon, Dr Henry Hicks, said.

“Access to private hospital services is a vital part of providing care to regional patients.

“Our patients are already often travelling long distances to access healthcare and additional barriers will have significant implications.

“Our regional public hospitals cannot cope with the additional demands if patients are not able to access private services,” Dr Hicks said.

“Medibank and others in the private health insurance industry who have come to its defence are in the wrong.

“Medibank’s dispute with Calvary is driven by the interests of shareholders, not the health fund’s members or patients as a whole.

“If Medibank and other insurers are able to refuse to pay for known complications, Calvary – and other private hospitals – will be unable to take on high-risk patients, forcing them back into the public system.

“A great feature of the Australian health system is the balance between the private and public systems and the ability of private hospitals to relieve pressure on public ones.

“Private health insurers are increasingly trying to disturb that balance and this feud is another example of this kind of behaviour,” AMA (NSW) President, Dr Saxon Smith, said.

“For every medical procedure, just like any medicine, there is potential for unwanted side-effects.

“In medical procedures, these are called known complications.

“Known complications are distinct from medical mistakes, because no matter how good the doctor is, no matter how flawless the surgery, known complications can still occur.

“Medibank is seeking to define known complications as mistakes, allowing it to refuse to cover follow-up treatment, if necessary, to correct them.

“This would mean private hospitals will no longer be able to take on high-risk patients for their initial treatment, let alone the follow-up.

“This not only drives down the value of private health insurance, it also means the public hospital system could be inundated with patients who would have otherwise been treated in the private system,” Dr Smith said.

Media contact: Lachlan Jones (02) 9902 8113 / 0419 402 955