Patients And Doctors Are The Victims In Private Health Funding Dispute

The Royal Australasian College of Surgeons (RACS) is calling for an immediate resumption of negotiations between Australia’s only national private hospital operator and private health funds, to avoid out of pocket price escalations for patients.

From 26 November 2024, private hospital operator Healthscope says it will begin charging an out-of-pocket fee to Bupa and Australian Health Service Alliance members in its 38 hospitals after failing to reach an agreement with the funds.

RACS says the breakdown in discussions will have significant implications for patients and surgeons across Australia.

“At a time when we know that cost of living pressures are hurting Australians, this is a terrible outcome," says RACS President Associate Professor Kerin Fielding.

"This will result in healthcare costs going up and may lead to patients deferring or cancelling their surgeries or opting to undertake them in the public hospital system. This would only create issues downstream, or add significant pressure to an already under pressure public health system.

“Our primary concern is ensuring patients get the care they need when they need it. We also want to feel confident that surgeons have the necessary resources to provide that care, in an appropriate, high-quality manner. Patients would rightly be confused about why they are being charged an out-of-pocket fee on top of the insurance premiums they are paying, which they were told would cover the cost of these surgeries when they were needed.”

“We urge all parties to return to the negotiating table for the sake of patients, doctors and the health system at large,” Associate Professor Fielding says.

“We ask that they resume negotiations in good faith and find an agreement that balances the needs of patients, surgeons, and healthcare providers, while recognising the increasing costs of delivering quality surgical care."

Private hospitals play a vital role in the provision of healthcare in Australia, alleviating pressure on public hospitals and ensuring timely access to surgery. A viable private sector is essential for maintaining a balanced healthcare system and benefits the broader community.

RACS remains committed to advocating for a sustainable healthcare system that provides fair access to care and encourages long-term collaboration between all stakeholders.

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