5AA Mornings program interview with Dr Rachel David on the issue of health care and the Royal Adelaide Hospital

Station: 5AA
Program: Mornings
Date: 10/07/2020
Time: 9:09 AM
Compere: Matthew Pantelis
Interviewee: Dr Rachel David, CEO, Private Healthcare Australia


MATTHEW PANTELIS: But starting off the issue today talking about health care and the Royal Adelaide Hospital. It seems if people are admitted as private health insurance patients, so they’ve got their private health insurance, they’re getting a price shock because they’re being hit for perks including things like free-to-air television, watching that in your hospital room at the Royal Adelaide Hospital, whereas perhaps in the room next door there’s a public patient who’s watching free-to-air for free.

How does that work? It’s amazing, isn’t it? The Opposition says removing things like free newspapers, free internet, free local phone calls is penny pinching stinginess. And you know, what else? I reckon it’ll make private patients who go to the RAH for whatever reason say: no, I don’t have health insurance. I’m a public patient, that’s how I’m here. Why wouldn’t you- you wouldn’t anyway. Would you expect to pay for free-to-air television, for goodness sake?

Let’s find out a little bit more about it. Dr Rachel David is CEO of Private Healthcare Australia and is on the line. Rachel, good morning. Thank you for your time.

RACHEL DAVID: Good morning, Matthew.
MATTHEW PANTELIS: This seems penny pinching in the extreme that a public hospital is charging private patients to this degree.
RACHEL DAVID: Yeah. And look, we’re still trying to get to the bottom of what’s actually happening here. It does sound like some pretty superficial revenue raising. But just to be clear, for people with private health insurance, normally we advise as much as possible, they should try and seek care in a private hospital. That’s both to take pressure off the public hospital system but also because often, a lot of these things are completely taken care of in a private hospital.

But the problem is that there are some people that simply don’t have a choice. That’s because if they have a specialist doctor that only works in the public system or they have a disease or a pre-existing condition that’s very complex or unusual and the public system is the only place it can be treated.

Now, in those situations you would really hope that the public system would step up and treat these people well because they don’t have a choice about where they’re being treated and yet, they’re prepared to contribute something towards the cost of their own care.

MATTHEW PANTELIS: Okay. So it’s- it certainly does raise the question then for people who for whatever reason can’t get into private- a private hospital, maybe it’s fall, maybe- I don’t know, maybe they’ve been taken in an ambulance to the first available emergency hospital and it’s the RAH.

What should they do? Should they- should they admit that they’re a public health- a private health insured person or should they just go with the flow and say I’m here in the public system, I’ll be a public patient?

RACHEL DAVID: Well look, it depends on the circumstances. I think anyone who has gone to hospital in an emergency, should not make that decision right away, particularly- there’s no need for someone whose been taken to hospital in an ambulance or gone to the emergency department to, you know, go through the details of their health insurance before they’ve actually been treated. That’s a decision that can be made down the track and in an emergency, you know, that’s what the Medicare system is for. There’s really no need for you to use your private health insurance at that point.

But for some other people who have planned to go to a private hospital- sorry, who plan to go into a public hospital because that’s the only place they can be treated and they want to use their private health insurance, it- you know, the reason that they might want to do that is because they get a fully trained medical specialist to take full responsibility for their care. That’s important and that’s a very valid reasons to want to use your private health insurance in a public hospital. And so you’d hope that, you know, you wouldn’t- that the public system wouldn’t be nickelling and diming those patients just to raise a few cents in the dollar, when in fact they’re getting paid to have that person in that bed.

MATTHEW PANTELIS: The gazetted change- and I’m reading this in The Tiser this morning. They’ve- they’ve announced through gazetting a rate to charge insurers $624 a night in a private room. Is that standard? Is that about what it should normally cost?
RACHEL DAVID: Yeah. Look, it does differ a little bit between states but that’s about standard. Most rooms are, you know, hospitals are moving towards single rooms at the moment and the charges that the funds get for that is a bit higher. Also, the funding agreement with the- that the Federal Government has made with the states, which was announced maybe about a month ago has also made it a little bit less lucrative for the public hospitals to actively take private patients and that might be another reason why this is happening.

However, that’s not a reason to treat long temptation who might have a serious- who probably has a very serious illness, which is why they’re come into the public system. That’s not a reason to treat those guys badly.

MATTHEW PANTELIS: [Talks over] Yeah. It does …
RACHEL DAVID: And I think, you know, the kind of bean counters in the system need to understand, no one makes- people do not make these decisions lightly. The people that are presenting regularly to the public system are doing so because there is nowhere else they can be treated. So there’s no point in treating those guys badly just to raise a few dollars here and there.
MATTHEW PANTELIS: And I guess too, Rachel, the worse thing for private health insurers is this sort of conduct, even hearing these sorts of things going on, turns people off having private health insurance because you say: well why bother?
RACHEL DAVID: Yeah. And in fact, there’s some very good reasons to have private health insurance at the moment because there’s absolutely no way with the current state of the economy and the impact of COVID-19 that the public system is really going to be able to catch up and manage the waiting time for many common elective surgical procedures, particularly for anything involving an implant, a cataract or a joint replacement.

People, if they don’t have private insurance, they can expect to be waiting a very long time. And you know, and certainly the other big advantage of having insurance is that you get that fully trained specialist who is completely responsible for your care; not a shift worker or a person who happens to be on call that night.

MATTHEW PANTELIS: Yeah. Indeed. I’ve just got a statement from SA Health here from the Central Adelaide Local Health Network Executive Director of Operations Bronwyn Masters and it says: private patients receive a number of benefits in our hospitals, including their choice of consultant. Recent changes made regarding other benefits for private patients like free-to-air TV are currently under review. So there we are. That’s the statement. So maybe they’re going to have another look about it …
RACHEL DAVID: [Interrupts] Yeah. You can imagine a great deal of money would be saved by restricting access to free-to- air …
MATTHEW PANTELIS: [Interrupts] No, it’s crazy, isn’t it?
RACHEL DAVID: In comparison to some of the other costs, that’s pretty trivial.
MATTHEW PANTELIS: Yeah it is. Okay. Appreciate your time this morning, Rachel. Thank you.
RACHEL DAVID: Thanks, Matthew.
MATTHEW PANTELIS: Dr Rachel David there, CEO of the Private Healthcare Australia Group.
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