Insurers Cover Hospital Bills
Sydney Morning Herald
Saturday May 22, 1999
Three private hospitals in NSW are already offering no-gap packages, where patients pay no extra fees to doctors for their treatment.
At Brisbane Water Private Hospital on the Central Coast and at Dudley Private Hospital in Orange, HCF members can leave hospital having had all bills from doctors, pathologists, other diagnostic tests and hospital accommodation paid for by the fund. Patients are given a receipt but not a bill.
Nowra Private Hospital will introduce the system on Monday. HCF plans to introduce the scheme in more hospitals but will not say which or when.
Not all doctors who practise at these hospitals have agreed to be in the scheme. Those who have are accepting fees above the Medicare schedule but below the AMA recommended fee.
At Dudley, where the scheme started two weeks ago, more than half the doctors who practise at the hospital are involved, including orthopaedic surgeons, gastroenterologists, gynaecologists, anaesthetists and pathologists. At Brisbane Water, where the scheme was introduced last November, only 30 per cent of the doctors have used it.
"But it has been well received by those who are in it," said Mr Graham McGuinness, the hospital's chief executive officer. "The doctors are paid within 30 days and they are happy with the deal. No-one was quibbling about the rate we were paying, simply the principle."
Doctors have traditionally been fiercely opposed to any insurance product which promises to cover all the doctors' fees. The AMA has argued that if doctors sign contracts to cap the amount they will charge patients, medical insurance funds will be able to tell the doctors when to discharge patients from hospital or to withhold treatment and tests on the grounds of cost.
"There is nothing to suggest we can interfere in any way in medical practice," Mr McGuinness said. "We can't force a patient out."
He said the hospital had undertaken to pay the cost of a patient's care for as long as a participating doctor said the patient should be in hospital.
Every party involved in the agreement was benefiting, he said. The doctors might be getting less than under the old system, where they billed a patient directly and the patient then applied for rebates under Medicare and HCF, but they were receiving their money faster, had fewer cash-flow problems and did not have the administrative costs of direct billing.
HCF may be paying more for its members' treatment, but expects to retain more members through the system. There had already been a 23 per cent increase in HCF member admissions to Brisbane Water over the past three months, compared with an average 7.6 per cent increase to private hospitals overall, said the fund's chief executive officer, Mr Terry Smith.
A similar system at Melbourne Private Hospital is open to National Mutual members in Victoria and South Australia.
© 1999 Sydney Morning Herald
