Australian Health Insurance

Overheard an interesting conversation today while visiting our of my customers. The customer is a gynaecological practice and while there my conversation was interrupted by a phone call.

The call was from a potential patient who was enquiring about the cost of delivery for her baby. She is not an Australian, but working in Oz as a doctor.

I heard the staff member discussing the procedure and associated costs and I was blown away by one part. The fee from the practice to the patient for an “simple and straight forward birth” was $1700. 

Wow!! A big figure you think? It is but the most amazing thing about this conversation was still to come. The staff member asked the lady on the phone if she had Health Insurance and as the answer was yes, they went on to discuss the “gap” payment. The “gap” is the amount between the scheduled amount (the amount the health funds will pay) and the actual fee.

Any guesses? You’re all wrong. The scheduled amount is $450. Yes that’s a gap of $1250. So even after all the premium payments, no matter how long you’ve been making them, you still need to find $1250 just to cover the gynaecologist’s fees. The patient was then advised to make contact with an anaesthetist to discuss the fees involved there.

We had a short discussion once the phone call was over and the main reason fo these charges was explained as “insurance”. The dosctors at this practice spend more the $450K dollars per year on “malpractice” insurance.

Puts the governments “Baby Bonus” in a new light. $5000 doesn’t go very far if you pay your own way…

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One comment on “Australian Health Insurance
  1. Interesting article i totally agree with the comments above. Keep us posting