Hospital Horror Story

I was surprised there wasn’t more in the media this week when Treasury's annual Tax Expenditures Statement, required as part of the charter of budget honesty, was released.

Peter Martin writing for the Sydney Morning Herald reports that the 25 tax breaks that were identified, each cost more than $1 billion and together cost $150 billion.

The private health insurance rebate costs the government $6.5 billion and is classified as a cash expense.

How it is classified however, does nothing to address the issue of under-funding in our public hospitals and the rate at which Australians are dropping private health insurance.

Which brings me to Janette and Pete’s story.**

Pete and Janette live in Sydney and 2 months ago, Pete suffered a major medical emergency. He was rushed to one of Sydney’s public hospitals by ambulance, admitted and remained in ICU for 10 days. At one point his heart stopped beating, but was successfully resuscitated and under went life threatening emergency surgery.

Once Pete was well enough he was moved from ICU  to a general ward and soon after discharged – since then, thankfully he has  fully recovered from the ordeal.

Pete and Janette have basic private health cover, after the dust had settled Janette began the process of sorting out the owing medical expenses that ran into the tens of thousands of dollars.

When Pete was originally admitted to hospital, he requested to go in as a public patient, knowing the out-of-pocket expenses would be substantial given the seriousness of his illness.

When Pete was discharged, Janette received a call from the hospital who were in her words “practically begging” us to claim through their private health fund, stating that since they had private insurance they should use this to cover all the medical costs.

Janette declined as she was unsure of the overall financial ramifications and felt more confindent processing the account through Medicare . A week or so later she received a second call from the hospital  asking the same question but this time ensuring they would have no  out-of-pockets expenses and the hospital would cover the excess payment in full. With the pressure from the hospitals accounts department and feeling bad as they had saved her husband's life, she agreed and they processed the account through their private health fund which fully paid for everything and the public hospital paid the excess as agreed. It worked out okay but was a learning curve for future hospital dealings.

If only their trauma insurance provider had been so generous... Pete contacted his insurance broker to make a claim on his Trauma policy only to find that they wouldn’t pay up because his heart had only stopped beating for 3 seconds and it must stop beating for 8 seconds to qualify.

Not only that but the insurance company specifies tests must be taken at the time the heart stops to determine the level of a particular enzyme that shows up during cardiac arrest. But the doctors were too busy saving Pete to take the blood test!

Have you had an experience like this? If so, we'd love to hear about it in the forum below.