Why paying full rate for private rooms is good for the public health system

Westfund is committed to supporting the public health system by paying the full rate for private rooms used by our members in public hospitals.

Recent media reports seem to suggest that some “for profit” funds are putting public hospitals under pressure by refusing to pay the full day rate for private rooms.

It’s worth noting that The National Healthcare Agreements (under which all funds and hospitals operate) require health funds to support the State Gazetted rates for a shared room – which is currently set at of $319 for private patients. A higher rate of $579 applies for private patients who occupy a private room in a public hospital.

Health funds have always paid the full amount for shared and private rooms in public hospitals, however, some for-profit funds are now insisting on only paying the minimum amount of $319 for both options.

There is even speculation now that privately covered patients may be asked by the public hospitals to cover the difference in the future. The NSW Government has already decided to increase their Health Insurance Levy to make up an anticipated $80 million health budget short fall.

We have decided to maintain our private room benefit for public hospitals at the existing rate because it is crucial to the viability of the public system, especially in regional Australia.

The fact is this is a key regional issue given the role of the public hospital in medical service delivery, healthcare infrastructure and local employment. As a not-for-profit fund our focus is on reducing medical gaps rather than contributing to uncertainty around them.

Unfortunately, these are the kinds of issues that are created by a health environment dominated by stakeholders who are predominantly motivated by profit.

Private health funds have a key role to play as a member of the local community and in encouraging healthy lifestyles.

That’s why Westfund is engaged in the community via a range of local sponsorships. We are also promoting better community health via our regional dental and eye care practices.