Station: 5AA
Program: Mornings
Date: 1/8/2019
Time: 10:06 AM
Compere: Leon Byner
Interviewee: Dr Rachel David, CEO, Private Healthcare Australia


LEON BYNER: There’s a very important story out about private health insurance. Now we’ve seen recently where it seems a lot of people are dropping private health because either they don’t see the value or they feel they can’t afford it. But what is interesting is that the value of private health care insurance for young Australians needing prolonged treatment for mental health care has been highlighted in an annual hospital high claims report, which I’ve got. And it says that nearly half of all payments for hospital treatment by Australian health funds were for claims where the benefit payment for the episode of care was more than $10,000.

So let’s talk to the CEO of Private Healthcare Australia, Dr Rachel David. Rachel, thanks for joining us today. Tell us a little more detail in this report.

RACHEL DAVID: Yes, morning Leon. I mean we thought it was important to release this information based on some of the scuttlebutt we were hearing that private health wasn’t value for money, particularly for younger people. And I think that in looking at this you can see that a number of people aged under 40 had very high claims for prolonged hospital treatment, including for mental health where we’ve got a number of claims over $100,000 for people who had severe conditions, couldn’t work, couldn’t form relationships. And I think one thing that’s really important to address here because it’s another myth that’s around, this was not treatment that was widely available in the public hospital system. And that’s not a criticism it’s just that the public hospital system is overwhelmed by acute cases of drug abuse, very, very unwell people who might be homeless and can’t look after themselves. The type of treatment we’re talking about is for people who have less acute disease but they can’t work and they can’t function in society. So if you’re young and in that situation, if you don’t have health insurance you could be faced with some really enormous bills to get your life back on track.
LEON BYNER: Which category of cover was mainly represented in the stats for the $10,000 being spent?
RACHEL DAVID: Look really a lot of people who, you know, who’ve had these claims had your silver and gold levels of cover. But one thing we do in the mental health space particularly, is if someone presents to a private hospital with a serious mental health condition, regardless of their level of cover we will cover them from that day. And the reason that we do that is it’s called a mental health safety net, so we give them immediate cover with no waiting period and the reason we do that is because of the growth in demand for this area for mental health and drug and alcohol addiction claims.
LEON BYNER: So if this, for example, was induced by somebody’s recreational habits, they would also be covered?
RACHEL DAVID: Well we don’t separate drug and alcohol addiction from mental health in our claims and the reason we do that is that people who are really struggling with mental health conditions have some substance dependence often as well.
RACHEL DAVID: And it’s because they have an underlying mental health condition usually. They’ve resorted to using substances to cope and by the time they end up in the private hospital system you need to deal with that to deal with both issues.
LEON BYNER: Do you think the public are well aware – if they are private health considerees – that there is this cover available that’s instantaneous?
RACHEL DAVID: No, it’s not something that you would be aware of unless you had been diagnosed with a serious mental health condition. We don’t have a waiting period for that if you’ve got the base level of cover.
RACHEL DAVID: And the reason is that, you know, I think that young people do have a sense that they’re invincible and from some of the diseases of ageing, yes, it is unlikely that they will have a heart attack or need a joint replacement. But what is very common in people aged under 30 are serious mental health conditions and eating disorders. It’s the main reason that women under 30 claim on their private health insurance actually.
LEON BYNER: Women under 30 – just repeat that again I want to- I want this to be out there so we understand this – so you’re saying the main reason a woman under 30 will claim on private health is a mental health issue?
RACHEL DAVID: Yes, it is. It overtook reproductive health some years ago and men aren’t exempt either. It’s actually the second biggest reason that men aged under 30 claim on their private health insurance. It’s only just tipped at the post by accidents and injuries associated with sport, but it is a very significant area of growth in claims by younger people and as you can see from this data, a number of these claims are close to six figures. So if there’s a message out there it would be – if you’re younger and you’re thinking of taking out private health insurance or you’re thinking of- you’ve got it and you’re thinking of dropping it, take this into consideration because this is not treatment that you can easily access in a public hospital.
LEON BYNER: Rachel, thank you very much for coming on today. That’s. The CEO- I am just connecting this with our caller earlier today, whose daughter is 21, attended at an ED and well, you heard what happened. And again, yes there’d be some who’d say look I can’t afford this, but if they could, or even at the lower levels of cover, what they’re being offered instantaneously is some coverage. Now I wonder how many people didn’t know that.
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