Costly medical procedures are driving up the price of Australian health insurance

Peter Terlato 23 August 2016

Expensive medical bill health insurance

Costs in Australia don't match what people pay elsewhere in the world, new research shows.

The average cost of medical procedures for Australian hospital patients is often significantly higher than corresponding operation charges in Britain and Canada, resulting in pricier health insurance premiums.

Figures from the 2015 International Federation of Health Plans Comparative Price Report reveal the average cost for the insertion of an Automatic Implantable Cardioverter Defibrillator (AICD) in Australia is $67,795. However, in Canada the same operation is less than a fifth of the price at $12,104, while in Britain it's only $5,315 (all figures in Australian dollars).

Need a hip replacement? In Australia the bill is a whopping $27,432, compared with just $8,604 in Canada. Knee replacements are similarly priced at $23,203 down under and $7,589 in the Great White North.

The only country in which a hip replacement procedure is more costly than Australia is the United States, where the total is a hefty $37,773.

This week, Private Healthcare Australia CEO Rachel David called on the government to reform health funds' regulated prostheses prices in an effort to help lower insurance premiums.

"Our latest market ­research shows affordability of premiums is the biggest issue... people are really hurting on this," Dr David told the Australian.

In a recent Findings post, finder.com.au editor-in-chief Angus Kidman predicts Aussies can expect higher insurance prices, more nit-picking over claims and additional exclusions if insurers' operating ratios continue to climb.

Following discussions with private health insurers at the beginning of the year, Health Minister Sussan Ley announced premium prices would rise by the lowest level in four years, an average 5.59% in 2016.

But if the costs of prostheses, pathology, anaesthesia, surgery, accommodation and treatment remain high, premiums will likely rise again.

Prostheses costs generally average around 15% of the total medical bill, however, in some cases it can be much higher. For example, a heart defibrillator accounts for more than 81% of total medical costs in Australia, according to the data.

Earlier this month we reported a sharp rise in the number of hospital treatment episodes and benefits paid for private health customers in the second quarter of 2016. There was also a hike in complaints during the same period, relating to issues of administration, membership and service.

If you're unsure what type of private health insurance you need, take a step in the right direction by comparing providers to find the health fund that best suits your lifestyle.

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