Australia’s public hospitals are funded jointly by the federal government and state and territory governments, and administered by state and territory health departments. There’s also an increasing number of private hospital operators in Australia (such as Australian Hospital Care), and some public hospitals are operated by private companies under a contract.
Medicare pays for the full cost of accommodation and medical treatment performed by hospital-appointed doctors for Medicare patients in public hospitals. Hospital bills for treatment under Medicare are always paid directly by Medicare. However, patients have no choice of doctors or hospital, nor of when they’re admitted for treatment or surgery.
Medicare patients also receive free X-rays and pathology tests in public hospitals and free out-patient services in some hospitals. Patients are usually accommodated in general wards or twin rooms. If you want a TV or a telephone, you must pay extra. When you visit a public hospital, you should take your Medicare card with you (if applicable). The staff may ask whether you wish to be treated under Medicare or as a private patient.
In recent years, there has been a funding crisis in public hospitals in many states, some of which have chronic shortages of basic medical supplies, including bandages, bed linen, drugs, sterile dressings, swabs and syringes. Some public hospitals also have a lack of diagnostic equipment, e.g. for brain scans. In some over-worked public hospitals, patients are left lying for hours in emergency departments and in corridors waiting for ward beds. Some public hospitals also suffer from a shortage of doctors and nurses, and are forced to recruit casual staff from locum and nursing agencies. Fortunately, there’s usually no shortage of life-saving equipment or medicines.
Even private patients are subsidised by Medicare. If you’re a private patient in a public or private hospital, Medicare pays 75 per cent of the schedule fee for medical services and the remaining 25 per cent is paid by your private health insurer, if you have one. When you leave hospital, you’re generally asked to pay the difference (if any) between your health insurer’s refund and the hospital fees, which you must then reclaim from your insurer.
If you don’t have private health insurance, you’re asked to pay the estimated costs at the time of admission. The average charge for a private bed is around $250 per day in a public hospital and over $600 per day in a private hospital, where prices have increased greatly in recent years. Patients in private hospitals are usually given a one or two bills for the total cost of treatment, although some hospitals still prefer to charge separately for different treatments and care.
Private patients are usually provided with single rooms equipped with all the comforts of home, including en suite bathroom, radio, room service, telephone and TV. If you’re a private patient, you can choose the hospital and your attending doctor and surgeon, although if you want your own doctor to treat you in a public hospital there’s a daily ‘accommodation’ charge.