The Australian Institute of Health and Welfare (AIHW) recently released a report, Australia's Medical Indemnity Claims 2012-2013, which details the number of medical indemnity claims made, both public and private. The AIHW classifies these claims as those that "arise from allegations of problems in the provision of health services".
This information could play a role in the health insurance choices consumers make moving forward, especially those looking into obtaining private health insurance coverage.
Private claim increase could be related to spike in those covered
One of the report's main findings was that private sector claims far outpaced those made in regard to public sector.
From 2010-2011 to 2012-2013, new private sector claims numbered 3,200 to 3,300 a year. However, the amount has increased slowly in recent years, with totals reaching only 2,300-2,500 from 2008-10.
While the number has gone up slightly, this is likely related to the increased number of Australians obtaining private health coverage and shouldn't put off individuals seeking their own policies. According to the Australian Bureau of Statistics, 52.7 per cent of Australians 18 years of age and older had private health insurance in 2007/08.
This number shot up to 57.1 per cent in 2011/12, which adds up to nearly 10 million people nationwide. With such a significant leap in the number of Australians covered by private health insurance, claims for these services are naturally bound to increase slightly as a result.
Trends in public vs. private claims
Public hospitals and day surgeries saw 26-41 per cent of claims close for less than $10,000. Between 68-71 per cent closed for $100,000 or more.
Private medical clinics made up 34-50 per cent of claims closed for less than $10,000. This percentage changes based on year. Between 22-30 per cent of claims were closed for between $10,000-$100,000 and 5-18 per cent were for $100,000 or more, significantly fewer high-value claims than were seen at public hospitals and day surgeries.
Claim size can be correlated with patient harm. These numbers suggest private medical clinics saw fewer patients come to harm as a result of treatment, considering the lower percentage of high-value claims when compared to public hospitals and surgeries.
Benefits of private health insurance still numerous
The fact that so many additional Australians are obtaining private health insurance speaks to the vast array of benefits it offers.
One of these advantages is the ability to see your own preferred doctor. This can be important for people with serious conditions or those who feel more comfortable with someone who knows their entire medical history and has treated them for a lengthy period of time. Similarly, you'll have more of a say in when and where any treatments will take place. With regards to dates, private insurance often leads to shorter waiting times than in the public sector for elective surgery, meaning critical procedures and treatments won't be delayed unnecessarily.
Private health insurance also can make services not covered by public health benefits more accessible. Dental, chiropractic and optical treatments, for example, may not be covered by public benefits. Certain private policies can make these services more affordable.
While the government also provides a rebate for eligible families and individuals, a health insurance consultant will make it easier to compare health insurance plans to determine which represents the best value for your specific needs. This rebate is based on how old the eldest person covered by the policy is and income levels. The rebate can provide a beneficial reduction in costs that makes the other benefits of such coverage even more worthwhile.