Visitors to Australia owe millions in unpaid health bills

VISITORS to Australia are racking up tens of millions of dollars in unpaid health bills, prompting calls for restrictions on their access to public hospitals.

In Victoria last financial year, taxpayers were left to cover bad debts of $11.6 million, a third of the cost of treating patients not eligible for Medicare in that state, while in NSW hospital staff could recoup only $25m of the $40m cost for treating such patients. Western Australia has problems with HIV-positive 457 visa holders who require expensive antiretroviral drugs, while in Queensland the cost of treating some non-residents, especially those with tuberculosis, can exceed $1m a patient a year.

Taxpayers have even had to fund the transport of patients to their home countries.

The states are demanding the commonwealth enforce the requirement in some 40 visa subclasses that visitors have appropriate health insurance so the cost burden can be shared with insurance companies, and take into account previous unpaid hospital bills when considering applications to re-enter.

While Immigration Minister Chris Bowen has agreed to review the insurance issue, it is understood the commonwealth has concerns about collecting data on hospital bills.

Enforcing the insurance requirement alone may do to reduce the cost burden on the states. In one case, a foreign student with an eating disorder has required repeated, lengthy stays in a public hospital, and already cost that state government more than $200,000. Health officials contacted the woman’s doctor in her home country, who recommended she be treated there for clinical reasons, but the woman did not want to leave Australia.

The state asked the commonwealth to intervene, but it was powerless to deport her because she had met the insurance requirement – even though the insurer would not cover her treatment because she had a pre-existing condition.

NSW Health Minister Jillian Skinner said her state was fortunate to have a higher cost recovery rate than others, but her Queensland counterpart, Lawrence Springborg, said the impact on his state was still significant.

The debate comes as health ministers, who are meeting in Perth today, prepare to discuss the impact of the commonwealth’s decision to accept more refugees and asylum-seekers.

A paper prepared for the meeting notes that almost all new arrivals require catch-up immunisation, 30 per cent have anaemia, up to 21 per cent in some cohorts have hepatitis B and between 17 per cent and 63 per cent of tuberculosis screens are positive.

The ministers will discuss whether translators should be extended to more health services and whether more asylum-seekers should have access to subsidised pharmaceuticals and Medicare-funded treatment.

The paper notes that there are “significant challenges in engaging private GPs to work with this population group, particularly in areas where the overall GP workforce is low. Without GP participation, refugee and asylum-seeker healthcare shifts to higher cost settings that are not sustainable,” the paper says.

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