'Waste of money': women ditch private hospitals, go public to give birth

Libby Nuttall and her six-month-old son Elliott. She is one of many women who have private health cover but have opted ...
Libby Nuttall and her six-month-old son Elliott. She is one of many women who have private health cover but have opted to use the public system instead to give birth.  Photo: Justin McManus

For 32-year-old mother of three Libby Nuttall, giving birth through the private hospital system would have been a “waste of money” .

Ms Nuttall and husband Rhys have three sons: Maxwell, 5, Lawson, 2, and Elliott, 6 months.

She is one of a growing number of women who opted to use public rather than private hospitals to give birth because of the high out-of-pockets costs involved with the private system.

"There’s a much higher rate of intervention in the private system than in the public system,” says Libby Nuttall.
"There’s a much higher rate of intervention in the private system than in the public system,” says Libby Nuttall. Photo: Justin McManus

Ms Nuttall had explored the option of going private before the birth of her first son, but said the cost of an obstetrician was prohibitive.

She'd also heard anecdotal horror stories about the private system, such as "when a doctor at 5pm on Friday wants to go home, and the woman’s in labour and will have to do a Caesarean rather than letting pregnancy play its natural course".

"There’s a much higher rate of intervention in the private system than in the public system,” she said.

Ms Nuttall, a former journalist now personal trainer, said she was healthy and therefore did not desire, nor require, medical intervention for her births. She also preferred midwifery care the whole way through rather than an obstetrician who may not be there for the birth.

Her own view - and she understands some women prefer and/or want closer medical attention during pregnancy from an obstetrician - is that "there’s just no need to make it so medical".

"Child birth has been around for centuries," she said.

Advertisement

Using a private obstetrician can be costly. Even before a woman gets to a hospital to give birth, out-of-pocket costs can amount to thousands of dollars due to hefty "booking fees" and "pregnancy management fees".

James Cook University analysed data from the Medicare Benefits Schedule and found that typical charges for single out-of-hospital obstetric services grew from $23.35 in 1992-93 to $264.98 in 2016-17 after inflation.

Then there are additional out-of-pocket charges for in-private hospital care. The same James Cook study found the 1992-93 in-hospital charge was $442.00, rising to $781.07 in 2016-17.

Medibank chief executive Craig Drummond said the private health funds need to "do more to address out of pocket costs"
Medibank chief executive Craig Drummond said the private health funds need to "do more to address out of pocket costs"  Photo: Jim Rice

Australian Institute of Health and Welfare data shows private hospital births fell from 28.2 per cent (or 79,617) of all births in 2006-07, to 24.5 per cent (or 75,881) in 2015-16.

On Wednesday Mercy Health in Queensland announced that its maternity health service at Gladstone Mater will be closing in October as births there had been declining for a number of years now.

Ramsay Health Care chief executive Craig McNally last week reported a 12 per cent reduction in May births.

Grattan Institute’s health program director Stephen Duckett said greater publicity about out-of-pockets costs and a ...
Grattan Institute’s health program director Stephen Duckett said greater publicity about out-of-pockets costs and a continuing decline in health insurance coverage, especially among people under 40, was likely impacting maternity care. Photo: Jeremy Piper

Medibank saw a 20 per cent drop in the number of its customers having babies in private hospitals between 2013 and 2017.

Medibank chief executive Craig Drummond said all private health funds and private hospitals needed to "do more to address out of pocket costs".

Last financial year 17,562 babies were born in private hospitals that Medibank covers. The average benefit Medibank paid on behalf of customers was $7969.

"We know that some of our customers are experiencing bill shock and are increasingly concerned about large gap payments,” Mr Drummond said.

State governments have made significant investments in public health infrastructure, he said, which may be a factor drawing people to the public system.

But he said the fact that Australians have access to "one of the best health systems in the world" was because of a strong public and private system that gave women choices.

The Grattan Institute’s health program director, Stephen Duckett, said greater publicity about out-of-pockets costs and a continuing decline in health insurance coverage, especially among people under 40, was likely impacting maternity care.

CHOICE director of campaigns and communications Erin Turner said more clarity and transparency on pricing was needed as currently “it's far too difficult to find out what costs you'll face upfront".

In December last year, she said CHOICE tried to find out whether surgeons would inform patients of out-of-pocket costs upfront.

Over a third of all surgeon offices CHOICE visited - 22 of 60 - could not give a price, with some people refusing to give a quote until after the first paid appointment, Ms Turner said.

Bessie Hassan at finder.com.au, said the online comparison site did a recent survey of over 2000 parents with children under 12, which found one in five pregnant women were opting to deliver their baby in a public hospital despite being covered by private health insurance.

She said some women were also using a public hospital, as a private patient, where "you are usually given priority for single rather than shared room where possible".