KEY POINTS:
Talk about sneaky. While the rest of us are trying to focus on the handouts being promised by our national politicians, the Auckland health boards have chosen this month to hold a secretive "consultation" process on the merits of, among other things, charging private patients for laboratory tests.
I say secretive, because you'll only discover the exercise is under way if you visit the websites of the Auckland, Waitemata or Counties Manukau health boards.
And how many of us do that? Even there, none highlight it. The Auckland District Health Board, the biggest organisation by far, buries it most skilfully, first under "news and publications" then "public consultations". Only Manukau bothers to say the consultation runs between September 22 and November 14.
I discovered it only because Southern Cross Healthcare put out a statement after receiving a letter of intent from the combined health boards. The health insurers were seeking reassurance for Aucklanders "that they can have faith in the process".
Given the underhand tactics of the health boards so far, the odds are not encouraging on that score. Even if you root out the consultation document, the explanatory statements are loaded.
For example: "When people go privately to see a doctor other than a family doctor they do not have to pay for any tests themselves. Currently taxpayers pay for this testing."
We're then told the Auckland regional district health boards "believe there are a number of areas where we can change and improve community laboratory services" and that they believe one way would be to "review if the taxpayer should continue to pay for tests when people go privately to see a doctor other than a family doctor".
Just how that will improve the community lab services is not explained. As Southern Cross suggests, it certainly won't improve the lot of its 330,000 Auckland members - myself included - who face having to pay twice.
What really bugs me is the implication that private patients are not taxpayers, and are bludging off mythical horny-handed toilers of the soil who are. Not only do we pay taxes, but by taxing ourselves additionally with health insurance payments, we're actually subsidising the taxpayer-funded health system we elect not to use.
The Auckland DHB flirted with this nonsense in 2002 when it faced a deficit of $86 million but abandoned it following protest. In 2006, following encouragement from the then Health Minister and onetime vet Peter Hodgson, Wellington and Hutt boards introduced it, squeezing $1.62 million out of insured taxpayers in the first year. Otago and Southland boards have followed suit, despite a consultative process across the whole of the South Island which recorded 75 per cent opposition to this double taxing.
The Auckland boards - combined annual revenues of around $3.5 billion - reckon that by penalising insured Aucklanders, they will save around $2.5 million. That's the equivalent of the pay of the top six employees of the Auckland DHB alone. What organisation in its right mind would think it worth outraging one-third of its target population just to raise this sort of petty cash?
It's petty cash to a $3.5 billion industry, for sure, but not to the cardiac surgery patient facing additional lab costs of $2400.
Southern Cross Healthcare chief executive Ian McPherson says the policy "assumes anyone seeking treatment from a private specialist has money to burn, yet time and again taxpayers are going private because the alternative is taking their chances with a points system which can turn care on and off, depending on public system workloads and budgets."
What the policy doesn't seem to appreciate is that squeezing the privately insured could have costly repercussions for the public system. It could tip those having difficulties paying their premiums out of the private system and into the public hospitals. Dr McPherson argued this year that 150,000 procedures costing more than $600 million a year are carried out in the private system. If these patients started knocking at the public hospital doors in any numbers, what price the $2.5 million saved then?
The health boards' fight for more funds should be with central government. They shouldn't be trying to shake down a group of their own customers whose only crime is helping the public system by staying away.
What's next on their list? No subsidised drugs and medicines for private patients either? The proposal stinks. So does the health boards' attempts to "consult" in secret.
