Unprecedented health insurance claims as strikes continue in public sector

Health insurers paid an unprecedented $1.322 billion in claims in the year to the end of March, reflecting the value of the private sector at a time surgeries in public hospitals have been cut and waiting lists grow due to ongoing industrial action.

Releasing its latest statistics today, the Health Funds Association (HFANZ) said claims paid were up $115 million, or 9.5 percent, in the year to March 31, 2019. Claims paid for the first three months of this year totalled $303 million, up 7.9 percent on the March 2018 quarter.

HFANZ chief executive Roger Styles predicted elective surgery forecasts for the full 2018-19 year would miss their targets. He said he had been analysing provisional data the Ministry of Health had collected from district health boards, and for the first year in over a decade elective surgery volumes were down compared with the previous year.

“The six-month figures were well down on expected first half volumes, and the year has been hampered by waves of industrial action, including strikes by nurses and, more recently, junior doctors,” he said.

“Elective surgery is the first casualty of strike action.”

An estimated 300,000 New Zealanders are waiting for elective surgery, according to a 2016 TNS survey commissioned by HFANZ and the Private Surgical Hospitals Association, although around 170,000 of them are not officially recognised as being on waiting lists. Mr Styles said HFANZ might look to repeat the survey in the coming year, as indications were the situation had further deteriorated.

“Having health insurance is really the only guarantee of timely access to elective surgery in the event you need it,” he said.

The latest HFANZ statistics showed the number of New Zealanders with health insurance remained steady at 1.403 million, up 1.2 percent for the year to March. Premium income for the quarter was up $5 million on the December 2018 quarter to $409 million. Annually, premium income rose $132 million or 9.1 percent to $1.586 billion.