Insured patients warned not to waive right to public care
All patients are entitled to free public care, but legislation allows hospitals to charge patients with health insurance as private patients.
Patients considering waiving their right to public healthcare in hospital should not do so until sitting in a private bed, a leading health insurance expert has advised.
All patients are entitled to free public care, but legislation allows hospitals to charge patients with health insurance as private patients. This was the subject of a High Court judgement in July outlining details of a previous decision which said patients can only be charged if they agree to this.
Hospitals usually seek agreement by asking patients to sign a waiver form. The High Court said patients should also be told about “consequences that flow” from opting for private care.
Dermot Goode, founder of TotalHealthCare, said there is a “mistaken belief” people with health insurance must sign.
“We will say to people even if they (the hospital) say to you will get a private room, don’t sign the form until you are in the private room, and in the bed,” he said.
“Lots of people have signed those forms, expecting to get the private room and it never materialises. We advise all of our customers you don’t have to sign the form.”
The judgement indicates if a private room cannot be found and the person is treated on a shared ward, the charge still applies.
“I always say to all of our clients, if somebody approaches you in a hospital and asks you to sign that form, your response should be ‘no problem at all, what changes for me if I sign that form?’,” he said.
Changes should include a private bed, and consultant-led care, he said, adding: "Nine times out of ten the answer will be that nothing is going to change, there are no private rooms.”
He also warned of risks for people who are new members of an insurance scheme.
“If you are a new member, and there is a risk you are being admitted for a pre-existing condition, then there is a risk your claim may not be paid by the insurance company,” he said.
“You need to make sure you know exactly where you stand. This is nothing to do with the HSE, it’s could be just somebody who has not been insured long enough.”
The HSE told the courts of a €170m potential exposure to loss since the disputed waiver form started being used. Private patients are charged between €813 and €1,000 per night compared to €80 per night for public.
Patient advocate Stephen McMahon also urged caution.
“Certainly the Irish Patient’s Association would like to see the protocol and guidelines for obtaining consent from patients,” he said.
“You have to have a single approach everywhere, and you can’t have people feeling they are being coerced into one route or the other route.”
He said patients having emergency treatment may find decision-making stressful.
“I’ve had anecdotal reports of people being asked to sign this waiver in the Emergency department, going out the ED door or bring approached there,” he said.
“They were very vulnerable and sick. People have said to me in the past ‘I’ll sign it because it will make a few bob for the HSE’ rather than feeling like a burden.”
The judgement also clarified it was the patient and not the insurer who is charged though insurers have direct settlement arrangements with most hospitals.
