Most foreign patients leave hospital bills unpaid

Garry Smith

Auckland health boards have wiped more than $3 million in debts owed by foreign patients ineligible for New Zealand healthcare.

Auckland District Health Board has written off $2.35 million in the 2003-2004 financial year, and the Counties Manukau board has given up trying to retrieve $1.18 million of debt.

But, unless people without health insurance are stopped from coming into the country, the problem is not likely to go away.

Auckland District Health Board chief executive Garry Smith says a person will always receive immediate treatment in an emergency situation.

In non-emergencies people are asked to provide identification for eligibility to free healthcare.

"If they are not eligible, they are told how much their treatment will cost and are given the opportunity to agree to the cost or to seek treatment privately," he says.

"If they agree to the cost they can choose to pay in a lump sum or by instalments over a 12-month period.

"After that period, the debt is transferred to Baycorp Advantage for collection."

Currently, only about 20 per cent of non-residents pay their debts, and this can take a while if they do take the option to pay by instalment.

Mr Smith says an increasing number of non-residents are coming here on short-term visas with tuberculosis or other infectious diseases.

General surgery accounted for the biggest proportion of debt at $500,395; cardiac services cost $464,544 and dialysis treatment cost $379,757 in the year ending July 2004.

In addition, a number of smaller accounts were written off in most hospital departments.

There is also an increase in the number of women who arrive here during the final months of their pregnancies, says Mr Smith, especially in the past year.

From July 2004 until June 2005, the Auckland District Health Board wrote off nearly $500,000 in unpaid maternity debts - something the Citizenship Act, which comes into effect next year, is expected to affect because children born here will no longer be automatically entitled to New Zealand citizenship.

Mr Smith says non-resident debt is a concern because it reduces available funding for New Zealand residents and citizens.

Ministry of Health finance manager John Hazeldine says health boards with a disproportionately high level of bad debts arising from non-residents receive a specified amount of Government funding to go towards paying that debt.

The ministry has specified $1.2 million for Auckland and $1.5 million for Counties Manukau to go towards non-resident debt for the 2005-2006 financial year.

- THE AUCKLANDER