Bec O'Neil with her children Maggie and Harry in Wagga Wagga. Picture: Simon Dallinger Source: News Corp Australia

Facing large out of pocket expenses for her monthly procedure at the only private hospital in the New South Wales city of Wagga Wagga she’s been forced to shift health funds.

Her move came as last minute talks between Medibank, the nation’s largest health fund, and Calvary Health Care, which owns 11 private hospitals, resumed just days before Medibank members were set to face huge out of pocket costs.

Nine months after it was privatised, the fund is embroiled in a war with private hospitals in three states and one territory and the medical profession over tough new contracts the AMA says amount to the Americanisation of Australian health care.

Medibank Private is embroiled in a war with private hospitals over a new contract. Picture: Supplied Source: Supplied

Medibank wants hospitals to sign a contract where it would refuse to pay for over 165 ‘preventable’ and sentinel events such as a mother dying in childbirth, a suicide in a hospital and a patient who fell in hospital and broke a bone.

It also won’t pay if a person is readmitted to hospital within 28 days of being discharged.

Medibank says its approach is about preventing hospital mistakes and says it will help keep premiums under control.

The St Vincent’s Hospital network, which includes Sydney’s St Vincent’s Hospital, says it signed a similar contract with Medibank last year.

Medibank is offering to pay any out-of-pocket hospital costs its members face at Calvary hospitals until October 31.

Professor Brian Owler President of the AMA says Medibank’s contracts amount to the Americanisation of health care. Picture: Kym Smith / News Corp Australia Source: News Corp Australia

But the Australian Medical Association and various medical colleges are opposing the contract as an attempt by health funds to direct patient care.

AMA president Professor Biran Owler has said he’s concerned the new contracts are heading towards a US style managed care system.

“We don’t want to go down a road to a system whereby an insurer can be basically dictating what doctor you can be referred to, what treatment you can have,” he told the National Press Club recently.

Calvary Health Care’s private hospital at Wagga Wagga where Bec O’Neil received treatment. Source: News Corp Australia

He’s warned the contract has the ability to threaten the balance between the public and private system right across the country.

And the Australian Commission on Safety and Quality in Health care says Medibank’s list of 165 ‘preventable’ events is flawed and 40 per cent are not preventable.

Health Minister Sussan Ley intervened on the weekend by bringing forward an independent review of preventable events in hospital.

And she told News Corp Australia that patients they held the “ultimate power” when it came to seeking the best deal for their private health insurance and encouraged them to shop around for a health insurance package that best suits the needs of them and their family.

Federal Health Minister Susan Ley said private health insurance members had the ‘ultimate power’ to seek the best deal. Picture: Isabella Moore Source: News Corp Australia

Opposition health spokeswoman Catherine King says ‘this sort of use of market power is precisely what Labor warned of when the Abbott Government made the decision to sell Medibank’.

A NSW Health spokeswoman would not comment on whether it would increase pressure on public hospitals. When patients used their private insurance in a public hospital ‘there is no provision for health funds to withhold payment,’ the spokeswoman said.

ACT Health Minister Simon Corbell said: “I am hopeful a resolution (between Calvary and Medibank Private) can been reached. I am concerned that if negotiations should fall over there could be thousands of people potentially turning to the public system for their health care needs.”

The Calvary Hospital group is refusing to sign Medibank’s deal and its contract with Australia’s biggest health fund expires on Monday.

Medibank members who use the hospitals in Wagga Wagga, Canberra, Tasmania and South Australia could over coming months face large out of pocket expenses as a result of the contract dispute.

Calvary has released indicative figures which show a Canberra surgical patient insured with Medicare face an upfront charge of $500 with an additional charge of $50 a day for each night they spent in hospital, an obstetric patient would pay a $400 upfront fee.

Calvary Hospital has released a list of indicative charges patients will face when its contract with Medibank ends on Monday. Picture: iStock Source: Supplied

Bec O’Neil and her family were insured with Medibank subsidiary AHM and when she rang the fund to check whether she’d still be covered they couldn’t guarantee she’d have no out of pocket expenses.

“I can’t afford to have a bill of $400 turn up from Calvary, currently it costs me nothing,” said the mother of two.

She doesn’t understand what the fight between the fund and the hospital is about.

“As long as I’m covered that’s all I care about,” she said.

“This is my treatment for the rest of my life,” she said.