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The growing cost of hip and knee replacements

13 February 2014 - 3:58pm

Australia's population is ageing and, as it does, the rates of arthritis, osteoarthritis and other joint issues are also escalating, according to Private Healthcare Australia.

Unfortunately, with a rise in these conditions, so too comes an increased demand for hip and knee replacements across the country.

These surgical procedures are the most expensive category of medical care within the private health sector, Private Healthcare Australia revealed in a February 7 media release. Growing demand for these surgeries may also influence an influx of Australians seeking private health insurance to help cover their medical expenses.

Hip Replacements

In 2012-13, more than 16,600 hip replacements performed in Australian hospitals were paid for by benefits from private health insurance funds. This represents a 19 per cent increase on 2011-12 results.

The total value of benefits paid also increased by 21 per cent from the previous financial year, climbing from $341 million in 2011-12 to $414 million in 2012-13.

On average, private health funds paid $25,000 per hip replacement surgery in Victoria, including the cost of the prosthesis. This was the highest rate of benefit payments. The ACT recorded the lowest average payment of $22,000 for the same procedure.

Knee Replacements

Knee replacements are a much more common surgery, as they are more likely to be required by the younger generation due to sporting injuries or other impact-related conditions.

In 2012-13, private health insurance providers funded more than 25,000 knee replacements, which is an increase of 41 per cent on figures recorded during the previous financial year.

The total value spent on knee replacements (including prostheses) by private health funds was $522 million, significantly higher than the $401 million spent in 2011-12.

For a procedure without complications, the lowest average benefit per surgery was recorded in the ACT at $17,888. The highest was reported in Victoria at $20,423.

What are my chances of needing a hip/knee replacement

Understanding your private health insurance requirements can be as simple as researching your chances of developing certain illnesses or needing specific medical treatments.

Arthritis is one of the leading causes of disability and chronic pain in the country, with more than 3.8 million Australians affected by the disease. This widespread condition costs our economy almost $24 billion every year in medical costs and indirect costs.

These indirect costs include loss of earnings and production caused by working age individuals developing the disease.

The economic affects of arthritis are expected to increase substantially over the next four decades, as figures from Arthritis Australia show that by 2050, experts forecast more than 7 million Australians will suffer from some form of this condition.

While you may believe you still have a significant amount of time before you need to worry about the onset of arthritis, research reveals this condition can affect many younger Australians. Currently almost 2.4 million people who have this disease are working age.

Once you begin to develop arthritis, symptoms include pain, stiffness, inflammation and damage to joint cartilage and surrounding support structures. These symptoms can often lead to an individual being unable to complete day-to-day tasks, which can be devastating for working-age individuals as it means a loss of income and livelihood.

If an individual is no longer able to work, it becomes significantly more difficult to pay for the necessary medical costs to treat and manage the condition. This is why private health insurance can be a wise investment to make before arthritis develops.

If you are interested in purchasing private health insurance to protect yourself against future illnesses and ailments, contact the team at HICA today.

HICA is a specialist health insurance broker that can offer you an obligation-free quote and health insurance comparison to help you choose the insurance cover you need.