Surgery for bad backs has topped the list of most expensive surgical claims funded by Southern Cross Health Insurance this year, with the biggest claim hitting $222,000.
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Eight of the top 10 most expensive claims paid by New Zealand's biggest health insurer were for spinal fusions - surgery which permanently connects two or more vertebrae in the spine.
Southern Cross chief medical officer Stephen Child said the not-for-profit society paid out over a billion dollars ($1.12 b) for more than three million claims for the year to the end of June.
"The most expensive individual claims were for those major surgeries, but in terms of the volume of claims, the highest number by far were for cryotherapy [freezing by liquid nitrogen] of skin lesions and other skin treatments."
Covid restrictions had put a dent in claims at some points, as people were not able to access treatment in level 4, he said.
"Southern Cross Society pledged $50 million back to members in the previous lockdown because it was not approriate to take their premiums when we couldn't pay out claims due to lockdown.
"There's been less of a drop in volumes with the most recent lockdown and what we also saw was a rebound increase in volumes when we came out of lockdown."
However, overall claims were increasing each year, due partly to the ageing population and also by screening programmes, which were picking up problems earlier.
"That's a good thing obviously because it means people are having their needs met, and we've also got increased awareness of things like skin cancer for instance.
"But at the same time, there's also a shortage of dermatologists so getting access to good skin care in the public sector is difficult. So that's one reason why the private sector is doing more of this work, complementing the good work of the public sector."
For those people who did not meet the criteria to get their surgery in the public sector or who faced a longer wait, private health cover enabled them to get their operations sooner, he said.
"Spinal operations are extremely expensive but so too are some major cardiac operations, breast cancer operations can be over $80,000, head and neck cancers can be over $150,000.
"So there are some really high-cost - hopefully rare - claims that people can have, and that's where private insurance can really come to the fore, with those kind of expenses."
Top 10 most expensive individual claims in FY21
- Spinal Fusion $222,000
- Spinal Fusion $210,000
- Spinal Fusion $201,000
- Spinal Fusion $200,000
- Spinal Fusion $179,000
- Spinal fusion $175,000
- Radical Neck Dissection $170,000
- Radical Neck Dissection $156,000
- Spinal Fusion $156,000
- Spinal Fusion $153,000
Top 10 procedures by volume in FY21
Subhead here or use
- Cryotherapy of Skin Lesions Liquid nitrogen treatment to freeze and destruct an abnormality. 34,000
- Excision Skin Lesion Cutting out abnormal tissue away, usually related to cancer. 31,000
- GP minor surgery N/A 26,000
- Colonoscopy An exam used to detect changes or abnormalities in the large intestine (colon) and rectum. 23,000
- Intravitreal injection An injection or shot of medicine into the eye. 10,000
- Nasendoscopy A test to look at the inside of the nose, the throat (pharynx) and the voice box (larynx). 9,000
- Biopsy of Skin and Subcutaneous Tissue A procedure to remove cells or skin samples from the body for laboratory examination. 9,000
- Cataract extraction and insert IOL Removal of cloudy lens in the eye and replacement with artificial IOL (intraocular) lens. 8,000
- Gastroscopy (+/- Biopsy / Polyp) A procedure to examine the upper part of the digestive system. 7,000
- Removal of Teeth N/A 6,000
