A trip to hospital in an ambulance in the Cook Islands will cost a foreigner 33 times as much as what locals will pay, whereas in New Zealand foreigners pay only nine times as much as residents.
Tourists and expatriate workers who have not resided in the Cook Islands for at least six months can expect an $800 fee should a medical emergency warrant the use of an ambulance compared to the local fee of $25.
In New Zealand, foreigners can also expect an $800 charge whereas residents, people from Cook Islands, Niue or Tokelau, work visa holders and UK citizens will be charged $88. However, the Ministry of Health says patient consultation costs at the hospital itself are on par with New Zealand and Australia, if not cheaper.
On Tuesday, CI News told the story of how an Australian tourist had been charged $800 for an ambulance to take his wife to Rarotonga Hospital after she collapsed on a local bus service.Jim Morris told CI News he was shocked when he was told he would be charged such a huge fee for a two kilometre ambulance drive. Morris also noted that the person who had to inform him of the price was very embarrassed to say it was $800.
“I don’t know how you justify that.”
The current ambulance fee schedule was set in 2008 following lengthy consultation with various stakeholders and the general public.
Secretary of Health Elizabeth Iro says the development of the National Health Services Fees Schedule has undergone considerable consultation process and has taken into account issues raised by different individuals over the years.
Iro says ambulance fees had been suggested initially through discussion with a St John Ambulance New Zealand representative who had been conducting training programmes on Rarotonga.
His advice was given with understanding that the fee would help offset some of the training and equipment upgrade costs.
Government funding for all health care services is set at $12 to $13 million each year.
Iro says there is never enough money. The Ministry of Health has been pushing to have five per cent of the GDP allocated for health, but has only been getting an allocation of 2.9 to 3.4 per cent.
She says the rest of the funding for the entire health service comes from user pay fee offsets, as set in the National Health Fees Schedule.
However, Iro also says the annual budget covers all costs for the ambulance services as part of their operations budget.
Additional needs are factored in order of priority with other hospital items as they are identified during the year.
Iro says for this year alone, there is $6,900 owing in outstanding ambulance fees although some of this is because of slow medical insurance processes.
The cost of a new ambulance is $150,000 including equipment and consumables, although the Ministry Health recently had a new fully equipped ambulance funded by New Zealand. However, to fully crew and equip the ambulance service costs the ministry over $450,000 a year.
This includes $194,666 for personnel, $10,000 to fully outfit each ambulance and $10,000 for the maintenance of each ambulance including fuel and servicing. A further $200,000 has also been used this past year for intensive training courses provided by St John’s in New Zealand, although Iro anticipates this will be scaled down.
Whatever the cost, the Ministry of Health strongly advises all visitors to ensure they are well-covered by travel insurance before they arrive in the Cook Islands.