Private Health Insurance - Is it Worthwhile?

[Dink]

Administration of hospitals is a major problem. Unfortunately, you have incompetent people running hospitals. Here is an example. An oncologist was going to move his family to a regional centre that currently has an extremely limited oncology service. One would think administration would be everything humanly possible to lure his services. He made one important request that his partner get a job in the hospital as an allied health professional (of which there is a shortage) and this was promised. Administration "forgot" to do this and he simply decided that he could not work under such an administration and I do not blame him. So we have a person who is obviously not qualified to do her job whose incompetence impacts on 1000s of peoples lives. This is not an isolated case. My partner who is also a doctor has just left this hospital for similar reasons. No-one would know but these people made national headline news 1 or 2 years ago because of their incompetence. They were moved around in the system for a few months but ended up exactly where they were initially. I often believe these administrators work where they do because they simply could not get a job anywhere else. They are incompetent, they make mistakes, they get "audited" but they don't get fired. They are faceless people whose decisions make a huge impact on patient care even though they never come face-to-face with patients. Why does no-one complain or go to another hospital? Because nothing changes and everyone thinks everywhere is the same... which it probably is. Do things like this occur in private hospitals? No... Why? Efficiency means money.

PS. Sorry once again for the rant. Particularly sore topic for me at the moment!!!

 

[wildkactus]

Have to say, though, that I've not come across too many private doctors who make themselves available 24/7!

Once again its down to the dollars, My private doctor here in HK will travel all over the region to see clients, and will make trips to see you at home or in a hotel, his services are not cheap but the service is superior.

This is a trend that is starting to happen with these types of doctors, have really only seen it in America and Europe, plus a couple here in asia mostly european Expat doctors.
How it works you pay a yearly fee to join the private client list and for this you get 24/7 response if you need it, plus you pay a fee per consultations which are longer normally about 45min to 1 hr if needed, and not much dearer then the normal fee's.

I think this will happen in OZ to, if it is already not. so if you can afford to self insure you can get the service you want when you want it. as they say cash is king and money talks.

 

[robots]

hello,

the next step is also the option to not be involved with medicare at all, totally self-funded, no medicare levey, no medicare surcharge levy etc

and be given tax cuts,

a leading syd academic recommended a yearly $2500 tax cut if electing out,

which means going to GP for visit you would just pay fee and thats it,

thankyou
robots

 

[Julia]

Administration of hospitals is a major problem. Unfortunately, you have incompetent people running hospitals. Here is an example. An oncologist was going to move his family to a regional centre that currently has an extremely limited oncology service. One would think administration would be everything humanly possible to lure his services. He made one important request that his partner get a job in the hospital as an allied health professional (of which there is a shortage) and this was promised. Administration "forgot" to do this and he simply decided that he could not work under such an administration and I do not blame him. So we have a person who is obviously not qualified to do her job whose incompetence impacts on 1000s of peoples lives. This is not an isolated case. My partner who is also a doctor has just left this hospital for similar reasons. No-one would know but these people made national headline news 1 or 2 years ago because of their incompetence. They were moved around in the system for a few months but ended up exactly where they were initially. I often believe these administrators work where they do because they simply could not get a job anywhere else. They are incompetent, they make mistakes, they get "audited" but they don't get fired. They are faceless people whose decisions make a huge impact on patient care even though they never come face-to-face with patients. Why does no-one complain or go to another hospital? Because nothing changes and everyone thinks everywhere is the same... which it probably is. Do things like this occur in private hospitals? No... Why? Efficiency means money.

PS. Sorry once again for the rant. Particularly sore topic for me at the moment!!!

Yes, this is just so utterly frustrating. Don't know which State you are in Dink, but here in Qld a couple of weeks ago a senior Emergency Dept specialist wrote an 'open letter' to the 'Sunday Mail'. He described the chaotic conditions under which he and his colleagues were working. He wrote anonymously.

The rather surprising upshot has been that Anna Bligh, the Premier, and the Health Minister invited him to come and talk to them in more detail. He did this. They now say it has been extremely useful and they will continue to consult with him with respect to future planning.

Now, the cynic in me says, well wouldn't it be nice if this was actually a genuine attempt by the Qld Govt to address the huge problems in our health system, but realistically I suspect it's some fancy window dressing to yet again make it look as though they are doing something, whilst in fact (as you have described, Dink) shuffling the bureaucrats around in a fashion designed to reinforce their incompetence.

Then, of course, we have the inevitable fall out from the Federal Government changing the Medicare Levy with the result that the already overburdened public health system will collapse even further under the additional demand.

Sigh!

PS. There was an excellent "Insight" programme last night on SBS regarding the dental problems. Despite repeated invitations to join the discussion, the Labor Health Minister (or her representative) was notable by her absence.

 

[Julia]

Here's an article on the payouts by Medibank Private this year.

When the premiums continue to rise so much I seriously consider dumping the private cover and just being prepared to pay if something needs to be done.
But when I see that a single procedure cost almost $365,000, I guess I'll continue to pay every year.

Any updated views on this?

http://www.news.com.au/couriermail/story/0,23739,24853124-953,00.html?referrer=email

 

[gav]

hello,

the next step is also the option to not be involved with medicare at all, totally self-funded, no medicare levey, no medicare surcharge levy etc

and be given tax cuts,

a leading syd academic recommended a yearly $2500 tax cut if electing out,

which means going to GP for visit you would just pay fee and thats it,

thankyou
robots

Sounds good to me!!!

Since my recent wage increase (new job), looks like ill be paying the Medicare levy or getting private health insurance. Havent even looked into it yet, but something I need to get around to!

 

[jackson8]

Here's an article on the payouts by Medibank Private this year.

When the premiums continue to rise so much I seriously consider dumping the private cover and just being prepared to pay if something needs to be done.
But when I see that a single procedure cost almost $365,000, I guess I'll continue to pay every year.

Any updated views on this?

http://www.news.com.au/couriermail/story/0,23739,24853124-953,00.html?referrer=email

having worked all my life and now age 48 having to stop as i need total knee replacements to both knees i wish i had health insurance as i cannot afford the 15-20 thous per knee to have it done self funded
only good thing is if i take out insurance now i can make a claim after 1 year even though it is a pre existing condition, well thats what they tell me

doesnt help me now thou as maybe another couple of months and i wont even be able to get out of bed

 

[Green08]

Wondering if anyone has changed their level of cover recently? We are at the highest bracket and extras, every year we break even on claims or above it. I have paid 6 months ahead for my brother to have cover.

I understand it is expensive and they will more than likely be putting up the rates in March.

What I am concerned about - have mentioned it elsewhere - is lack of government money, reduced hygiene, increase in transmittable disease or contamination.

With some nurses having to pay for medicine for patients out of their own pockets - one of my friends is a nurse and does exactly that - buys Panadine Forte takes about 2 - 3 weeks for her to get reimbursed!! It's like a 3rd world country. Read of another nurse talking about no paper towels to dry hands, hospital does not have hand dryers - first line of defence - dry them on a contaminated uniform. One good spread of Golden Staph and off it goes.

I sliced my palm 6 cms long and 5 mm deep recently. Had a booster Tentus. Had Hep A & B tested for booster but it came back immune.

Are you keeping up your shots?

 

[drsmith]

I have private health insurance but only because it's cheaper than the medicare levy surcharge.

While private health insurers have a large captive client base due to tax incentives there will not be much incentive for them to actually provide a service for the premiums they recieve.

Health funding should be overhauled with tax removed as an incentive to take up private health cover.

We should all be entitled to basic health care paid for via income taxes as is the case now. Where private health services are used this should be funded to a scheduled level by the government as part of the basic health service with the remainder funded by the individual. Private health insurance should then be an insurance to cover the difference between the scheduled level and the overall private cost.

There should be no tax incentives (carrot or stick) for this type of private health insurance and for overal simplicity the medicare levy should be integrated into income tax rates.

 

[johenmo]

Have had health insurance for 25 years. Main reason being I don't want o wait in the public system. It's been used a few times - including wisodm teeth removal for one of our children.

If you're critically or very ill, you'll get seen to but issues like a gallbladder (recently removed from a family member) meant quick relief. I will need joint replacement in a few years and know people who have been a list for a while. The wisdom teeth woudl have been 12 months under teh system.

Problem is the surgeons etc who charge more than the schedule fee. Patient pays for that.

 

[tasmart]

My conclusions are;

1. You need private health insurance.
2. In an emergency you will receive very good service from the public health system.

This is the best conclusion - but it does depend on where you live and what stage of life your are in.

I work in the health system In Hobart and the waiting periods for elective surgery in the public system are basically inhumane! As an example waiting in pain for a hip replacement for up to 9 years is crazy! On the other hand emergency treatment for life threatening conditions is not that bad.

The biggest problem is that there has been a failure of public health management - and they persist in treating staff (nurses, doctors, paramedical staff) as a cost rather than an asset. Hence there has been an ever increasing middle management, measuring lots of things mainly related to cost containment but not to real outcomes. Also considerable political interference and micro management. As a result there has been a major move of good staff into the private sector, which although driven by profit does mean there is a focus on patient care (& throughput) and with a bit of competition, and inclusion of staff in decision making, makes for a reasonable system - especially for elective surgery. This move of staff out of the public system along with past erroneous political decision cutting nurse & doctor training has led to an increasing dependence on overseas trained doctors in the public sector. Although many of the imports may have the knowledge - the levels of technical skills, and also communication skills often leaves a lot to be desired - sometimes with very unfortunate outcomes.

But if you are young & single, only likely to damage yourself falling off horses, cliffs or crashing cars then having the public sector as a backstop is fine.

If you are older with family then private insurance becomes more of a neccessity. Self insuring is fine but the costs may be very high! Joint replacement surgery can cost you $20,000 - private hospital fees & prostheses are not cheap! At least the medical costs in hospital are a little covered by medicare but again can have high 'gaps'.

Mind you - I think income & business expenses insurance are probably more important if you are selfemployed.

 

[tasmart]

Administration of hospitals is a major problem. Unfortunately, you have incompetent people running hospitals.

PS. Sorry once again for the rant. Particularly sore topic for me at the moment!!!

I think a lot of us who work in the health system have the same feelings!

What amazes me is how bad it has become and they continue to poor money into the failing system (Australian today):

"Mr Rees, who is faces crises of his own, will ask the Prime Minister for a $2.5 billion bailout of the struggling NSW public hospital system. "

Sadly the effect on the future calibre of health staff is incalculable (the majority of whom are trained in the publice sector)! We allready see the 'work to rules' and mercenary nature of younger staff. And with the flood of medical students now in place - without any govt committment to provide an increase in actual hospital training positions - the system is likely to become even more chaotic!

 

[Green08]

My brother who works in construction and drives heavy vehicles has always worried me.

I put him on the second basic one (his xmas present). I asked about hip and knee replacement in case he is in an accident. He is covered for his knees and hips (which may need replacing or removing!)

In a normal replacement - he is not.

My daugther grinds her teeth at night, had a plate made $450 I received $380back. Her teeth are worth more than that to fix. Cost of implants $4 - 5k's each plus the major discomfort - pain after. Yes could have gone to a cheaper dentist but she is comfortable with ours.

If you are a young family you need to think ahead of issues which children face. I have 2, one needed an expanding plate and braces. As I had had private cover for @ 20 years before most of the cost was covered - $k's

There is nothing worse than a child suffering with dental problems and not being able to have it attended to reasonably fast.

Know of two families where the children have developed adult teeth they are looking at $65k's up in implants.

In some rare cases the government will pay for it at Westmead Children's Hospital, linked to certain growth diseases. Then some kids just don't develop adult teeth.

Yes our Doctors and fellow collegues are worth it. To pay for their study fees, insurance premiums etc but one thing you can't buy is bedside manner and genuine care.

 

[grace]

We have been in private health cover for over 20 years, highest level of everything. Young family with four young children.

The only thing about living in the bush is, if you go to hospital, there is only one hospital, and it is of course public. Only in rare cases do we get a private room (when we are really sick and get airlifted out to the city).

I spent 3 weeks in hospital once in a private room. I think those 3 weeks were equivalent to 10 years of family premiums alone.

By the time the six of us go to our routine 6 monthly preventative dentist visit, the gross fee is about $1200 - $1400, which is twice a year. We get most of that back.

It is well worth it as there are six of us.

 

[adobee]

Manchester unity recently paid out all of its members.. I was surprised to learn the cheque I received from the was not dated an therefore was returned ... I wonder how much this hiccup has cost them in processing fees, reissuing and posting new cheques !

 

[Happy]

For all those who get -super value- out of any system where there is one pot of money including insurance, there must be some that pay and get little out.

Insurance Co is not a charity so it looks like this -

Premiums – expenses to run (including super for CEO and reinsurance) – payouts – profit = 0


If only multi-child families with massive medical expenses used private insurance fund, premiums would reflect expenditure according to above equation.

In other words, some will not get value; just peace of mind that there might be enough in a pot for them should one day they need it.

 

[Green08]

Manchester Unity are great! I received a lovely surprise as I've been with them for 15 years at the top level. Moved over from HCF now back under their 'umbrella arrangement'.

In the country here but should I need any surgery other than emergency I would go to Armidale or North Shore Private.

Had a major surgery at North Shore Private was in for total 20 days in a Private room the bill for surgery theatre, room etc was over $20k I would not have had this operation done in the public system. All the staff were great and they catered for my allergy diet with great food!!

 

[drsmith]

Got the annual premium rise statement from Medibank Private today. Premium up 10% and services reduced.

That's to be expected when the health insurer knows they don't have to actually provide any service as a cost below the tax incentives.

Oh the pain! The pain!

 

[Julia]

That's to be expected when the health insurer knows they don't have to actually provide any service as a cost below the tax incentives.

Sorry if I'm being dense, but I don't know what you mean by the above.
Could you put it differently?

 

[drsmith]

Assume the medicare levy surcharge for a taxpayer is $X. The health insurer then knows that for an annual premium below $X that the taxpayer will pay for health insurance (regardless of the service privided) to avoid the surcharge.