Private Health Insurance - Is it Worthwhile?

[prawn_86]

From the horses mouth,

I have been advised by numerous tax professionals that this is not only legit, much encouraged if one can afford it. Pretty much everyone from our work did it.

 

[sptrawler]

it would be really interesting to have someone giving us some real $figure on that: anyone with a knee reconstruction cost within full private cover?
And someone who went without private cover??
As I said my skin, nerve and vessel graft was just an endless list of above threathold so not covered;
Private insurance will at the most (and within limits) cover the gap between medicare paidback and a grossly undervalued figure supposed to be the "cost" of a procedure; you will soon discover that all decent surgeons, hospitals, etc are way above the medicare figure.

A bit late on the answer, been away. However I have had both knees replaced with full private cover total cost $25,000 each. I ended up approx $3000 out of pocket for each knee.

 

[johenmo]

Interesting thread. I had a shoulder done privately - arthritic bone spurs ripping the muscle when I moved it. It was day surgery but I was still nearly 1K out of pocket - the anaesthetist XS was as much as the surgeon. But it was a 3 or 4 year wait in the public because there were many more before me. So I decided to pay in order to get rid of pain, be able to sleep, etc.. Cheaper and more use than my suit! Best 1K I have ever spent.

We've had health insurance forever and it's worth it.

My renewed interest in health insurance comes from probably needing to have a CABG (still working it out). Cardiologist is recommending it even though I am reasonably symptom free. On that basis the public won't touch me as I don't rate as bad enough within the guidelines - which don't allow for family history. We have a public and a private hospital next door to each other in town so will have to shop around. And when I know & have known people who are 100% public reliant and have bad heart problems and have to wait months to get a test (have known two to drop off the perch whilst waiting) I can see why it's good to have a choice. What's a few dollars saved if you aren't here to spend it...

 

[Smurf1976]

And I'll be keeping my health insurance too. I've never made any sort of claim, actually I don't even know how to go about claiming, but you never know what's around the corner. I've heard more than enough public hospital horror stories to know that I'll be keeping my health insurance.

Well on Tuesday night I had the misfortune of finding out how it works. Massive pain, lots of other nasty things happening (let's just say my face "blew up" just like a balloon), never been in an ambulance before, all very scary and nasty.

But ultimately it took about 3 minutes from getting in the hospital (private) to having a doctor doing this, that and everything else to me. Very quick and efficient compared to the public system horror stories of people waiting for hours in the emergency department.

I'm back home now, mind and body are both still messed up a bit from it all (and from the drugs pumped into me probably) but the doctors say I'll be OK but need to wait for the remaining swelling etc to go (might take a while apparently) then come back and they'll determine how I got such a nasty infection in the first place.

So the private health system seems to be working fine for me when I need it. Obviously I don't have a direct comparison to how well the public system would deal with it, but I suspect it would have been more than a 3 minute wait.

 

[Julia]

Smurf, I'm sorry to hear of your experience. Hope you're soon quite well again.

Can you say how it was that you were taken directly to a private hospital in the first place? All the private hospitals I've ever known don't have an emergency/acute admission facility and people who have called for an ambulance are taken at least initially to the public hospital then arrangements made for transfer to private if appropriate medical personnel are available there.

Did you perhaps have your GP see you first and the admission was arranged by him/her?

 

[McLovin]

Smurf, I'm sorry to hear of your experience. Hope you're soon quite well again.

Can you say how it was that you were taken directly to a private hospital in the first place? All the private hospitals I've ever known don't have an emergency/acute admission facility and people who have called for an ambulance are taken at least initially to the public hospital then arrangements made for transfer to private if appropriate medical personnel are available there.

Did you perhaps have your GP see you first and the admission was arranged by him/her?

There's a few around Sydney, usually the bigger privates that aren't attached to a public hospital. You usually need insurance unless the nearest public hospital has no room at the inn, in which case you're sent to the private hospital. Example...

http://www.norwestprivatehospital.com.au/

 

[Smurf1976]

Smurf, I'm sorry to hear of your experience. Hope you're soon quite well again.

Can you say how it was that you were taken directly to a private hospital in the first place?

I'm feeling reasonable now, a bit "spaced out" so hopefully this reads OK.

In short, started feeling a bit unwell late in the morning, went home from work mid-afternoon and called GP to make an appointment with the earliest available being the next day.

Within a few hours I was having real trouble so ended up writing a short note explaining the situation and went next door to get someone to call for help - it was beyond my abilities to be making phone calls by that stage.

Handed a note to the ambulance people saying that I had private health insurance and wanted the fastest treatment, public or private. They made some calls and took me to Hobart Private Hospital - it's physically in the same city block as the public hospital but has its' own emergency department. So that's how I got there.....

First time I've ever been a patient in a private hospital. I'm quite happy with the standard of service, despite obviously costing me more than using the public system. That goes against my principles somewhat, I'd rather we had properly resourced public hospitals and just pay more tax or whatever is needed to make that happen, but unfortunately that's not the situation we have.

 

[sydboy007]

First time I've ever been a patient in a private hospital. I'm quite happy with the standard of service, despite obviously costing me more than using the public system. That goes against my principles somewhat, I'd rather we had properly resourced public hospitals and just pay more tax or whatever is needed to make that happen, but unfortunately that's not the situation we have.

My attitude as well. I'd much rather see a better funded public system. I fear we're more and more headign towards US style health care here.

As for PHI, I make a lot of use of mine. Mostly the extras cover though. Touch wood haven't had to get any hospital treatments, though thinking I might have to get something done to my knee since it's started to play up and the physio hasn't seemed to help so far.

 

[drsmith]

I'm feeling reasonable now, a bit "spaced out" so hopefully this reads OK.

Red back spider on the toilet seat ??

It's good to see you're OK.

 

[shouldaindex]

I'd rather insurance for the capital I spend on health insurance than health insurance.

Isn't it one and the same, except you probably have more money in investments than health insurance.

 

[Julia]

From the Weekend Australian today:

UNPROVEN natural therapies will be stripped of government subsidies, amid signs private health insurers and their members have embraced the so-called alternatives to traditional medicine and driven up costs.

More than half of all Australians ”” about 13 million people ”” have general treatment policies, many of which now provide cover for alternative medicine and still attract the government rebate.

Under changes being considered for April 1, the rebate would be stripped from any policies covering natural therapies not supported by scientific evidence.

Documents obtained from the insurance regulator, the Private Health Insurance Administration Council, reveal natural therapies have been responsible for the biggest increase in benefits paid to members outside of hospital services ”” an incredible 345 per cent increase in 10 years.

The growing popularity of natural therapies ”” sometimes described as complementary, or alternative medicine, such as acupuncture, homeopathy, Chinese herbalism and various massage techniques ”” threatens to distort the market. It is putting pressure on premiums and drawing down more of the commonwealth’s *insurance rebate, which will soon cost taxpayers more than $6 billion a year.

About time. As more and more of these unproven lurks have been included - even when not wanted by the customer - premiums have risen exponentially.

 

[Bill M]

First time I've ever been a patient in a private hospital. I'm quite happy with the standard of service, despite obviously costing me more than using the public system. That goes against my principles somewhat, I'd rather we had properly resourced public hospitals and just pay more tax or whatever is needed to make that happen, but unfortunately that's not the situation we have.

My attitude as well. I'd much rather see a better funded public system. I fear we're more and more headign towards US style health care here.

My wife and I have never had private health insurance. When we were working and young we thought we were paying more than our fair share with the medicare levy. We rarely got sick and couldn't see the point of forking out more for something we didn't use much.

Then we got older and my wife needed a rather large procedure. She went to a specialist and asked to be admitted through the public hospital system. Within 5 weeks she had her procedure and it was totally covered by medicare. Then only a few Months ago I needed a medium sized procedure, same deal asked to be admitted into a Public Hospital. Again my operation was performed within 6 weeks and medicare paid. We think the public hospital system was good in both cases and still can't see the point in getting private insurance.

My Mother is in her 80's and has private health insurance, she does not like the public system. She has the opposite view to us about the system. She says things like, they send you home too early and the level of care is not so good. I am not sure about that as I was up there taking her to the 2 major public hospitals on the Gold Coast and they seemed professional enough for me. With her last episode she ended up in a private hospital, I couldn't see the difference between the two systems although she did get her extended stay in the private one.

My Mother has a circle of elderly friends, all + 80 Y/O. Some of them have private health insurance but when they have an episode they still ask to be taken to a Public Hospital and not a private one and the reason is they do not want to pay the $400 - $500 excess fee for private admittance. To me I can't see the point of having the insurance in the first place if they aren't going to use it.

I agree with Smurf and Sydboy, I would like to see a stronger better Public Hospital system. I and many of my friends would be happier to pay a little bit more in the medicare levy to fund a better Public Hospital system. I do not want to go anywhere near a system like the USA has, even what we have now is far superior to that.

 

[qldfrog]

remember that for many of us working people, private insurance is de facto mandatory with a punitive medicare extra levy if you do not belong;
Do I want to have private medical insurance?
no
do i prefer public hospitals: yes i do for real emergencies.
In case of non urgent, you quickly realise that the fact you have insurance does not make much difference for the bill you pay in a private hospital; your yearly premium would easily cover the extra cost
private health insurance has a very low ROI for the insured

yet i have a private insurance as the current laws do not give me the choice
nanny state australia again

 

[Julia]

Bill, it's good that you were looked after so rapidly in the public system. Might depend where you live.
At least in this regional area, people wait up to six years for such as knee replacements, by which time they need a hip replacement as well because of the awkward way they've been walking for so long.

The other factor is the standard of the public hospital. It is, um, less than great here. If you live in a major city and have access to hospitals of the highest standard it's a whole different story from what you get in regional areas where top medical personnel simply don't want to be.

And then anything serious like complicated surgery the patient has to be taken to Brisbane because they just aren't up to doing it here.

And apart from all that, I want my choice of doctor, not some less than fully qualified Registrar which is a choice you don't get in the public system.

 

[Bill M]

And apart from all that, I want my choice of doctor, not some less than fully qualified Registrar which is a choice you don't get in the public system.

People have mentioned this before but it is totally irrelevant to my wife and I. We don't know any Doctors other than a couple at our clinic and even then we don't see them everytime. Sometimes we just take the first available and they all seem to know what they are doing.

When something needs more attention they send us elsewhere where we don't know anyone or any provider so we wouldn't know a good one from a bad one. I will say that when I had my operation, they told me just before I went in that they had just performed the same operation on 5 people before me. It was like a production line, a very well organised one. I had 3 different surgeons speak to me just before the op and they were very professional. I have not seen them again (except for the head surgeon) and my operation was a 100% success. I guess what I'm trying to say is that I don't care who does my operation as long as they do it right.

By the way, the head surgeon does exactly the same operations in a local private hospital too, the only difference is one is public and the other is private, same end result.

 

[Julia]

. I guess what I'm trying to say is that I don't care who does my operation as long as they do it right.

And that's the only thing any of us are worried about. You live in a major city with access to the best standard of care. You don't need to have had anything to do with the surgeon as long as he's competent.

What the big difference is, as I've tried to explain, is that you simply do not have access to that level of professionalism in many regional hospitals.
Just one example: my father had an acute bowel obstruction. Needs immediate surgery, no question.
It was carried out here by foreign trained doctor with minimal surgical experience. Colostomy as a result which is not unexpected. However, the procedure was so badly done that the stoma constantly leaked and actually 'exploded' at times, spreading faecal matter all over him, his clothing, bed etc.
I don't think anyone would consider that a satisfactory outcome.

I had an instance a few years ago where in the middle of the night I couldn't swallow properly. Breathing was difficult. Phoned ambulance which came very quickly and took me straight in. Those symptoms can be part of infarction.
I was first seen by an intern whose English was not understandable. He went away and came back clutching book "Medicine for Students". No thanks. He didn't have a clue, and eventually went away and came back with the Registrar who was much better.

So it's great that you've had such good attention but the reality is that not everyone has access to the same.

 

[Bill M]

Both cases sound horrible Julia, that was awful to go through.

If you had to be put in an ambulance at 3 AM in the morning, could you be taken to a much better private facility with better medics there? I mean, if you were conscious and could direct them to take you to that private facility would it be adequately staffed?

 

[Julia]

Both cases sound horrible Julia, that was awful to go through.

It was particularly horrible for my father. I'm certain the ongoing embarrassment and "yuk factor' was a large part of his decision to commit suicide.

If you had to be put in an ambulance at 3 AM in the morning, could you be taken to a much better private facility with better medics there? I mean, if you were conscious and could direct them to take you to that private facility would it be adequately staffed?

Unfortunately, no, which is something I'm constantly concerned about. We have a brand new private hospital with the best of facilities but they have no emergency department. So there's simply no alternative to the public hospital for other than elective situations.

In cases like you describe for yourself where it seems you had plenty of warning, yes one could elect to go to the private hospital with private specialist who your GP would assure you was up to the job. Even then, the same principle applies to some extent about the best doctors wanting to stay where they converse and have ongoing training with their peers at teaching hospitals.
We have no cardiologist here, for example, which seems ridiculous in a town of 55,000 people many of whom are retirees.

 

[Bill M]

In cases like you describe for yourself where it seems you had plenty of warning, yes one could elect to go to the private hospital with private specialist who your GP would assure you was up to the job. Even then, the same principle applies to some extent about the best doctors wanting to stay where they converse and have ongoing training with their peers at teaching hospitals.
We have no cardiologist here, for example, which seems ridiculous in a town of 55,000 people many of whom are retirees.

It does seem ridiculous not having a cardiologist in your town considering the size and demographic.

My area has a population of around 320,000 and we are serviced by 2 Public Hospitals. We do have cardiologists and an operating theater that is dedicated to only heart related procedures.

I'm pretty sure you are right, we are serviced better here and I fully understand why you have health insurance. I really think more pressure needs to be put on the Queensland Government to provide better services. Medicare can always be improved and it seems like a bit more resources could go to areas like yours, I hope the situation improves for you all up there.

 

[Julia]

Thanks, Bill. It's the one down side in living in an otherwise great situation, eg 5 minutes walk to beautiful beach, wonderful weather, no traffic snarls or road rage, laid back friendly population.
All of life is a compromise, I guess.