Is health insurance worthwhile?

[wylie]

I'm with you Brisbaneite. Two years ago our bill for five of us for physio, chiro, orthotics, dental etc came to $10K. We got back $7.8K. That was unusual, and this financial year we have used a fraction of that.

I have done the exercise of working out how much it would cost if we didn't pay for health cover for the extras, and it is still worth having the cover, but I do check each year.

With two sons having had (or about to have) three minor operations, I know they can be done quickly with a couple of hundred excess through private cover. None of the procedures is "urgent" and I don't even like to think of how long they would be waiting in the public system. Perhaps they would get in straight away, but I doubt it.

For me/us, it is like car or house insurance... hate paying it, but not game to risk not having it.

And for us, having had our first child at age 28/29 and our last at 36/37, by the time we don't need cover for the kids, we will be nearly 60 and not game to downgrade our cover.

I guess it is like the private/public school debate and like all other types of insurance (life, income protection, disability etc). We each make our decisions based on our past history and experience and, like all other insurances, can adjust the cover as circumstances change.

 

[weg]

You're definitely right there wylie, it's like any insurance - you need to do your figures, and homework on what is being offered.

We also have Gold Extras for things like dental. With a family, costs really add up, not to mention the public dental system is atrocious.

I think we're near the 3K mark for the last 12 months. At some stage I will be needing an implant (2 root canals on 1 tooth doesn't make for a very strong tooth).

For general healthcare we use both private (as Medicare patients) and public depending which we think will be of bigger benefit.

Biggest bill for surgery in a private hospital so far has been $1600 - day surgery. That was for everything.

So far we all have perfectly good knees and hips, and general health, and apart from child birth the collective days spent in hospital for our entire family ever, is probably 10 days.

Our savings on hospital cover is in the 10's of thousands.

If and when (touch wood) our bodies deteriorate and we require elective 'non urgent' surgery we are prepared and happy to pay the few K that major elective surgery demands.

General health care is pretty good in Australia regardless of the shock stories. The problems are in mental health (private not very happy to deal with difficult mental health patients - not where the money is and public shutting the door on them) and disability.

And like I said, so is dental - if you have problems that extend beyond a filling or extraction .

 

[pennyk]

If there is profit in it, it would be a bonus to the public system if anything.

That was exactly my point... if everyone goes to a public hospital as a public patient, the hospital will have less money than if they take private patients as well. So, the more people who have private health insurance, the more robust our public health system is.
I think we shouldnt just think about what benefits us as individuals, but also what benefits the community... and if we all give up private health insurance, its likely that our public services will suffer as a result.

 

[weg]

That was exactly my point... if everyone goes to a public hospital as a public patient, the hospital will have less money than if they take private patients as well. So, the more people who have private health insurance, the more robust our public health system is.
I think we shouldnt just think about what benefits us as individuals, but also what benefits the community... and if we all give up private health insurance, its likely that our public services will suffer as a result.

I get that there would be some profits but MY point was the private patients would not change the required funding allocation (assuming the percentage using these beds is static year in year out), meaning the hospital has full funding and hence it should not be dependent on this 'extra' to deliver care.

I suppose I just don't see how this could be seen as a a legitimate way of funding a public hospital. I can't imagine it would even be 'officially' endorsed by the hospitals doing it either.

Sounds more like a case of some hospitals running into strife in managing their budget.

 

[Indifference]

I believe our 2 tiered health system has a corresponding 2 tiered copay scheme... Ie. those that have demonstrated an ability to pay more, do so.

This boils down to Private patients being out of pocket more than Public patients for the same type of treatment. There are only 2 benefits I see of Private Health cover: 1. Choice 2. Elective coverage.

The 1st point is moot on the basis that Public patients can have the choice to use Private services with Medicare offset & only pay the difference.

The 2nd point is lifestyle based, not life threatening, so is an individual assessment on whether this alone is worth the extra cost.

So, Private health cover is one big cash machine in Australia that offers very little over & above the Public system. But to many people those few minor benefits are worth the thousands of $. Personal choice, but certainly not one I see much value in.

Australia has one of the BEST public health system's in the world. Be thankful your not part of the other 99% of the world's population that isn't as fortunate. A little perspective goes a long way!

 

[BayView]

My wife is a theater nurse, and I worked in ICU as a nurses' aid for almost 3 years.....

If you can afford private health insurance....get it.

Hospitals are full of people who never get sick, or who thought they never would..

At the end of the day, if you are REALLY sick or have a serious accident, you will go to a public hospital where the facilities to save your life are better.

When you get well enough, then they'll ship you out to a private facility if you wish, or if they need your bed.

 

[lizzie]

When you get well enough, then they'll ship you out to a private facility if you wish, or if they need your bed.

True - my MIL (the only one in the family who has used both systems extensively before her death) was treated for urgent cases in the public system ... and then quickly shipped off to private rehab, as they needed her bed. I do wonder where she would have ended up if she wasn't private and couldn't afford the rehab.

Also when she needed life threatening, but non-urgent, surgery she got straight in to the private system. I am sure she used every cent of the payments she ever made.

Also watched my hubby's aunt suffer for years waiting for a hip OR knee replacement via the public system. She was in constant pain for over 18 months and stuggled to walk ... and was only eligable for one or the other replacements, but not both as required.

 

[weg]

I do wonder where she would have ended up if she wasn't private and couldn't afford the rehab.

lizzie, they ALL get shipped off because public hospitals don't do rehab. They are an acute care facility.

There are special public rehab facilities for patients who need it, ie. stroke, orthopedic, amputee, spinal injury type patients.

The major public one we have in SA is by far the most superior because it deals with the most complex of rehab patients and involves multiple disciplines that not only help the person get physically better, but assists them in getting geared up to manage in their home on return.

It also offers hydrotherapy, exercise classes and other group therapies on an outpatient basis to anyone that gets a referral from a doctor.

My mum actually qualified because of her osteoporosis and went a few times (pool aerobics) but then switched to a local council exercise group for convenience and to be with her neighbour friends.

All top notch, and FREE .

http://www.myhospitals.gov.au/hospital/john-hunter-hospital

 

[Macca]

I suspect this argument can go on for a while but by reading the posts it seems to me that it depends on what state you are in, where you are situated within that state and then it depends on which hospital they take you to on the day

I would agree that elective surgery is a lot easier if you have private cover so I guess I will keep paying for it.

 

[travelbug]

I
There are only 2 benefits I see of Private Health cover: 1. Choice 2. Elective coverage.

The 2nd point is lifestyle based, not life threatening, so is an individual assessment on whether this alone is worth the extra cost.

Lifestyle based??? Like case below? So wanting to walk is now a lifestyle choice? Not all non life threatening surgery is a lifestyle choice.

Also watched my hubby's aunt suffer for years waiting for a hip OR knee replacement via the public system. She was in constant pain for over 18 months and stuggled to walk ... and was only eligable for one or the other replacements, but not both as required.

 

[Belbo]

This is a really important discussion topic, but it seems to be inconclusive.

My 2 cents worth: Private insurance costs the wife and I the same as a good cup of coffee each a day, so the cost is not the real concern. It would be nice to know we are getting value for money, but honestly suspect we won't know that unless / until something very bad happens to one of us. So, we pay and pray, but in our hearts want the public system to be as good as possible in case our private coverage lets us down.

 

[lizzie]

That's like any insurance - house, car, life - you pay with the hope that you'll never need it but you'd be crazy not to have.

 

[BayView]

True - my MIL (the only one in the family who has used both systems extensively before her death) was treated for urgent cases in the public system ... and then quickly shipped off to private rehab, as they needed her bed. I do wonder where she would have ended up if she wasn't private and couldn't afford the rehab.

It depends on where you are I suspect.

Here on the Peninsula there is a rehab section of the Peninsula Health Network (own Frankston and Rosebud Hospital, for example). I worked there a few shifts when I was first in the nurses' aid job before getting the gig in ICU. People often get shipped to the Rehab which is located in Rosebud.

She would have been kept in the public bed until she was well enough to go there if she was in their system for her initial care.

No doubt other Public facilities who don't have a rehab might send you straight home once they deem you well enough to leave.

 

[Belbo]

That's like any insurance - house, car, life - you pay with the hope that you'll never need it but you'd be crazy not to have.

Life insurance? No, that IS a waste of time. If your investment portfolio isn't life insurance, you're doing it wrong. (But this belongs to another thread.) The real question is, are any private insurance programmes in Aust good enough?

 

[BayView]

Life insurance? No, that IS a waste of time. If your investment portfolio isn't life insurance, you're doing it wrong. (But this belongs to another thread.) The real question is, are any private insurance programmes in Aust good enough?

The wife and I are addicted to Forensic Files on the teev, and I love all the Anne Rule books (on same topic).

You'd be amazed how many spouses amazingly die (in the USA) not long after the Life Insurance was upgraded.

 

[Belbo]

The wife and I are addicted to Forensic Files on the teev, and I love all the Anne Rule books (on same topic).

You'd be amazed how many spouses amazingly die (in the USA) not long after the Life Insurance was upgraded.

Hahha! Good one.

 

[RumpledElf]

I have private health insurance and wouldnt be without it.
I used it when I gave birth. I had significantly more positive experience than many of my friends who went public. Many of them were out the door within a day before their milk came in. I really appreciated those extra days to get a handle on the basics.

I think it depends on the hospital. I've had all 3 kids public, and the first one I ended up staying in for several days as they wouldn't let me leave before breastfeeding was established. The other two I went home within a few hours and had a visiting nurse come afterwards. Grand total? $0.

Ambulance cover is $84 a year for the family.

Doctor and drugs are nearly free - we have a pension concession card.

Various specialist appointments we pay a gap on, medicare covers most of it.

We buy our own glasses at a couple $hundred every few years. I've had the same glasses for ~6 years, mainly because they have detachable arms so they've survived toddler abuse.

As to dental, haven't been for years but this year will be spending $800 on dental, which is what you get for not going to a dentist for 15+ years. Kids are covered free. Partner is going to have to wait until next year to average things out.

I want some elective surgery but what I want is explicitly excluded from all the health funds that I know of, so that's going to be out of pocket. Partner also wants some surgery, same problem. Both have a small medicare rebate. So why even bother with private health cover?

 

[Indifference]

Lifestyle based??? Like case below? So wanting to walk is now a lifestyle choice? Not all non life threatening surgery is a lifestyle choice.

Yes it certainly is a lifestyle choice.... it is a quality of life decision. A hip or knee, whilst debilitating is hardly life threatening. If a paraplegic can continue to have a meaningful, productive and happy life, then a hip or knee debilitated patient has little to complain about in comparison.

It is all relative and is precisely why I said it was a personal choice. I've had 3 knee surgeries, 2 shoulder surgeries (including a complete reconstruction) & surgery for a complete non-reducible fracture. NONE of these were "necessary"... they were a lifestyle choice as they were non-life threatening. So yes, wanting to walk IS a lifestyle choice once the patient is in a stable condition.... as hard as it is to accept in such terms. A sucking chest wound, uncontrolled hemorrhage, cancer etc... are on the other hand, life threatening. Some within seconds/minutes, others within months. There is a very distinct difference.

 

[wylie]

Yes it certainly is a lifestyle choice.... it is a quality of life decision. A hip or knee, whilst debilitating is hardly life threatening. If a paraplegic can continue to have a meaningful, productive and happy life, then a hip or knee debilitated patient has little to complain about in comparison.

It is all relative and is precisely why I said it was a personal choice. I've had 3 knee surgeries, 2 shoulder surgeries (including a complete reconstruction) & surgery for a complete non-reducible fracture. NONE of these were "necessary"... they were a lifestyle choice as they were non-life threatening. So yes, wanting to walk IS a lifestyle choice once the patient is in a stable condition.... as hard as it is to accept in such terms. A sucking chest wound, uncontrolled hemorrhage, cancer etc... are on the other hand, life threatening. Some within seconds/minutes, others within months. There is a very distinct difference.

Whilst I agree with this in a purely technical sense, it is hardly helpful in this debate about paying for health insurance for "non life threatening" procedures required by people. If there was only "sucking chest wound" or "uncontrolled hemorrhage" cover most of us wouldn't bother because there would be ambulances standing by ready and hospital beds empty waiting for such cases.

I think we all understand such cases would see the patient taken directly to the nearest public ED. But this is not what we are discussing here, really.

This discussion needs to stick to "real life" scenarios for those people who may need physio, chiro, dental work, broken bones, hip replacement etc. We all know if we are having a heart attack the ambos are not going to ask us if we want to see our own doctor next Monday to book us into our chosen private hospital.

 

[Indifference]

.......

This discussion needs to stick to "real life" scenarios for those people who may need physio, chiro, dental work, broken bones, hip replacement etc. We all know if we are having a heart attack the ambos are not going to ask us if we want to see our own doctor next Monday to book us into our chosen private hospital.

I am sticking to real life. To quote your example above of "broken bones"... my son has had two separate instances of multiple concurrent fractures both requiring orthopedic surgery. All done in public hospital, with physio, without waiting & without any private health insurance. The second time required multiple surgeries to remove metallic rods, with extensive follow up, rehab/pyhsio & even a few days in hospital.... no cost, no wait, no private health insurance.

Perhaps my "real life" is not real enough?

I have more personal not so "real life" examples of fused discs, vertebral cartilage removal etc... Once again, in "real life" and in medical terms, these are elective, non-life threatening procedures..... Once again, no private health, done in a timely manner & within the public system. Perhaps I live in a different Australia.... you know, the one where we have one of the best public health systems in the world.

Perhaps you should redefine "real life" since broken bones & physio no longer apply, not to mention spinal joint surgery.