Is health insurance worthwhile?

The only problem with not having the insurance (as I see it) is the waiting lists.

My hubby will need a knee replacement and can't wait years. The doctor said if he had insurance (or we wanted to pay $thousands) he could do it in 6 weeks time.
I read a blog from someone in 2007 that had a knee replacement. It cost $27,000. He was privately insured and he was $5,000 out of pocket. That's still a lot I think.
 
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Only a couple of months later she was diagnosed with breast cancer. She was told that she had a 70% chance of living if she had the surgery and started chemo straightaway. If she waited to get through the public system, she'd have to wait at least 6 months (he said most likely a year) and then her chance of living would be around the 20% mark.

FALSE! She would get in immediately (or in a very short time frame, much like a private patient), as she would be considered urgent.

So now she had no choice but to pay for everything herself. She's been told it'll cost somewhere between $50,000 - $80,000 all up for the treatment. Thankfully she has some investment properties so she's going to sell one in order to pay for her treatment.

Friend of mine who had advanced cancer who isn't insured went private because he wanted a specific Oncologist, and his out of pocket expenses after Medicare in the first 12 months of treatment came to around 3K. He was also initially concerned about cost.

He went into remission following that so can't tell you what he paid 3 years later when the cancer came back but I can't imagine it being that much more. Like I said earlier Medicare pays for most of the bill.


No need to sell any IP's.

Very sad but true.

Sounds like scaremongering by the Oncologist.
Sounds like scaremongering by the Oncologist.

Not sure if it's scaremongering, but who would want to risk it?
 
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Not sure if it's scaremongering, but who would want to risk it?


Is it someone taking advantage of someone that's naive, or a GP trying to drum up business for his Oncologist mate, or could it be someone who doesn't know how his own line of work operates :eek:.

Even when in the investigative stage for cancer (before diagnosis), if the symptoms or patient/family history (these are all stated on the referral) put the person at higher risk for disease the public hospital make them a priority, and therefore they are seen quickly. That's people who have YET TO BE diagnosed.

The reason I have responded to your post is because people could be reading it and believe it to be true -not saying this is not what your friend told you.
 
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Not sure if it's scaremongering, but who would want to risk it?

Depends whats area they are in ... I know the waiting lists in the Hunter Region - even for urgent, life threatening cases is so long that a percentage die waiting ... to the point where the oncologists are paying out of their own pockets for extra staff. Apparently we are short around 20 treatment chairs in the Hunter/New England region alone.

Easy to say "if you're urgent" but when there are severe shortages, being bumped to the top of the list knocks off someone else who may also be just as urgent.

The cost may also be dependant on the type of treatment. I know my MIL had an angina op privately, that would've cost her $30,000 if she didn't have insurance (otherwise would have been put on a lengthy public "waiting list") ... so very possible extended cancer treatment would be much higher.

And those waiting lists can be horrendous. There was a recent report in the local paper about how some Sydney hospitals were fudging the waiting list times by actually having two lists - one waiting list, and one waiting "to get on the waiting list" list

Not worth the risk IMO.
 
The cost may also be dependant on the type of treatment. I know my MIL had an angina op privately, that would've cost her $30,000 if she didn't have insurance (otherwise would have been put on a lengthy public "waiting list") ... so very possible extended cancer treatment would be much higher
Not worth the risk IMO.

Did that figure account for the Medicare rebate that a self insured person would be entitled to (at least 75% of the MBS fee) and the tax offset of 20% (that is, 20 cents in the dollar) of net medical expenses over $2,000 that a taxpayer is able to claim? There is no upper limit on the amount you can claim.
 
I wonder if this was a bit of median beat up... people dying waiting? Was a report done by the coroner who would be the one to comfirm this?

Reminds me of a media report only a couple of years ago, when one hospital here had a dramatic increase in ER waiting times over a couple of weeks, but they failed to mention major renovations were the main cause.

Urgent cases would have still been seen, they just didn't have enough cubicles and some waited in the corridors, but media insinuated care was compromised :rolleyes:.

ER waits are generally short too, or within the recommeded wait times, except according to the media (coughs and cold excluded here).

In regards to chemo I know The Royal Adelaide Hosptital has a 0 wait time (this has just been confirmed to me by the person that recommended the particular Professor Oncologist to my friend who had the cancer), but perhaps there have been isolated areas where for some reason waits increased for a time, for whatever reason in your area. I don't know, but this isn't the norm.

There are good and bad in both private and public. Yes even private has negatives over public.

I've seen it first hand where totally unecessary surgery is performed, or a doctor performs treatments outside of recommeded treatment guidelines and appears answerable to no one.

I've seen a death from this where standard treatment wasn't carried out, much to the horror of the last Oncologist the lady saw just prior to dying.

In public you can't chose your doctor and have to wait for non urgent surgery (orthopedics being the longest) but the health care is generally on par with private, unless you get a situation like the one mentioned above.

Public hospitals are generally better staffed and imo safer places in the case where something goes wrong (why I chose public for the birth of my children).

There are more differences, but they're less to do with healthcare.
 
Did that figure account for the Medicare rebate that a self insured person would be entitled to (at least 75% of the MBS fee) and the tax offset of 20% (that is, 20 cents in the dollar) of net medical expenses over $2,000 that a taxpayer is able to claim? There is no upper limit on the amount you can claim.

For a cost difference don't forget to subtract from that, the gap the insured pays, and some of the insurance premium.

Much of the time with ops that don't require long hospital stays (with contstantly improving surgical techniques most stays have got MUCH shorter), the uninsured going private would come out ahead cost wise for the same private treatment - like in the case of Bird Dog.
 
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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.

We went public 2 years ago and had the reverse.

We had free prenatal classes, free parenting classes, free post natal exercise classes, free swimming classes, free belly band and other pregnancy aides compared to others we knew who went private and got nothing.

I would suggest that these things vary from hospital to hospital region to region but we were overall very happy with the public hospital system :)


My overall thoughts on private health insurance is that it is a never ending changing scam. How many 'health insurance changes' have we all heard from the government over the past 2 or 3 years? I am sure like myself we have heard many of them. Its like all insurance, complex lengthy contracts with the intention to give you as little as possible while promising as much as possible.

If they simply said "ok if you are sick, come to us and we will fix it and pay 90% of the bill but you have to pay a $5k a year premium" then I might even look into it, but as it stands now I doubt most people who have health insurance actually even know what that are and arnt insured for and what they would have to pay.
 
I have just now set up a new uBank savings account called "Health Insurance" and set up a direct debit for the quoted premium from my insurance provider.

I am officially Self-insured. The thought crossed my mind that there wouldn't be much to draw from it if I ran into trouble too soon, but then I realised that there are 12 month waiting periods to make a claim anyway, so I can deal with that.

Still sticking to my "Essentials plus ambulance" for $200 a year though, as I said. I more than pays for itself in contact lenses and glasses.
 
Did that figure account for the Medicare rebate that a self insured person would be entitled to (at least 75% of the MBS fee) and the tax offset of 20% (that is, 20 cents in the dollar) of net medical expenses over $2,000 that a taxpayer is able to claim? There is no upper limit on the amount you can claim.

No, she only had the raw figures when i saw her, said she didn't know the rules for claiming anything back.
 
We had it and cancelled it, 1 month later, Murphies law, and my wife was admitted to hospital for 7 days.

Subsequently she had CT scans, Bone scans, full body x-rays, regular blood tests etc.

Did she have to wait? No, got straight in and saw many specialists within a week or 2.

Had we had kept the cover the excess for her stay would have been $850 vs free in public.

I reckon the public system is a lot better than people think. A lot of it is scaremongering by private health companies so you’ll take up the cover.

My advice is that people take out a critical illness / trauma policy with their financial planner at an early age, with level premiums. If anything serious goes wrong cancer, heart attack, stroke etc, you get paid a big lump sum that goes along way to cover the bills your mortgage etc.

As a 30 year old I pay $110 pm (fixed for until age 65) for $500,000 worth of cover that pays out if anything really serious goes wrong with me.
 
I have just now set up a new uBank savings account called "Health Insurance" and set up a direct debit for the quoted premium from my insurance provider.

I am officially Self-insured. The thought crossed my mind that there wouldn't be much to draw from it if I ran into trouble too soon, but then I realised that there are 12 month waiting periods to make a claim anyway, so I can deal with that.

Still sticking to my "Essentials plus ambulance" for $200 a year though, as I said. I more than pays for itself in contact lenses and glasses.

Good Idea.

I am seriously thinking of the same. What is Essentials plus ambulance" for $200? Is Ambulance the $200 bit?

regards

Peter 14.7
 
I mis-named it.

http://www.hbf.com.au/health-insurance/essentials-covers/essentials-saver.html

The Optical allows me one free pair of glasses and and one free set of contacts per year. I don't get the glasses every year but the free contacts easily pay for the whole policy in value. I also get the peace of mind that if I fall alseep on the train and some clown calls me an ambo, I'm not coughing up for it.

It may be more worthwhile for me being West Australian as there are a lot of providers over here with solid agreements with HBF, but I'm sure most other insurance companies will have a similar product.
 
one thing to also be aware of is that public hospitals rely on those with private insurance to subsidise their funding.
I was in a public hospital for 10 days last year. The hospital asked if I would be prepared to be considered a private patient, because that would mean they could charge the private health insurer. In return, I had to pay the excess ($250 in my case), and I got free TV and a voucher for the cafe each day. I agreed to do that.
Not sure how much they charged. But if everyone goes out of private insurance, the services provided by public hospitals will deteriorate, because they will no longer be able to get that additional funding for private patients.
 
one thing to also be aware of is that public hospitals rely on those with private insurance to subsidise their funding.
I was in a public hospital for 10 days last year. The hospital asked if I would be prepared to be considered a private patient, because that would mean they could charge the private health insurer. In return, I had to pay the excess ($250 in my case), and I got free TV and a voucher for the cafe each day. I agreed to do that.
Not sure how much they charged. But if everyone goes out of private insurance, the services provided by public hospitals will deteriorate, because they will no longer be able to get that additional funding for private patients.

The public hosp I had my veins removed in also had same policy - and they paid the gap for you. Also, got free tv and a glass of wine each night - but you were in a public ward.

I declined as was only in for one night - and wouldn't be drinking or watching anything, but in hindsight - perhaps I should have for the sake of the hospital.
 
one thing to also be aware of is that public hospitals rely on those with private insurance to subsidise their funding.

Not real sure what you mean by this, or why we need to be aware?

Public hospital funding is based on the Casemix model, and is what determines funding.

It shouldn't matter if you went private or not because the funding is calculated on the services provided to the public patient.

In other words, it shouldn't make any difference to the funding the hospital recieves.


http://en.wikipedia.org/wiki/Case_mix
 
Not real sure what you mean by this, or why we need to be aware?

Public hospital funding is based on the Casemix model, and is what determines funding.

It shouldn't matter if you went private or not because the funding is calculated on the services provided to the public patient.

In other words, it shouldn't make any difference to the funding the hospital recieves.


http://en.wikipedia.org/wiki/Case_mix

There must be some benefit to the hospital of having patients being private, otherwise they wouldnt do it!
I imagine they can get more from private health insurance than they can when you are a public patient. This helps to subsidise their services.
 
There must be some benefit to the hospital of having patients being private, otherwise they wouldnt do it!
I imagine they can get more from private health insurance than they can when you are a public patient. This helps to subsidise their services.

I'm not aware of any special arrangements or special benefits, but not saying there aren't any outside of Casemix, which is funding for public patients, calculated independently of private ones.

Perhaps they ask simply because you're insured. ?Instructed to do so. If there is profit in it, it would be a bonus to the public system if anything.
 
I have private health insurance and wouldn't be without it. Having had five 'elective' surgeries in the past few years from sporting injuries, the bill to my insurer has been around $65000 and I've paid $500. I would have been waiting 12 + months to be seen in the public system thus delaying getting back into sport and fitness. Just because it is considered elective doesn't mean you are comfortable enough to wait for it to be done.

Four years ago I became sick and spent a very long time in a private hospital, the bill was around $70k :eek: and my out of pocket was $92. I am sure the public system would have been just as good but it was nice to have my own room the whole time to make it easier for family to visit etc.

I use the extras cover extensively too. So far this year I've used $1800 worth of dental alone. My insurance costs me $250 a month and I get more than this back each month in chiro, massage, dental etc.
 
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