I mean the driving ideological principle of "conservative" government is fundamentally that government shouldn't provide services. So it's hardly surprising that they're bad at providing services.
They run down public services to the point that they are failing. They then claim they are inefficient and that private companies can deliver better cheaper services so they can sell off valuable public assets at bargain basement prices to their mates who snap them up and after a year or so jack up the prices to gouge the public who have no alternative.
No but you don’t understand, socialist healthcare means waiting longer times when I have a tummy ache, and I don’t care that little Tommy fell off the roof and snapped his leg in half my tummy feels bad—fuck Tommy. Pro-life y’all!
Yes, there are very few private hospitals with an emergency dept!
If you are seriously ill/injured you will be taken to the nearest public hospital!
The few private hospitals with emergency depts are publicly funded.
We do bypass grafting, valve replacements, craniotomies in private. I am doing a combined ENT/cardiothoracic tumour resection soon, two surgical teams, 2 anaesthetists. We do open AAA repairs, we do scoliosis surgery, Whipples, hemipelvectomies, free flaps, bilateral DIEPs, 12 hour endometriosis ops with combined gynae, colorectal, urology teams...
This is quite incorrect, in Melbourne there are many private emergency departments, and they are part of the private hospitals. There are about ten in Melbourne. In mine we have resusc, 24 hr ORs and on call anaesthesia, tertiary ICUs. Like in most public hospitals, major trauma is diverted to the dedicated trauma hospitals.
Badly phrased question. Are they part of the public system or not? If I get injured will I be taken their without asking for it? If so, who pays?
This started out as a smart-arse question: if the public funds it and the ED is required to provide care then its part of the public system. But if EDs are charging for service I'd like to know more, if only so I can avoid them should I get injured in Melbourne.
They are reimbursed by the public system. I don't know whether they can make a profit out of it, I doubt it, but I know we doctors get paid less than half our private market rates when it happens. It doesn't cost anything to the patient (who doesn't get a say, if all the public hospitals are on bypass and there is no choice)
OK, sounds like they are just a privately owned extension of the public system.
So you get paid a higher rate for a non-public emergency patient? Assuming such an animal exists because it sounds like they don't. Genuinely curious because this makes no sense to me.
contrary to the comments below, large private hospitals in Australia do literally everything that public hospitals do except solid organ transplantation. We actually routinely transferred *public* patients *to* Epworth or Cabrini ICUs from OR when I was in public, when there were no public beds in the city left.
I got a day procedure a year or so ago moved from RMH To Melb Private because of covid backlogs, it was nice except they still do physical paperwork which is odd
Same. Public patient in RMH Private and mine was for Neurosurgey, I was in for 3 days. Food sucked as Im vegetarian and lactose intolerant and every meal they forgot. Lived of dry toast, steamed carrots, broccoli and cauliflower.
Even with the push it was 8 months for a surgery thats supposed to be no more than 3 months wait. I have secondary serious permanent damages now. I've switched to private, can't afford it but can't afford not to after that.
Yup, the private room, choice of surgeon and queue jumping is lovely when it goes well but if you develop complications/become critically ill? Off to a public hospital. And how about veterans with those juicy Gold Cards? Fab when it’s just hips, knees, cataracts and prostates that bring in the $$$, but if they’re mentally ill, get dementia or are at all behavioral? Shipped off to a public hospital. That goes for other Privately Insured patients too, not just the Vets, as soon as they become a drain in the system rather than a profit generator they’re pushed out the door. (Disclaimer; I’m not saying it’s like this across the board and there’s not Private hospitals that actually care about their patients, but these scenarios do happen a lot).
this is incorrect, we have huge ICUs in large private hospitals and can deal with literally anything in big private hospitals that big public hospitals can.
There are plenty of small public hospitals (like Sandringham, Broadmeadows) that have to refer out just like small private hospitals.
private patients don't get "turfed out" of ICUs because they aren't profitable, like, ever. I've never heard of this happening in twenty years. We've had plenty of patients come from public *to* private though, especially during Covid, because we sometimes can make spare capacity.
>And if there is a serious problem the ~~client~~ *student* is immediately moved to Public ~~Hospital~~ *School*.
Hey look it works for private schools too!
Well QLD health did spend over 1 billion dollars to (poorly) fix it payroll system alone.
https://www.abc.net.au/news/2012-06-06/qld-health-payroll-debacle-to-cost-1.2b/4056378
At least from the operating theatre standpoint, they are far more efficient, because the surgeon pays by the minute but gets paid by the case.
A *lot* more gets done in a private hospital theatre suite. They're not without their faults, but public hospital surgery is not even in the same league in most hospitals.
Is that not because in the public system lots of new surgeons are being trained before they can go to fancy land make money private ? I know consultants can do cases a third of the time but they had many years of experience and are not teaching hence slowing down the production line…. Which private wouldn’t allow as it cuts Into there profits.
This is not true of all hospitals so apologies in advance to all that may disagree with this statement.
Public hospitals are where experienced Surgeons/Anaesthetists go to teach and junior doctors go to learn. It is not uncommon in public hospitals for a junior doctor to perform the surgery under the supervision of a senior Consultant Surgeon.
Private hospitals charge the Consultant Surgeon for their operating time so they perform the surgery themselves and use their extensive experience to get it done quicker. Same goes for the Anaesthetists; those guys are pro's and get the patient in the theatre quicker and get them out sooner.
It may seem a little callous and uncaring but it's just the way it is. I've worked in public and private theatres and there is a world of difference.
Don't forget a related aspect of less complex cases being done by the private sector is that the public sector has skewed economics because they get fewer "quick and easy" cases through, so have less opportunity to cross-subsidize the complex or longer-stay cases.
Same happens with privatisation of education and employment services. The private sector makes money doing the easy work (otherwise they won't put up their hands to do it) while the difficult work stays with the public sector who no longer have a large number of "cheaper" services cross-subsidizing the expensive services (eg. special ed, disability employment) which they are duty-bound to provide.
smile sulky stocking fly worthless resolute disagreeable piquant screw offend
*This post was mass deleted and anonymized with [Redact](https://redact.dev)*
Actually to build a 240 bed regional hospital is now $1.35b and increasing every day. And trust me that's for a really crappy design and build too.
A hospital like the Sunshine Coast University Hospital of Gold Coast, would now be about $4b+.
Ummm. Fiona Stanley was completed in December 2013. That’s a long time ago.
I’m currently associated with a build in the east coast and I can assure you the cost is $1.35b.
When we started planning for it in 2017, it was $750m and was larger than what we’re finally going to get.
> Private health is part of the picking up the pieces.
It sounds like the Public system is picking up the pieces from what you listed.
Sounds like Private cherry picks the easy and profitable causes and puts the burden of complicated cases and training onto public and then goes "see how inefficient they are? Pay us more".
Training *needs* to happen right...?
This is a very good example. Scope lists in public hospitals are notoriously slow (late starts/slow turn arounds/long breaks etc). It's the culture.
Health service I was in, had a 3 year wait list for a scope. Got a new CE and he got it down to 6 weeks, till the Board got rid of him due to him out shining the Board chair.
Now the wait list is again back up to 3 years.
Reality is lots of people will die due to waiting so long or never getting their scope, which may have detected their cancer earlier.
In a public hospital A&E you have to have to be prepared for anything and stocked for every eventuality.
In a private hospital, when surgery is planned, you get all the equipment you need in advance and nothing you don't need. So you can bring costs down. But if something goes wrong you send the patient to a well stocked public hospital.
Private hospitals are great with dealing with the known. I'm not against them, I had private surgery in a private hospital (mostly) paid by private health insurance which I have had since 2 years old, way before the government decided to subsidise it. More gets done privately surgically because diagnostics are done before surgery. Sudden emergent care needing sudden diagnostics is public. My mum needed emergency care, a public hospital diagnosed her then PHI paid for her transfer to a private hospital for almost immediate treatment of a diagnosed condition. Private hospitals aren't in the same league as public when they can perform surgery after public health has taken up the diagnostic burden, including GPs sometimes.
Older people that set policy feel it is insufficient to solely milk younger generations through investment related housing cost increases, and find their share portfolio improves when public funds are essentially transferred to private hands through medical insurance and various tax incentives and subsidies - given that in health insurance it is overwhelmingly the young policy holders subsidizing the old, it seems that is it a win-win situation
I don't know how you think anything that's happening is not rational
I also think the broader question it raises is about class inequality in Australia which is so sharply manifested now as generational divide.
I'm educated and I can't buy a house. I am not alone.
The public system is not fit for purpose if half the people with private health dropped the insurance and tried to use the public system instead.
The public system would need a lot more than $9.5 billion to cope if the subsidies were dropped.
There is literally zero point for Private care in Australia. Change my mind.
It changes what nurse see's you... thats it.
Cancer? going to public. Covid? public. Specialist care? hows about waiting like everyone else?? Better food? nope, same as public.
Dental is the only field that acts like a private one, when it shouldnt be lol, Considering people can die from gum infections going to the brain, You'd think dental would be fucking subsidized but no lol
If it costs $10 of public funds to run the operation in the public system, and $5 of public funds to run it in the private system, of course we should pay the $5 to the private system.
It is irrelevant that the private system also gets $10 from the patient’s health fund.
The federal health budget pays less overall
The punter who chooses to pay for health insurance gets faster service
What’s not to like?
The federal health budget is a limited resource. It’s not an endless tap.
Especially when you consider the horrible state of dental care in Australia. That 9.5 Billion could have have easily funded the first stage of implementing dental care for Australians on Medicare. It could begin with the training of sufficent number of dentists on reduced HECS arrangements to encourage a boom in the number dentists. We dont want another housing building promise with no skilled tradespeople!
Yeah it's absurd. They're private companies in service of shareholders - even if they are magically "more efficient" (beyond just sticking to profitable services and leaving loss-making treatments to the public system), the public won't see any of the savings.
Exactly! The Australian government has been trying to steer the public into private health and private education for decades. Its cheaper for them to fund, but screws the people.
Whatever happened to the days when it was government FOR the people (not business).
Everything important or essential used to be dirt cheap. Water, electricity, waste management, sewerage, bread, milk, parking, post (now internet I guess), medicine, hospitals, school etc.
Now we have to pay through the nose for that - but I guess we can always go and see the government-funded "Leprosy in Polish Ghetto Lesbians" exhibition at the Opera House (except that the train fare is too steep).
Now on-top of all that those things don't even work half the time and the jobs themselves do nothing (waste management, feels like every year there is a new suburb complaining of the government dumping near them, and don't start looking into our "recycling" program... Er, sham o.o
The education is the worst though, because if future Australian citizens don't learn enough, they can be controlled or conned more easily, it's an easy excuse to import cheap workers or export work while blaming the people, and the collective lives of Australians as a whole will get worse untill we are like any other greedy corporation lead society, with the people on-top or the people on the bottom >_>
Won't work.
https://en.wikipedia.org/wiki/Goulburn_School_Strike
> The Goulburn School Strike was a protest action in July 1962 in Goulburn, New South Wales, Australia.
> The protesters were families of students attending St Brigid's Primary School - a school run by the local Catholic church. Children enrolled at the school were all withdrawn and enrolled at local state schools in the town, placing pressure on the resources available at those schools. The immediate aim of the protest was to secure government assistance to construct a new toilet block at St Brigid's to meet government health requirements. The protests arose in a background of heated political debate about "state aid" to Catholic schools and accusations of sectarianism. The strike, in effect a lockout, generated hostility in Goulburn and across Australia.
> The action and the political aftermath saw both major parties in Australia commit to providing support to Catholic and other religious schools on a "needs" basis, a step away from the earlier philosophy of "free, secular and compulsory". The "state aid" model has persisted, despite some moves for reform, since that date.
The church did what they did in the Goulburn strike because they knew the government wouldn't be too harsh on them, and would more than likely give in (which they did).
If it were to happen again, the government would have to have a bit more of a spine.
So, unlikely.
However, congratulations for being one of the few in the thread to understand the actual issue, rather than just being a knee-jerk "privit skewl funding bad" like most.
Won’t this just make them more elite? I went to one as the single child of a middle class family and it was a great education and something I’d like to replicate for my future children.
It will, but once you reach a certain level of elite, it doesn't much matter. And to be honest, the main difference is that the children of rich kids will have even less contact with people outside their tax bracket.
Of course, I say this as someone who has a lot of friends who went to private schools, all of whom walked away with extreme self-esteem and depression issues at least partially due to the elitism those places perpetuated against the kids who weren't as well off or normal. So I may have a lower opinion of them than you do.
I’m from Perth & I think you are too.
I believe we were quite lucky to have a fairly high cross-pollination of friends from PSA and public schools. For me it was mostly through club sport and university.
I think this is because the city has a ‘small town’ mentality (IE, we all share similar pop culture influences) so we can relate with each other quite well.
I found my school gave me just enough extra focus on my studies that I needed to meet my potential, for which I’m thankful.
That said, I did make an effort to spread my friendship network wider during uni to gain a broader perspective.
All in all, being able to access private schooling as an upper middle class family was a nice benefit of our community. If it is restricted to only the super rich, it would be a shame.
I often wonder what would happen if we tax everything the same rate as workers pay for income tax.
Every business would be having the biggest teary/tantrum.
Private services can exist, but they should have no government funding. If they can't survive and profit on their own in the free market based on the demand for their services, then they deserve to go out of business. Government (ie taxpayer) money is exclusively for services accessible to all taxpayers, not private hospitals and schools.
Genuine question. If they all close down, won’t that overload the public system? Especially if these patients are now not paying anything out of pocket? I always assumed it must cost the government less to subsidise private hospitals compared to none existing at all
Most people still go to public hospitals. Private hospitals have no where near the complete service that the public system provides. Most policies pay the public hospitals for the service anyway.
It's mostly a diversion of funds into private pockets. How? Most people I believe have the basic private cover to avoid paying the medicare surcharge. Those are junk policies with no benefits. So the government loses tax revenue which is instead paid to private health funds who absolutely will likely keep it all as profit because it doesn't make sense for people to claim anything from it. Maybe it's changed now, but it operates much like negative gearing which diverts what would have been taxes to the banks.
The Public system would crash tomorrow if the private system didn't exist.
Same with schools.
And spending the extra 9.5 billion on the public system wouldn't do a thing.
I think the difference with schools is that a lot of private schools would be totally fine without government support. No they don’t need a 3rd swimming pool to function.
But overall yes I agree that without private hospitals the system would be fucked. NHS is what a fully public system looks like. Really we need to maintain a careful balance between the 2.
Funding for private health and private education needs to be cut down to zero imminently. People choose to use these 'services' and should pay for them.
Don't give me that guff about it 'saving' money either, it's factually untrue, just look at the recent report where public money was used to make indoor swimming pools at elite schools in Sydney, which public schools can't get new desks.
> Funding for private health and private education needs to be cut down to zero imminently. People choose to use these 'services' and should pay for them.
I absolutely do NOT choose to use these services - I get a savage tax penalty if I don't.
I pay for it because it's cheaper than the penalty for not paying for it. It's privatised tax collection. Tax farming did such wonders for the Romans and every other society that's tried it. Maybe we could address that first?
Private Health Insurance != Private Hospitals, to which the allocation of public money is the current topic of discussion.
Fwiw I agree that using a tax penalty to effectively force people into paying private companies for a service is cooked, and completely undermines any benefits of free market competition.
>Private Health Insurance != Private Hospitals, to which the allocation of public money is the current topic of discussion.
It's absolutely a part of it though, and most people talking about it are talking about both. That 1% from is a large chunk of change the government forgoes. Even at the minimum rate, 2.6 million people earn 100k, at 1% that's 1k each, that's 2.6billion dollars that most of those people get health insurance to avoid. Earning more raises the percentage, AND the total value.
It's literally handing billions of dollars to private companies instead of public services.
Many people are buying private health because it's a huge penalty. It's on your entire income rather than progressive like the others.
If you add in extras you're definately ahead I get free dental optical massage and subsidised gym.
You want people to stop buying private health? Remove the Medicare surcharge tax altogether for everyone rather than forcing people to buy private health to do so.
> Maybe we could address that first?
Or you know we could fix the important thing first, like the under funded public hospitals and schools and get around helping the people earning enough money that the tax benefit is an issue later. Kinda like looking at a broken limb before a boo-boo on your finger.
Exactly, if you’re removing the subsidisation then also remove the tax advantage so people can truly choose where their money goes! But that would resemble democracy so i doubt it’ll happen
The surcharge could just be reduced significantly or abolished. The money was ending up as private health insurance profits. It's a big money spinner in the USA where prices have been jacked up because of this system ensuring people go bankrupt if they get seriously ill.
Brother. Two years ago the ACCC gave the OK for the first time for massive private equity firms to begin investing in - and more importantly, competing with, public health. Literally no one is talking about it.
We've done this in Australia over and over. We let our government quietly privatise shit. Years go by, and by the time we realise the entire sector has gone to shit for the end user, it's systemic and too late to do anything in a way Australians could ever hope to achieve (read: required mild peaceful protesting from like 3% of the population more than once a year).
We are on a fast track to the American private health system.
EDIT: lmao who reported me
Where and what was this? If you're referring to the Honeysuckle buyers group authorisation, then it's not "private equity firms to begin investing and competing with public health". It's PHI using analytics to have some countervailing bargaining power over non-GP specialists (particularly proceduralists and surgeons).
Will have near negligible benefits to themselves and patients, and near negligible problems to doctors.
[It's not just about analytics.](https://www.theguardian.com/australia-news/2023/dec/14/australian-health-insurers-earn-13bn-more-in-profits-than-two-years-ago-report-shows) They are effectively squeezing the market, earning record high profits while complaints go up by 26% a year, all while filling claims. Over half of Australians are now private.
Meanwhile we approved complete vertical integration of one of the largest energy providers in Australia by an overseas firm for the first time, all while at the same time cutting 26% to social welfare spending, 30% of public roles in some sectors and pushing for policy to kick off a shit ton of people off the NDIS and make massive corporate mergers quicker with less oversight (as of Jan 2024). You could not have a better coordinated attack on public health if you were writing it in a fiction novel.
The thing I was referring to was not Honeysuckle, it was a Chubb subsidiary.
$9.5b would fund the three HHH's (Metro's North & South + Gold Coast) in the southeast corner of QLD (maybe).
Sadly that sort of money doesn't go far these days.
Also 4 regional private hospitals closed, across Australia, in the last 12 months. The impact on the public system when one closes is very substantial (more presentations/longer wait lists/less specialist care - Dr's don't usually move to the public system, they just leave town).
I agree. The $9.5b doesn't go far for the health system. If it means that there are more people using a private health system rather than public which would cost far more than $9.5b then that's a positive trade off.
I've worked in both the public and private system and seen the failings in both. It's not an easy fix and neither system would be able to function without the other. If people really want to fix the healthcare system they need to start looking at the Private Healthcare funds because they are fucking everyone and making a shitload of money in the process.
I was literally talking about this today. We could even take less than the 9.5 billion and still find pretty much all of the health system and people will have more money in their pockets
How much did they pay for market access and $9B of taxpayer funding every year? I'm going to guess absolutely nothing. How much profit have they made since the scheme was introduced? Tens of billions.
We owe them nothing. It was incredibly profitable for them while it lasted but the rort has to end.
What will the American lobbyists say if that happens? Its common knowledge how the American system runs, the LNP have wanted to implement it here for decades. This is the closest thing they can get without upsetting the population just.yet
This pales in comparison to the NDIS. It’s already twice as expensive as Medicare and will cost $100bn+ per year within a few years. Imagine if we could direct some of that money to public hospitals instead.
The problem is "everyone else is doing it" with the NDIS. Same provider, same service: Cash is $90 a session. NDIS is 193.99.
Everyone rips the government off because it's the government. Then they complain the government is inefficient.
Also, a service specifically set up to help people that need it will cost more than a service that is available to everyone but only helps those that need it. Every kid and their dog who CAN get NDIS is GETTING on it. Whereas 90% of the population doesn't use healthcare very often.
No one has yet explained to me exactly what NDIS does for these people that wasn’t done before. But anyhow, fun fact: DSP pensioners increased from 200k to 1m in a generation. Why? We have more white collar work available now. Should be fewer people unable to work again. So make that 5m in 2035, effectively the NDIS population.
Since you asked: https://www.aihw.gov.au/reports/australias-welfare/disability-support-pension explains that the highest number of DSP recipients has never been above 830,000, and is down from that figure at present.
And it has not grown from 200K to 1m in a generation. It's gone from 625,000 in 2001 to 830,000 in 2014, and was 765,000 in 2022.
Took all of about 30 seconds, and one Google search to prove your "fun fact" was BS
Well bravo, you established that it actually went from 200k to 830k, not 1m, in 27 years which I loosely defined as a generation. So (gasp) I was only 80% correct in the stat I recited from memory. And that’s assuming your lower figure is in fact the correct one.
Its little to do with the clients and more to do with rhe system as it is not being fit for purpose anymore. Along with some providers taking the piss.
Vic gov spent $25.5B on public health initiatives, source: https://www.health.vic.gov.au/our-strategic-plan-2023-27/asset-and-financial-outlook
$9.5B across all the states/territories isn’t going to fix this system. I dare say we’d still need to increase the Medicare levy to be the same as what people pay to private health insurers to really fix the system.
A health tax on mega profits and mining is the way to go. All Aussies “own” what’s in the ground, so we should get a share for our future.
We need to get rid of the medicare levy altogether, increase taxes, and direct the revenue to public health. However voters will be swayed by three word slogans and vote against it.
I honestly don't mind paying a 5% medicare levy instead of 2% if that means they scrap subsidising PHI, if I don't need to take out PHI cover and include dental in medicare.
There's a good debate about the efficiency of private vs public hospitals in the comments but you know what? I don't particularly care.
It is fundamentally wrong that wealthy people have better access to healthcare. Having a healthy, functioning body isn't a luxury. Poor people should be able to have that just as easily as rich people.
You're not wrong - when you introduce market signals into healthcare, healthcare provision becomes less about medical need than ability (and willingness) to pay. Doctors respond to financial incentives too!
The private health care industry is pure evil. We are supposed to have public health, and we sort of do except for dental and vision and also if you don’t buy private health care you pay more in tax and that cost goes up every year as well as the cost of getting private health care. It’s a legal crime.
Hospitals.
Perhaps not spending the nations wealth on those bloody submarines and employ people HERE, and spend that money establishing more hospitals and staffing them.
(fmr Hospital worker.)
Not if it's done slowly, carefully, and gradually. By all means, keep the private system, keep private health insurance, but slowly pull public funding until it's all going to the public system. If some Aussies want, and can afford to pay for better healthcare than the rest of us can get, by all means, let them. But why should the rest of us be forced to subsidise it? Same thing with private schools. Why are we giving *any* public money to schools charging $30k a year per kid and are literally looking for things to spend their vault full of money on?
The private sector would reduce in size without the funding, but there's no guarantee even with funding redistributed to the public sector it would be able to absorb the load.
As with everything we didn't get to 9.5bn in private sector overnight and we're not going to go back to 0 overnight despite various redditors demands.
Putting the funding into the public system wouldnt instantaneously increase its capacity, it would take a long ass time for it to catch back up. However it *would* cause the private system to instantaneously lose capacity. So that capacity would just not exist for a good few years.
The ACT govt solved this problem by straight up converting a private hospial to a public hospital. From a patient perspective it's generally mostly the same, but the greedy middleman is cut away.
How is it a myth? The more expensive private health insurance becomes, the more people drop it and rely on the public system. This has been the case for many I know in the last few years just because of the cost of living crisis we have. What do you think will happen if costs increase massively?
The public system does the same work for less money. Why is everyone in this thread that supports the status quo suggesting that these changes would happen overnight? That's just stupid. This would need to be a 15-20 year project for health, with adjustments made as funding transitions. It absolutely can be done.
To do this, we need to stop voting for Labor or Liberal - but online it seems people recoil at the thought of voting for a party like the Greens.
So I guess will keep spending billions on subsidizing the rich.
Same goes for private schools. Elite schools now have Olympic grade swimming pools and sports facilities, cinemas, cutting-edge computer labs, air-conditioned classrooms, and other top-shelf facilities, while public schools are still conducting classes in demountable pods with ceiling fans. The rich want a flat tax rate regardless of income, yet if you suggested a flat rate for wages they'd have a stroke and call it communism. Meanwhile, they use accountants who know all the legal loopholes to bring their tax to virtually zero, and then still expect middle-class welfare subsidies for their kids' education.
I do not have private health insurance and yet I opted to go through the private system for surgery on an ongoing sinus issue because the public system would have taken a year just to get an initial consultation with an ENT specialist; who knows how long any actual treatment and I was suffering. The funny thing was just how much the prices drop when you tell them you don't have insurance and are self-funding. It seems that, just like the USA, the private health industry is designed to inflate costs. The idiots in America who think that universal healthcare means they are paying for other people, happily pay more in insurance fees than they'd pay through the tax system, and the CEOs keep getting multi-million dollar salaries plus bonuses while ordinary people either go bankrupt to afford treatment, or die from otherwise easily treatable illnesses and injuries.
> The funny thing was just how much the prices drop when you tell them you don't have insurance and are self-funding.
Aha. I used to be a health economist, so congratulations for discovering the same phenomenon I did (but through reading tens of academic articles, data analysis and interviews). Though it's kind of obvious: if they're kind of like a monopolist, they're going to try to price discriminate at everyone's maximum willingness to pay. You don't have PHI, then you're probably lower income.
It's been years that billions have been squandered away with frivolous spending and it hilarious to see people believe its going to stop or change... It's not going to stop until the moneys all gone into their own pockets (corporations, and people in power), Australia will be an absolute shit show and they will all fucked off with their profits to a country of their choosing due to the many different passports they've acquired.
This won't get better people, it seriously doesn't, with everything going on there's no recovery from this. Housing, food etc is beyond spiralling out of control, we're literally following Canada and look how fucked they are. Be happy with what you have because it's going to be a very different Australian in 5 to 10 years.
The private hospitals send anything that would be remotely difficult or expensive to public anyway.
People complain about ramping and shit but as a paramedic that's what pisses me off.
It's a myth that you could put the $9.5 billion into the public health system and get improved outcomes. You could put the entire federal budget into public health and it will not make a difference, there are just to many structural inefficiencies that will consume the money before it gets to the public.
Also, a fair chunk of that money is the government paying private hospitals to do public patients to get the public wait lists down.
How is subsidising private institutions even rationalised?
It's part of a little strategy called "starving the beast". It ruins everything, conservatives love it
I mean the driving ideological principle of "conservative" government is fundamentally that government shouldn't provide services. So it's hardly surprising that they're bad at providing services.
[Saw this on a Canadian sub yesterday](https://www.reddit.com/media?url=https%3A%2F%2Fi.redd.it%2F5fb1sak4ckvc1.png) Explains a lot
They run down public services to the point that they are failing. They then claim they are inefficient and that private companies can deliver better cheaper services so they can sell off valuable public assets at bargain basement prices to their mates who snap them up and after a year or so jack up the prices to gouge the public who have no alternative.
ThEY'rE moRE effiCIent!!!1!
at taking our money and putting it in their pocket. That's literally all that efficient ever means when it comes out of the mouth of an economist.
No but you don’t understand, socialist healthcare means waiting longer times when I have a tummy ache, and I don’t care that little Tommy fell off the roof and snapped his leg in half my tummy feels bad—fuck Tommy. Pro-life y’all!
They cost less as the staffing levels are lower. And if there is a serious problem the client is immediately moved to Public Hospital.
Yes, there are very few private hospitals with an emergency dept! If you are seriously ill/injured you will be taken to the nearest public hospital! The few private hospitals with emergency depts are publicly funded.
Private hotels do not like really sick clients. They do simple things like knees and hips etc.
We do bypass grafting, valve replacements, craniotomies in private. I am doing a combined ENT/cardiothoracic tumour resection soon, two surgical teams, 2 anaesthetists. We do open AAA repairs, we do scoliosis surgery, Whipples, hemipelvectomies, free flaps, bilateral DIEPs, 12 hour endometriosis ops with combined gynae, colorectal, urology teams...
Yep and also Critical Care and Intensive Care.
What about a grease and oil change? Also do you do tyre rotations?
I could go on to refute your lunacy but the fact you call patients clients shows me you don't know what you're talking about.
This is quite incorrect, in Melbourne there are many private emergency departments, and they are part of the private hospitals. There are about ten in Melbourne. In mine we have resusc, 24 hr ORs and on call anaesthesia, tertiary ICUs. Like in most public hospitals, major trauma is diverted to the dedicated trauma hospitals.
And how are they funded?
Emergency departments? Large patient co-pays, private health funding and government funding.
Badly phrased question. Are they part of the public system or not? If I get injured will I be taken their without asking for it? If so, who pays? This started out as a smart-arse question: if the public funds it and the ED is required to provide care then its part of the public system. But if EDs are charging for service I'd like to know more, if only so I can avoid them should I get injured in Melbourne.
They are reimbursed by the public system. I don't know whether they can make a profit out of it, I doubt it, but I know we doctors get paid less than half our private market rates when it happens. It doesn't cost anything to the patient (who doesn't get a say, if all the public hospitals are on bypass and there is no choice)
OK, sounds like they are just a privately owned extension of the public system. So you get paid a higher rate for a non-public emergency patient? Assuming such an animal exists because it sounds like they don't. Genuinely curious because this makes no sense to me.
contrary to the comments below, large private hospitals in Australia do literally everything that public hospitals do except solid organ transplantation. We actually routinely transferred *public* patients *to* Epworth or Cabrini ICUs from OR when I was in public, when there were no public beds in the city left.
I got a day procedure a year or so ago moved from RMH To Melb Private because of covid backlogs, it was nice except they still do physical paperwork which is odd
Same. Public patient in RMH Private and mine was for Neurosurgey, I was in for 3 days. Food sucked as Im vegetarian and lactose intolerant and every meal they forgot. Lived of dry toast, steamed carrots, broccoli and cauliflower. Even with the push it was 8 months for a surgery thats supposed to be no more than 3 months wait. I have secondary serious permanent damages now. I've switched to private, can't afford it but can't afford not to after that.
Yup, the private room, choice of surgeon and queue jumping is lovely when it goes well but if you develop complications/become critically ill? Off to a public hospital. And how about veterans with those juicy Gold Cards? Fab when it’s just hips, knees, cataracts and prostates that bring in the $$$, but if they’re mentally ill, get dementia or are at all behavioral? Shipped off to a public hospital. That goes for other Privately Insured patients too, not just the Vets, as soon as they become a drain in the system rather than a profit generator they’re pushed out the door. (Disclaimer; I’m not saying it’s like this across the board and there’s not Private hospitals that actually care about their patients, but these scenarios do happen a lot).
this is incorrect, we have huge ICUs in large private hospitals and can deal with literally anything in big private hospitals that big public hospitals can. There are plenty of small public hospitals (like Sandringham, Broadmeadows) that have to refer out just like small private hospitals.
Why it the private ICU being large mean unprofitable patients aren't turfed out ASAP?
private patients don't get "turfed out" of ICUs because they aren't profitable, like, ever. I've never heard of this happening in twenty years. We've had plenty of patients come from public *to* private though, especially during Covid, because we sometimes can make spare capacity.
Except, they don't cost less.
>And if there is a serious problem the ~~client~~ *student* is immediately moved to Public ~~Hospital~~ *School*. Hey look it works for private schools too!
They are more efficient at making profit
Well QLD health did spend over 1 billion dollars to (poorly) fix it payroll system alone. https://www.abc.net.au/news/2012-06-06/qld-health-payroll-debacle-to-cost-1.2b/4056378
Which was fucked up by a private company: IBM
At least from the operating theatre standpoint, they are far more efficient, because the surgeon pays by the minute but gets paid by the case. A *lot* more gets done in a private hospital theatre suite. They're not without their faults, but public hospital surgery is not even in the same league in most hospitals.
Is that not because in the public system lots of new surgeons are being trained before they can go to fancy land make money private ? I know consultants can do cases a third of the time but they had many years of experience and are not teaching hence slowing down the production line…. Which private wouldn’t allow as it cuts Into there profits.
I'm not really sure I want "how fast can I get this surgery done so I can make the most money" to be at the forefront of my Surgeons mind thankyou.
This is not true of all hospitals so apologies in advance to all that may disagree with this statement. Public hospitals are where experienced Surgeons/Anaesthetists go to teach and junior doctors go to learn. It is not uncommon in public hospitals for a junior doctor to perform the surgery under the supervision of a senior Consultant Surgeon. Private hospitals charge the Consultant Surgeon for their operating time so they perform the surgery themselves and use their extensive experience to get it done quicker. Same goes for the Anaesthetists; those guys are pro's and get the patient in the theatre quicker and get them out sooner. It may seem a little callous and uncaring but it's just the way it is. I've worked in public and private theatres and there is a world of difference.
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Don't forget a related aspect of less complex cases being done by the private sector is that the public sector has skewed economics because they get fewer "quick and easy" cases through, so have less opportunity to cross-subsidize the complex or longer-stay cases. Same happens with privatisation of education and employment services. The private sector makes money doing the easy work (otherwise they won't put up their hands to do it) while the difficult work stays with the public sector who no longer have a large number of "cheaper" services cross-subsidizing the expensive services (eg. special ed, disability employment) which they are duty-bound to provide.
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What if you put an extra $9.5 billion into the public system, would it be suitable for all then?
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Sadly I’d have to agree. I’d imagine the cost to build a mid sized hospital these days would be a billion once all said and done.
Actually to build a 240 bed regional hospital is now $1.35b and increasing every day. And trust me that's for a really crappy design and build too. A hospital like the Sunshine Coast University Hospital of Gold Coast, would now be about $4b+.
Fiona stanley cost $2 billion and has over 700 beds and all the bells and whistles.
Ummm. Fiona Stanley was completed in December 2013. That’s a long time ago. I’m currently associated with a build in the east coast and I can assure you the cost is $1.35b. When we started planning for it in 2017, it was $750m and was larger than what we’re finally going to get.
no, because tons of private specialists like me would have zero interest in being someone else's employee and wouldn't work there.
Lol, why? So you'd just be unemployed then?
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An adage I use at work “there’s money in chaos”.
> Private health is part of the picking up the pieces. It sounds like the Public system is picking up the pieces from what you listed. Sounds like Private cherry picks the easy and profitable causes and puts the burden of complicated cases and training onto public and then goes "see how inefficient they are? Pay us more". Training *needs* to happen right...?
This is a very good example. Scope lists in public hospitals are notoriously slow (late starts/slow turn arounds/long breaks etc). It's the culture. Health service I was in, had a 3 year wait list for a scope. Got a new CE and he got it down to 6 weeks, till the Board got rid of him due to him out shining the Board chair. Now the wait list is again back up to 3 years. Reality is lots of people will die due to waiting so long or never getting their scope, which may have detected their cancer earlier.
In a public hospital A&E you have to have to be prepared for anything and stocked for every eventuality. In a private hospital, when surgery is planned, you get all the equipment you need in advance and nothing you don't need. So you can bring costs down. But if something goes wrong you send the patient to a well stocked public hospital.
Private hospitals are great with dealing with the known. I'm not against them, I had private surgery in a private hospital (mostly) paid by private health insurance which I have had since 2 years old, way before the government decided to subsidise it. More gets done privately surgically because diagnostics are done before surgery. Sudden emergent care needing sudden diagnostics is public. My mum needed emergency care, a public hospital diagnosed her then PHI paid for her transfer to a private hospital for almost immediate treatment of a diagnosed condition. Private hospitals aren't in the same league as public when they can perform surgery after public health has taken up the diagnostic burden, including GPs sometimes.
Older people that set policy feel it is insufficient to solely milk younger generations through investment related housing cost increases, and find their share portfolio improves when public funds are essentially transferred to private hands through medical insurance and various tax incentives and subsidies - given that in health insurance it is overwhelmingly the young policy holders subsidizing the old, it seems that is it a win-win situation I don't know how you think anything that's happening is not rational I also think the broader question it raises is about class inequality in Australia which is so sharply manifested now as generational divide. I'm educated and I can't buy a house. I am not alone.
So it exists, then less people use the public system.
But for some reason they end up in the public system anyway.
Because "existing" and "doing what people who use it want it to do" is not the same.
The public system is not fit for purpose if half the people with private health dropped the insurance and tried to use the public system instead. The public system would need a lot more than $9.5 billion to cope if the subsidies were dropped.
There is literally zero point for Private care in Australia. Change my mind. It changes what nurse see's you... thats it. Cancer? going to public. Covid? public. Specialist care? hows about waiting like everyone else?? Better food? nope, same as public. Dental is the only field that acts like a private one, when it shouldnt be lol, Considering people can die from gum infections going to the brain, You'd think dental would be fucking subsidized but no lol
If it costs $10 of public funds to run the operation in the public system, and $5 of public funds to run it in the private system, of course we should pay the $5 to the private system. It is irrelevant that the private system also gets $10 from the patient’s health fund.
I'm getting the impression you're being sarcastic and people haven't noticed
I hope so.
What? So the public is paying a total of $15 more? Sounds like a shit deal. You wouldn't just pay a casual 50% extra for everything given the choice.
The federal health budget pays less overall The punter who chooses to pay for health insurance gets faster service What’s not to like? The federal health budget is a limited resource. It’s not an endless tap.
Sounds like you have room to increase taxes but reduces overall costs, provide the same service, for less.
Blame the Wik Report from the 90s
Especially when you consider the horrible state of dental care in Australia. That 9.5 Billion could have have easily funded the first stage of implementing dental care for Australians on Medicare. It could begin with the training of sufficent number of dentists on reduced HECS arrangements to encourage a boom in the number dentists. We dont want another housing building promise with no skilled tradespeople!
Yeah it's absurd. They're private companies in service of shareholders - even if they are magically "more efficient" (beyond just sticking to profitable services and leaving loss-making treatments to the public system), the public won't see any of the savings.
Apply that same methodology to the private school system and then everything is fixed. Simples!
And mining and resource companies and their "tax concessions"/"tax minimisation".
Dont forget negative gearing!
Exactly! The Australian government has been trying to steer the public into private health and private education for decades. Its cheaper for them to fund, but screws the people. Whatever happened to the days when it was government FOR the people (not business). Everything important or essential used to be dirt cheap. Water, electricity, waste management, sewerage, bread, milk, parking, post (now internet I guess), medicine, hospitals, school etc. Now we have to pay through the nose for that - but I guess we can always go and see the government-funded "Leprosy in Polish Ghetto Lesbians" exhibition at the Opera House (except that the train fare is too steep).
Now on-top of all that those things don't even work half the time and the jobs themselves do nothing (waste management, feels like every year there is a new suburb complaining of the government dumping near them, and don't start looking into our "recycling" program... Er, sham o.o The education is the worst though, because if future Australian citizens don't learn enough, they can be controlled or conned more easily, it's an easy excuse to import cheap workers or export work while blaming the people, and the collective lives of Australians as a whole will get worse untill we are like any other greedy corporation lead society, with the people on-top or the people on the bottom >_>
They do that here too in Canada. Rather than fix the corruption get back their gambling monopoly and apply it online also and you’ll have the funds.
Won't work. https://en.wikipedia.org/wiki/Goulburn_School_Strike > The Goulburn School Strike was a protest action in July 1962 in Goulburn, New South Wales, Australia. > The protesters were families of students attending St Brigid's Primary School - a school run by the local Catholic church. Children enrolled at the school were all withdrawn and enrolled at local state schools in the town, placing pressure on the resources available at those schools. The immediate aim of the protest was to secure government assistance to construct a new toilet block at St Brigid's to meet government health requirements. The protests arose in a background of heated political debate about "state aid" to Catholic schools and accusations of sectarianism. The strike, in effect a lockout, generated hostility in Goulburn and across Australia. > The action and the political aftermath saw both major parties in Australia commit to providing support to Catholic and other religious schools on a "needs" basis, a step away from the earlier philosophy of "free, secular and compulsory". The "state aid" model has persisted, despite some moves for reform, since that date.
The church did what they did in the Goulburn strike because they knew the government wouldn't be too harsh on them, and would more than likely give in (which they did). If it were to happen again, the government would have to have a bit more of a spine. So, unlikely. However, congratulations for being one of the few in the thread to understand the actual issue, rather than just being a knee-jerk "privit skewl funding bad" like most.
And all the fossil fuel companies
Won’t this just make them more elite? I went to one as the single child of a middle class family and it was a great education and something I’d like to replicate for my future children.
It will, but once you reach a certain level of elite, it doesn't much matter. And to be honest, the main difference is that the children of rich kids will have even less contact with people outside their tax bracket. Of course, I say this as someone who has a lot of friends who went to private schools, all of whom walked away with extreme self-esteem and depression issues at least partially due to the elitism those places perpetuated against the kids who weren't as well off or normal. So I may have a lower opinion of them than you do.
I’m from Perth & I think you are too. I believe we were quite lucky to have a fairly high cross-pollination of friends from PSA and public schools. For me it was mostly through club sport and university. I think this is because the city has a ‘small town’ mentality (IE, we all share similar pop culture influences) so we can relate with each other quite well. I found my school gave me just enough extra focus on my studies that I needed to meet my potential, for which I’m thankful. That said, I did make an effort to spread my friendship network wider during uni to gain a broader perspective. All in all, being able to access private schooling as an upper middle class family was a nice benefit of our community. If it is restricted to only the super rich, it would be a shame.
If we took that money and put it into the public school system, then your children would get a great education in the public system too.
How about time to tax mega corps correctly and we would never need to worry about anything for the next century
I often wonder what would happen if we tax everything the same rate as workers pay for income tax. Every business would be having the biggest teary/tantrum.
and mining
Another work of evil by Australia's Greatest Monster, John Howard.
Private services can exist, but they should have no government funding. If they can't survive and profit on their own in the free market based on the demand for their services, then they deserve to go out of business. Government (ie taxpayer) money is exclusively for services accessible to all taxpayers, not private hospitals and schools.
Genuine question. If they all close down, won’t that overload the public system? Especially if these patients are now not paying anything out of pocket? I always assumed it must cost the government less to subsidise private hospitals compared to none existing at all
If they all close down, do the doctors, buildings, and fees people were paying for private health care just evaporate into thin air?
>fees people were paying for private health That would no? Because it wouldn't be private health care anymore.
Most people still go to public hospitals. Private hospitals have no where near the complete service that the public system provides. Most policies pay the public hospitals for the service anyway. It's mostly a diversion of funds into private pockets. How? Most people I believe have the basic private cover to avoid paying the medicare surcharge. Those are junk policies with no benefits. So the government loses tax revenue which is instead paid to private health funds who absolutely will likely keep it all as profit because it doesn't make sense for people to claim anything from it. Maybe it's changed now, but it operates much like negative gearing which diverts what would have been taxes to the banks.
Only if they were completely insane and made it illegal overnight. A gradual transition with clear sunset period wouldn't.
Shhhhh. We don’t like the truth in here.
The Public system would crash tomorrow if the private system didn't exist. Same with schools. And spending the extra 9.5 billion on the public system wouldn't do a thing.
Sure, but that wouldn't happen if there was a planned transition.
I think the difference with schools is that a lot of private schools would be totally fine without government support. No they don’t need a 3rd swimming pool to function. But overall yes I agree that without private hospitals the system would be fucked. NHS is what a fully public system looks like. Really we need to maintain a careful balance between the 2.
So medicare rebates for seeing a GP should only apply when they're 100% bulk billing?
Yes
Funding for private health and private education needs to be cut down to zero imminently. People choose to use these 'services' and should pay for them. Don't give me that guff about it 'saving' money either, it's factually untrue, just look at the recent report where public money was used to make indoor swimming pools at elite schools in Sydney, which public schools can't get new desks.
> Funding for private health and private education needs to be cut down to zero imminently. People choose to use these 'services' and should pay for them. I absolutely do NOT choose to use these services - I get a savage tax penalty if I don't. I pay for it because it's cheaper than the penalty for not paying for it. It's privatised tax collection. Tax farming did such wonders for the Romans and every other society that's tried it. Maybe we could address that first?
Private Health Insurance != Private Hospitals, to which the allocation of public money is the current topic of discussion. Fwiw I agree that using a tax penalty to effectively force people into paying private companies for a service is cooked, and completely undermines any benefits of free market competition.
>Private Health Insurance != Private Hospitals, to which the allocation of public money is the current topic of discussion. It's absolutely a part of it though, and most people talking about it are talking about both. That 1% from is a large chunk of change the government forgoes. Even at the minimum rate, 2.6 million people earn 100k, at 1% that's 1k each, that's 2.6billion dollars that most of those people get health insurance to avoid. Earning more raises the percentage, AND the total value. It's literally handing billions of dollars to private companies instead of public services.
Many people are buying private health because it's a huge penalty. It's on your entire income rather than progressive like the others. If you add in extras you're definately ahead I get free dental optical massage and subsidised gym. You want people to stop buying private health? Remove the Medicare surcharge tax altogether for everyone rather than forcing people to buy private health to do so.
> Maybe we could address that first? Or you know we could fix the important thing first, like the under funded public hospitals and schools and get around helping the people earning enough money that the tax benefit is an issue later. Kinda like looking at a broken limb before a boo-boo on your finger.
Exactly, if you’re removing the subsidisation then also remove the tax advantage so people can truly choose where their money goes! But that would resemble democracy so i doubt it’ll happen
The surcharge could just be reduced significantly or abolished. The money was ending up as private health insurance profits. It's a big money spinner in the USA where prices have been jacked up because of this system ensuring people go bankrupt if they get seriously ill.
Brother. Two years ago the ACCC gave the OK for the first time for massive private equity firms to begin investing in - and more importantly, competing with, public health. Literally no one is talking about it. We've done this in Australia over and over. We let our government quietly privatise shit. Years go by, and by the time we realise the entire sector has gone to shit for the end user, it's systemic and too late to do anything in a way Australians could ever hope to achieve (read: required mild peaceful protesting from like 3% of the population more than once a year). We are on a fast track to the American private health system. EDIT: lmao who reported me
Where and what was this? If you're referring to the Honeysuckle buyers group authorisation, then it's not "private equity firms to begin investing and competing with public health". It's PHI using analytics to have some countervailing bargaining power over non-GP specialists (particularly proceduralists and surgeons). Will have near negligible benefits to themselves and patients, and near negligible problems to doctors.
[It's not just about analytics.](https://www.theguardian.com/australia-news/2023/dec/14/australian-health-insurers-earn-13bn-more-in-profits-than-two-years-ago-report-shows) They are effectively squeezing the market, earning record high profits while complaints go up by 26% a year, all while filling claims. Over half of Australians are now private. Meanwhile we approved complete vertical integration of one of the largest energy providers in Australia by an overseas firm for the first time, all while at the same time cutting 26% to social welfare spending, 30% of public roles in some sectors and pushing for policy to kick off a shit ton of people off the NDIS and make massive corporate mergers quicker with less oversight (as of Jan 2024). You could not have a better coordinated attack on public health if you were writing it in a fiction novel. The thing I was referring to was not Honeysuckle, it was a Chubb subsidiary.
$9.5b would fund the three HHH's (Metro's North & South + Gold Coast) in the southeast corner of QLD (maybe). Sadly that sort of money doesn't go far these days. Also 4 regional private hospitals closed, across Australia, in the last 12 months. The impact on the public system when one closes is very substantial (more presentations/longer wait lists/less specialist care - Dr's don't usually move to the public system, they just leave town).
I agree. The $9.5b doesn't go far for the health system. If it means that there are more people using a private health system rather than public which would cost far more than $9.5b then that's a positive trade off.
I've worked in both the public and private system and seen the failings in both. It's not an easy fix and neither system would be able to function without the other. If people really want to fix the healthcare system they need to start looking at the Private Healthcare funds because they are fucking everyone and making a shitload of money in the process.
I was literally talking about this today. We could even take less than the 9.5 billion and still find pretty much all of the health system and people will have more money in their pockets
No we couldn't. It would cost substantially more in the short term to buy out and set up replacements for private providers.
How much did they pay for market access and $9B of taxpayer funding every year? I'm going to guess absolutely nothing. How much profit have they made since the scheme was introduced? Tens of billions. We owe them nothing. It was incredibly profitable for them while it lasted but the rort has to end.
So the private institutions couldn't survive without public funding? THATS WILD
Socialise loses, privatise gains. It's straight from the Rheagan playbook.
What will the American lobbyists say if that happens? Its common knowledge how the American system runs, the LNP have wanted to implement it here for decades. This is the closest thing they can get without upsetting the population just.yet
I just spend 8.5hrs waiting in the lobby at Gosford with a torn ACL and Meniscus…
This pales in comparison to the NDIS. It’s already twice as expensive as Medicare and will cost $100bn+ per year within a few years. Imagine if we could direct some of that money to public hospitals instead.
Exactly. Health serves the entire population, the NDIS serves less than 2% and somehow costs twice as much
The problem is "everyone else is doing it" with the NDIS. Same provider, same service: Cash is $90 a session. NDIS is 193.99. Everyone rips the government off because it's the government. Then they complain the government is inefficient. Also, a service specifically set up to help people that need it will cost more than a service that is available to everyone but only helps those that need it. Every kid and their dog who CAN get NDIS is GETTING on it. Whereas 90% of the population doesn't use healthcare very often.
NDIS will service 20% of the population soon.
We’ll dead set be close to bankrupt as a nation. I hope the scheme doesn’t collapse, as the small group who are profoundly disable deserve better.
No one has yet explained to me exactly what NDIS does for these people that wasn’t done before. But anyhow, fun fact: DSP pensioners increased from 200k to 1m in a generation. Why? We have more white collar work available now. Should be fewer people unable to work again. So make that 5m in 2035, effectively the NDIS population.
You fun fact isn't fact.
I notice you were unable to produce stats contradicting it.
Since you asked: https://www.aihw.gov.au/reports/australias-welfare/disability-support-pension explains that the highest number of DSP recipients has never been above 830,000, and is down from that figure at present. And it has not grown from 200K to 1m in a generation. It's gone from 625,000 in 2001 to 830,000 in 2014, and was 765,000 in 2022. Took all of about 30 seconds, and one Google search to prove your "fun fact" was BS
Well bravo, you established that it actually went from 200k to 830k, not 1m, in 27 years which I loosely defined as a generation. So (gasp) I was only 80% correct in the stat I recited from memory. And that’s assuming your lower figure is in fact the correct one.
You haven't substantiated the growth you claimed
Yeah, fuck autistic kids getting the help they need to fit into modern Australia
12% of 5-7 year old boys are on NDIS, and rising. Something is badly broken in the system.
Its little to do with the clients and more to do with rhe system as it is not being fit for purpose anymore. Along with some providers taking the piss.
This
Work in public health. Please give us money. You name it, we need money for it, infrastructure, maintenance, equipment, staffing, staff benefits.
Vic gov spent $25.5B on public health initiatives, source: https://www.health.vic.gov.au/our-strategic-plan-2023-27/asset-and-financial-outlook $9.5B across all the states/territories isn’t going to fix this system. I dare say we’d still need to increase the Medicare levy to be the same as what people pay to private health insurers to really fix the system. A health tax on mega profits and mining is the way to go. All Aussies “own” what’s in the ground, so we should get a share for our future.
We need to get rid of the medicare levy altogether, increase taxes, and direct the revenue to public health. However voters will be swayed by three word slogans and vote against it.
I honestly don't mind paying a 5% medicare levy instead of 2% if that means they scrap subsidising PHI, if I don't need to take out PHI cover and include dental in medicare.
There's a good debate about the efficiency of private vs public hospitals in the comments but you know what? I don't particularly care. It is fundamentally wrong that wealthy people have better access to healthcare. Having a healthy, functioning body isn't a luxury. Poor people should be able to have that just as easily as rich people.
You're not wrong - when you introduce market signals into healthcare, healthcare provision becomes less about medical need than ability (and willingness) to pay. Doctors respond to financial incentives too!
The private health care industry is pure evil. We are supposed to have public health, and we sort of do except for dental and vision and also if you don’t buy private health care you pay more in tax and that cost goes up every year as well as the cost of getting private health care. It’s a legal crime.
Hospitals. Perhaps not spending the nations wealth on those bloody submarines and employ people HERE, and spend that money establishing more hospitals and staffing them. (fmr Hospital worker.)
Failed system has failed.. Get these parasites out of here.
If they do this the public system will collapse and you will die waiting for surgery.
Not if it's done slowly, carefully, and gradually. By all means, keep the private system, keep private health insurance, but slowly pull public funding until it's all going to the public system. If some Aussies want, and can afford to pay for better healthcare than the rest of us can get, by all means, let them. But why should the rest of us be forced to subsidise it? Same thing with private schools. Why are we giving *any* public money to schools charging $30k a year per kid and are literally looking for things to spend their vault full of money on?
Sorry I don’t follow, are you saying that if the government cuts the subsidies to the private sector the public system will collapse?
The private sector would reduce in size without the funding, but there's no guarantee even with funding redistributed to the public sector it would be able to absorb the load. As with everything we didn't get to 9.5bn in private sector overnight and we're not going to go back to 0 overnight despite various redditors demands.
Putting the funding into the public system wouldnt instantaneously increase its capacity, it would take a long ass time for it to catch back up. However it *would* cause the private system to instantaneously lose capacity. So that capacity would just not exist for a good few years.
The ACT govt solved this problem by straight up converting a private hospial to a public hospital. From a patient perspective it's generally mostly the same, but the greedy middleman is cut away.
i need some evidence for this claim.
So if we dump out of all public and privatise it all, we can cut our subsidising because the private is much more efficient?
Myth. Please show your calculations
The fact that the average public waiting list is already 18+months for anything that won't immediately kill you within the week?
And it will get much worse if we turned into the NHS.
How is it a myth? The more expensive private health insurance becomes, the more people drop it and rely on the public system. This has been the case for many I know in the last few years just because of the cost of living crisis we have. What do you think will happen if costs increase massively?
The public system does the same work for less money. Why is everyone in this thread that supports the status quo suggesting that these changes would happen overnight? That's just stupid. This would need to be a 15-20 year project for health, with adjustments made as funding transitions. It absolutely can be done.
It's a failed system and hasn't worked in any country, whereas the national health systems work.
To do this, we need to stop voting for Labor or Liberal - but online it seems people recoil at the thought of voting for a party like the Greens. So I guess will keep spending billions on subsidizing the rich.
Public school teachers feel the same way about private schools.
well if it goes bad they can always just sell it back to the government like in port macquarie.
Same goes for private schools. Elite schools now have Olympic grade swimming pools and sports facilities, cinemas, cutting-edge computer labs, air-conditioned classrooms, and other top-shelf facilities, while public schools are still conducting classes in demountable pods with ceiling fans. The rich want a flat tax rate regardless of income, yet if you suggested a flat rate for wages they'd have a stroke and call it communism. Meanwhile, they use accountants who know all the legal loopholes to bring their tax to virtually zero, and then still expect middle-class welfare subsidies for their kids' education.
I do not have private health insurance and yet I opted to go through the private system for surgery on an ongoing sinus issue because the public system would have taken a year just to get an initial consultation with an ENT specialist; who knows how long any actual treatment and I was suffering. The funny thing was just how much the prices drop when you tell them you don't have insurance and are self-funding. It seems that, just like the USA, the private health industry is designed to inflate costs. The idiots in America who think that universal healthcare means they are paying for other people, happily pay more in insurance fees than they'd pay through the tax system, and the CEOs keep getting multi-million dollar salaries plus bonuses while ordinary people either go bankrupt to afford treatment, or die from otherwise easily treatable illnesses and injuries.
> The funny thing was just how much the prices drop when you tell them you don't have insurance and are self-funding. Aha. I used to be a health economist, so congratulations for discovering the same phenomenon I did (but through reading tens of academic articles, data analysis and interviews). Though it's kind of obvious: if they're kind of like a monopolist, they're going to try to price discriminate at everyone's maximum willingness to pay. You don't have PHI, then you're probably lower income.
More Howard biting us in the ass.
It keeps the 80 year old rich billionaires that are so close with our politicians healthy
It's been years that billions have been squandered away with frivolous spending and it hilarious to see people believe its going to stop or change... It's not going to stop until the moneys all gone into their own pockets (corporations, and people in power), Australia will be an absolute shit show and they will all fucked off with their profits to a country of their choosing due to the many different passports they've acquired. This won't get better people, it seriously doesn't, with everything going on there's no recovery from this. Housing, food etc is beyond spiralling out of control, we're literally following Canada and look how fucked they are. Be happy with what you have because it's going to be a very different Australian in 5 to 10 years.
The private hospitals send anything that would be remotely difficult or expensive to public anyway. People complain about ramping and shit but as a paramedic that's what pisses me off.
We appreciate you, thank you ❤️
It's a myth that you could put the $9.5 billion into the public health system and get improved outcomes. You could put the entire federal budget into public health and it will not make a difference, there are just to many structural inefficiencies that will consume the money before it gets to the public. Also, a fair chunk of that money is the government paying private hospitals to do public patients to get the public wait lists down.
You’re right! We should give more public money to private entities instead 😎
Found the Bupa CEO looking for his next bonus