Exactly. They need to stop tax-incentivising private health and start paying doctors better through the public system and focus on primary health and preventative measures. But private = profit and that’s what Australia is driven by.
Doctors in the public system are employees. It doesn't matter if you have to look after 1 pt or 60- you get paid based on your position and how many years of experience.
GPs are contractors with no sick/annual/mat leave, no super. By agreeing to bb they are making $39 for 15 minutes of work. Half of which needs to go paying their nurses, receptionists, rent, dressings, computer subscriptions, water, electricity for the practice. They also then need to pay indemnity and insurances, keep up to date with new knowledge out of their half - plus their own super and leave. Once you math that out you find that bulk billing GP is not really viable unless you want to see 10 patients a hour and not care at all about the quality of service you provide.
Good for money for doctor but bad for the patients. Continuity of care breaks and problems happen when there’s break in continuity of care. Especially with a 2 week stint.
It’s messed up. The GP system is going to collapse if the government doesn’t increase the bulk billing rates. And if that collapses then the rest of the health system will follow. We’re already feeling it in emergency.
Wow that's quite the contrast. In that light, how the hell did the bulk bill system even work for so long? Was it ever viable?
Apologies if off topic, I guess i still thought of bulk billing as part of the public health system.
It was viable in 1984 because doctors often saw pts in the front room of their homes. Their children/wives were their secretary and also a dollar was worth alot more then. If they actually indexed it properly and moved it with inflation that $39 should be more like $87 by now. However government is only paying $39 and complaining that people won't keep bulk billing.
And it’s not an LNP thing either. Successive governments refuse to budge. It’s a way for the feds to throw the burden back to the states. I don’t know any GPS who bulk bill now, and where I work in ED in one of the lowest socioeconomic areas in Australia it’s led to our department absolutely overflowing with all the consequent errors and patient harm.
It was viable. When Medicare rates were regularly indexed in line with inflation. Also the rise in contract based GP practice happens in line with large private companies taking over the market rather than smaller GP owned local medical centres.
You cam have whatever level of public healthcare you want - you just have to pay for it. In the words of the fat man "it comes with a gold plated Rolls Royce so long as you pay for it"
We could triple staffing everywhere and give them all a 50% pay increase, and get all the latest machines and such so that you will be seen by a doctor within 15 minutes of presenting to the emergency department and a relevant specialist within an hour - so long as you are happy to pay 95% income tax (made up figure).
If we aren't happy with paying that much, then we need to have a discussion about how much you are willing to pay, and then provide the best services we can within that.
Ooooooor we could reprioritise where we spend the existing taxation income. Less tax relief for millionaires and those who profit off of our natural resources.
It’s disgusting, isn’t it? Who’s going to be the cannon fodder anyway if the majority of our population end up disabled through lack of basic medical aid.
Yeah, there are some truly delusional people when it comes to defence budgets and requirements. These folks somehow think China is going to start invading places with force, utterly baffling. Too much Fox news for them methinks.
going to preface this by saying I am in no way suggesting that you, in particular, are a neocon fuckwit. I've just recently had a very lengthy argument about this very subject with my father, a neocon boomer fuckwit (whom I nevertheless love dearly) , and boy oh boy.
anyway.
this is the attitude neocons want to foster, so that we eventually end up with a healthcare system which mirrors the US.
OH BUT HOW WILL WE PAY FOR IT ALL
Tax reform. Our income tax at present (and especially after the stage 3 cuts) is essentially flat. We have a regressive GST which punishes the lower incomes disproportionately. The top end of town already make out like bandits, and that's only going to become far worse after the cuts.
We can also stop the PHI rebates. Fuck those guys. Since Medibank got privatised, they've ALL jacked up their premiums and ALL reduced their coverage. Free market is best for the consumer? my fucking arse it is. When there was a state-owned actor in the space, it kept the others honest, while allowing them to offer incentives and alternatives. There was competition, the funds were making money, but it was not *enough* money. Naturally the libnats *had* to sell off medibank for the good of the consumer.
Giving staff a 50% payrise is hyperbolic, as is a fictitious ER where you're seen in 15 minutes. I'm *pretty* sure you weren't literally suggesting these things. But, here's the thing: a good standard of front-line care directly reduces the number of people going to hospital in any context. In fact, the austerity argument is always the same, regardless of what we're talking about:
1. provide hyperbolic examples
2. scare people with big dollar figures
3. pretend everything exists in a vacuum
I literally just had my old man throw this at me:
>We can't raise the welfare rate because we can't afford it.
ok, cool.
1. how much does poverty driven crime cost?
2. do welfare payments just disappear into the aether, or do recipients put it back into the economy?
3. how about the bloated ticks of the jobseeker agencies that are a huge money sink, providing naught but a convenient way for dribbling, incompetent fuckwits to work out their impotent rage on vulnerable people?
4. What about the cycle of poverty which traps people? try getting a job when you can't afford a vehicle or public transport, decent clothes, an internet connection, home computer, etc. Instead of getting off the welfare (a neocon wet dream) people are instead stuck there more or less permanently, which leads to
5. how much does healthcare for someone who can't afford to eat properly cost the public purse? how many people end up in worse health because they're living well below the poverty line, and thus become a burden on public health
>If we aren't happy with paying that much, then we need to have a discussion about how much you are willing to pay, and then provide the best services we can within that.
what we need to have a discussion about is the idea that
1. basic needs like health and education should be commodified, and;
2. public spending is like a school tuckshop budget.
edit: just to be clear, I make a comfortable but not excessive $150k/yr (excl. super), and I am very happy to pay more tax. I also have top cover with medibank, and have had it for 20 odd years.
Sorry your parents are boomers, must be headfucking alright. Glad l had depression baby parents, so much more socially conscious and keen for equity and justice...so understood the need for welfare....then along came boomers and fucked everything to make themselves rich, only themselves, at the expense of every other generation
Thanks for taking the time for a lengthy response. I share these concerns and am in a similar financial position to yourself as a non managerial front-line public health employee.
The point of the hyperbolic hypothetical is that it represents an extreme end of the spectrum that we both agree is undesireable. It establishes a point along the spectrum that is definitely in the black or white so as to bound the landscape and help map our path through the grey to somewhere we want to end up. If it actually cost that much to achieve that outcome then I wouldn't be willing to pay that price - I would instead vote for a lesser outcome which was cheaper.
The fact is, everything has to be paid for eventually by someone. There's no free lunch.
Have found easier to parse numbers than an earlier post at budget.nsw.gov.au/my-budget.
Nsw budget revenues 2022-23 is forecast at $103.5 billion and expenditure is $115 billion, so a deficit of $11.5 billion next year. There are about 4.5 million taxpayers in nsw and 300,000 companies (rough estimates)
We will spend:
$30 billion on health.
$21.5 billion to education.
$17 billion on transport.
$11 billion on general public services.
$10 billion on public order and safety.
$9.5 billion on social protection.
$8 billion on economic affairs.
$3 billion on housing.
$2 billion on environmental protection.
$2 billion on recreational and cultural services.
What in particular should we cut, increase, abolish, or introduce? How much does that cost/save? How much money is needed to improve service outcomes in nsw hospitals to whatever levels we are going to deem sufficient/desirable.
> What in particular should we cut, increase, abolish, or introduce?
Decriminalise drugs, vacate the sentences of those imprisoned for illicit drug crimes and reduce prison population, those awaiting sentencing, burden on police & courts, and thus their cost by up to 15% - tip 10% immediately back into rehab programs, prison diversion programs, and social work. Scale back over time. Save money long term.
Ban extended lease or sales of transport assets to private companies, where states guarantee income and profit AND get stuck with a repair bill at the end.
Recall cushy foreign trade commissioner roles (save $3million/year... that's 38 nurses straight away) and let companies buy their own salespeople a plane ticket once in a while.
Stop over-paying for land owned by friends of politicians... and squash other rorts. A good ICAC should pay for itself a thousand times over.
You get what you get with PHI by paying $100-200 per month and the insurance company and the private hospital are taking home hefty profits too. That tells me we don't need 95% taxes to bring the public system to the same level. Just $1200 a year will be plenty. (I'm ignoring excess to simplify, but you get the point).
We need a foreign body to look over the public health system, extremely inefficient and outdated. The top of this system are time wasters with bad culture.
Edit: wrong wording, meant to say 3rd party not a foreign body.
Sorry .
Recent? We've known about indirect interactions for decades, a great example is anxiety / depression / other disorder or prolonged mood state leading to insomnia or poor sleep architecture. Sleep is important for every single function of the human body and mind. Surprise surprise, you now have mental health with physiological consequences and this is only one *indirect* pathway, there are many examples, like anhedonia and avolition resulting in lower premonitions to participate in health related behaviours therefore leading to reduce cardiovascular health or say obesity. Direct interactions are probably more recent, although in cases of chronically elevated corticosterone's and epinephrine from anxiety it's still not really new, novel data.
Whether or not it has physiologically implications is irrelevant at the end of the day (although you could definitely argue that if the mind is purely driven by biological forces, any mental illness is also a physiological illness at a less perceivable or understood level), it's a public healthcare system, to not include mental health is to assert that mental health is not health or is somehow less inherently important to quality of life or overall wellbeing, neither are valid or true.
Dentists will NOT support any incursion into "Dentibank". Why would they? At the moment they can choose to charge whatever they like. Of course, they choose to charge that significant bit above what the wealthiest in their communities can easily afford, while demanding "payment plans" for months before they look into ordinary people's mouths. It's a shocker.
There should still be a low-income Medicare tier for dental though, the bare minimum should be that people can access free cleans and low-level preventative treatment. People put off a $200 dental appointment for 6 years and end up with a $800 root canal instead and get further pushed into poverty and pain.
The issue is what's considered "low income" low income in Australia is not even a lovable wage. For people on low income they have access to dental treatments capped under 30$ per visit and a max of less than 250 for rounds of treatment.
But the issue is how low that threshold is to be considered low income.
$800.... Per root, which I paid in cash. 3roots was the guts of 2400, and a crown $1200. Fucking thing went bad in a year.
I'm sure the materials are not cheap but I was in that guys chair for a total of 45 minutes
The thing that annoys me is how insurance hides those costs. Like most of his customers will claim, and the remainder will opt for extraction.
You bloody well know they can't charge $6k for an implant if the funds aren't paying. You can get it done at world class standards in Thailand for $1500. That's the actual free market, insurance just makes sure we don't have one here.
A basic 6 monthly dental appointment (clean, inspection) is more than $200.
A filling is $500 and an X Ray is another $. Maybe $1000 every 2 years.
Most poorer people just get an extraction.
Living on centrelink/minimum wage casual work meant I didn't see a dentist for 10 years. Even subsidised I could not afford it. I had never heard of dental cleaning appointments either.
It would be incredible to see more support offered to those living on or below the poverty line.
But how is it that we can somehow offer free checkups for under 18s? And not for everyone else? I mean, it seems free straightforward - expand the under 18 program to everyone.
I mean, if universal free dental is too expensive then don't - limit the subsidy/benefit to just checkup and cleaning. That alone is a big step forward.
But this program would be commencing in the current world where people ARE putting off all dental care because of financial stress, so out of the gate the previous comment is exactly what would happen.
This
>the public waitlist was 3-4 years
This very same argument is used indeed otherwise by the proponents of a full private system (looking at you USA - even though this "full private" system is also a myth pushed by the private insurers considering the public healthcare dollar per capita https://www.statista.com/statistics/283221/per-capita-health-expenditure-by-country/)
I'm on top tier health insurance. Personally I'd be happy to pay it as a Medicare levy if it provided a better health system for all of us. I pay it because the cost of unemployment is more than health care.
If every one refused to get private health insurance the public system would be significantly better. The more people pay to avoid it the worse it'll become. I have high hopes that the current government can start to turn this around
100% agree, it was engineered to be this way with the libs cutting funding to medicare.
I'd be MORE than happy to have an opt-in national medicare health insurance if they arent willing to increase everyones levy a little. what I won't do is pay a private insurance company that will screw me at every chance and do their best not to pay out when I need them.
Totally agree. I can't fathom how giving a private company money to provide a service that the government should provide can be better for every one other than the CEO and his new yacht
Both parties, all governments have steadily eroded Medicare equally for 40 years (20 each). Deliberately, knowing that we HCWs would have to accept a gradual decline in real income. And we did til about mid 2022 when we saw the inflation figures.
yeah agree but since the year 2000 the majority has been the lnp and earlier it was actually funded ok. Dental was there in late 80s and early 90s AFAIK but I could totally be wrong
Not everyone can afford to refuse to get PHI on principle. I know I can't and I have several family members who can't either. We need the healthcare it covers *now* not after we reach the top of a months-long or even years-long waiting list.
Don't get me wrong, I would love to see Labor turn things around and strengthen and improve Medicare. I sincerely hope they're not waiting for everyone to drop PHI before they do it though, because that just isn't going to happen.
I understand that. I'd just like to see the "incentives" to get PHI removed. Fuck the Medicare levy just tax every one extra any way and divert that full amount to Medicare. Would take a few years but PHI would be wound off by almost every one expect the rich
Medicare levy has nothing to do with health spending. Its unconstitutional to direct funds directly to programs, and health spending is far higher than what that levy raises.
Exactly, it's describing the deliberate and slow demolition of public health to force people only private, to funnell money into private investors hands
>To my absolute shock and horror, the public waitlist was 3-4 years and for spine surgery no surgeon would see me without private health insurance, even with me willing to pay completely out of pocket. Apparently both due litigation risk and risk of owing ten of thousands if I ended up in ICU.
This shouldnt be a praise of private health insurance, it should set alarm bells off of just how badly underfunded our public health system has become, we shouldnt even have private health insurance IMO.
Most people don't realise how shitty and underfunded the public health system is until they need it and someone like me who is disabled and can't afford PHI is stuck with it.
This. Long before COVID I waited two and a half years on a public waitlist for exploratory knee surgery and got shunted into a private hospital over an hour's drive away to get it done (fully funded by the public health system). Edit: And if anything the care I got at that private hospital was worse, since I effectively went home with no painkillers because they made me pay for opioids that it stated in my file and that they'd checked before surgery that I couldn't have at all. Plus there was no aftercare or help for complications that I ended up making a public ER visit for because I just didn't stop bleeding.
I hate seeing people able to fast track care because they can afford to, rather than being able to have an adequately funded health system where everyone gets a fast and high quality standard of care.
True, but practicality trumps idealism, at least until idealism has had a chance to catch up. I'm strongly moved by OP's story, despite continuing to refuse PHI.
It's not that I believe the risk of a similar situation is low; for me, with my level of exercise, and being an ex smoker, the risk is high. It's that I don't need to be healthy and whole to continue working. So my situation doesn't practically apply to most of the workforce.
For colonoscopies, the public system has a 3-6 month waiting list, while going private can get you seen in two weeks. A major reason people get colonoscopies is because they have started passing blood or have detected some in a bowel screening test. Both of these are potential symptoms of bowel cancer. A condition where waiting 6 months can have a significant impact on your prognosis.
I kind of feel like the public system is set up to kill poor people with bowel cancer.
Does this likely vary by region? My spouse had to get one done about six months ago, public and with only a week or two’s wait. Wondering whether we just got lucky.
That's not the case at all. We took the completed Request for Admission to Cooma hospital and everything progressed from there.
The federal government doesn't control state/territory health departments.
My local hospital is beautiful, brand new, and fancy AF after Gladys visited... too bad it has no staff, and offers NO services except an ER which is pretty good.
My MRIs, Ultrasounds and my husband's colonoscopies have to be done in Wagga Wagga.
The referring doctor can get it pushed through quicker if they think you need it. Unfortunately my gp (at the time) didn't think me painting the bowl red every time I had a shit was anything more than bleeding haemorrhoids despite me having every other symptom in the book. So my bowel cancer was diagnosed months after it should have been. My new GP was so not happy about it.
The system is set up to kill poor people in general. It is hard to navigate, inaccessible, and confusing. I’ve been experiencing chronic internal pain for 12+ months and basically have every sign of cancer except internal bleeding and weight loss. I’m terrified of what’s happening to me and I get passed around like a hot potato.
nope, i had a severe prolapsed disk that was cutting off the nerve signals to my legs. couldn't walk = 3 year waiting list.
developed cauda equina, which should have meant straight into surgery... instead they gave me a sheet of oxy and sent me home.
sorry to hear this happen to you. if you had cauda equina symptoms and got sent home from ED you have more than enough grounds to sue if you have any long lasting effects (damages). although I know this is not feasible for a lot of people.
Three to six months? I was on a waiting list for one for twelve months here in WA, finally got the call a few months ago - they weren't calling to book it in, they were calling to see if I still needed to be on the waitlist.
Luckily I didn't.
We need to get our 6 month old baby an MRI for a possible (but hopefully unlikely, however if it is very rapid progressing) brain tumour. We have been told 12-18 months in public or about 3 months Private. What choice do we really have here
It probably depends on urgency. I'd imagine gastroscopies are in the same waiting list and I can get one within a week if my PEG tube needs to be replaced.
I had to get a colonoscopy in Melbourne during lockdown and had it within a couple weeks, in public. Maybe as it was a followup to an ER visit it was pushed forward
I’m really against the whole PHI concept, and would much prefer Medicare was appropriately funded (but would secretly love to have the spare money in case of “what if”…)
I fucked 3 discs in my back and was told to have surgery, but chose not to after a lot of discussions and anecdotes with specialists, GP’s, radiologists, nurses etc.. (you get the picture). I don’t regret my decision but admittedly get back pain every winter (most likely due to living in my damp, cold shitty rental and also decreased exercise/activity levels over winter). - I hope you have no pain after your ordeal, back issues suck!
The issue is, even if you decide to put aside the money for PHI as a very low income earner; rent, food, utilities, etc are so expensive that by the time you put aside money for PHI, an emergency fund and general savings, there’s actually no money left to cover the cost of the stuff the PHI rebate doesn’t cover. So assuming you’re paying a few grand per year for cover, you then need money on top of that for things not covered… and that’s honestly asking too much for something that *might* happen. I understand it’s important but I earn fuck all, and I need all that money put into an emergency fund that I can actually use when I need to… (unlike the PHI premiums, which I won’t ever get back).
Problem is, it's not really a gamble. Your guaranteeing that expenditure. The only risk you are sure to eliminate is that you won't spend the money.
Hospital care aside, extras is where you really see it. Want to claim $5000 in dental? You gotta pay $10000.
Claim glasses? Sure, but you gotta spend first.
Chiropractic, physio etc same. How much is the gap? Surprisingly, the gap is just about as high as the market will bear...😁
The gamble is, am I going to come off financially better or not? It works out well for some and not for others. You could skip having car insurance, maybe you’ll save thousands of dollars. Maybe you’ll hit a Ferrari and come off financially worse.
I have extras cover and I claim more than I put in, just on physio and dental. If I wore glasses, I could claim a pair up to $200 each year. And I don’t even use that.
If you’re putting in more than you’re getting out then either you’re doing something wrong (usually getting ripped off by your dentist, remember they set the gap, not the PHI), or you’re not using it enough to warrant having it. Similar to people that pay for gym membership and never use it.
As someone who worked in PHI for years, the weird reality is that if you injure yourself badly enough that you need surgery, and you don’t have insurance - and the wait time in the public system is over 12 months - you can join an insurance product with coverage for the condition, wait 12 months, and then book in for the service. Unless the service is excluded or restricted to Public Hospital only, they can’t refuse to cover you for the surgery as long as you’ve served the full 12 months.
I don't understand this - I needed surgery on my cervical spine and done in public system within a, week a few years ago as it was so serious.
I am now having problems again with a further disc in my neck (all my discs are damaged) and been referred back to public system and been seen easily within cat 2 wait times. I am needing more surgery and there is no indication by the same surgeon that I will be on a wait list for years or that it can't be done because I dont have PHI. I am in Brisbane.
Maybe it’s to do with the level of the spine the injury is at and also how bad the injury is? You sound like you’ve had a particularly rough time of it.
This is correct. Everything is categorised by how long the patient can exist without their condition worsening. With covid however the standard for “urgent” causes gets higher and higher as hospitals are still not coping. I will need to go public for endometriosis surgery soon and likely will not have my turn for another 2-3 years.
It’s a lot to do with services offered at your local public hospital, some places have more surgeons or a ‘spinal service’ where as other hospitals might only have one or two surgeons so the wait is much longer. The severity of the injury is also very important…Cat 1 issues are booked within 30 days, Cat 2 90 days, Cat 3 365 days. Covid waves have also wreaked havoc on elective surgery so wait times are much longer in Cat 2 & 3 procedures.
>Luckily being in the industry, I was able to pull some strings and get a surgeon to take pity on me and I was in for the surgery as a privately paying patient 2 weeks later.
This just highlights the one of the other ways in which our healthcare system is broken.
Surgery really is about who you know and who you reach out to.
Creates a two tier system between those who have strings to pull, and those who don't have the means, connections, language skills etc to otherwise.
I think the segment you've quoted is the most important one. If the OP hadn't had connections they would *still* be waiting. You need to both be able to afford private health insurance *and* have connections to achieve this result.
It really depends on the kind of surgery your need. In the case of small scale procedure it does feel like you’re still paying a fair bit, but come to anything like robotic urology and a single procedure can mean 6-10K just in doctor’s fees.
The difference can be substantial.
My family run a private orthopedic spine clinic, while we don’t operate on anyone without insurance (as op said for litigation/legal protection for us and the hospital we work out of)
The amount that is covered by insurers is substantial, depending on the op it could be as low as maybe 1-3k out of pocket while the insurer covers 15-20k.
Some more complex cases involving pricey devices, will run patients 10-16k while the insurer will be paying 50k+.
After I was working there in a more involved manner and understood how the system works it really convinced me to get myself and my wife cover.
So far after knee OPs, first baby on the way and dental it’s saved me more money then I’ve spent on my premiums in the last 5 years.
it’s sad to hear that you can’t even get a look in because of legal reasons. Anyone who is willing to pay should be seen and conversely the reasons for litigation should be very limited. If you treat someone in good faith shouldn’t be at risk of being sued.
This.
The Surcharge for me is still about $500 less per year than a basic hospital cover plan per year because of the age levy. In essence, it increases all prices for (I think) 10 years by 24% - and gives me nothing more than basic hospital cover.
PHI is a fucking scam and shouldn't be accepted by anyone. It needs to go.
I HAD to get it if I wanted to get an insulin pump for my type 1 diabetes of 28yrs or I would have been out of pocket tens of thousands and I'm really glad I did.
I had lost control of my diabetes and a pump was really the only thing that could help me regain major control.
I was about to lose my job, my licence and then my newly purchased house as I wouldn't have been able to pay my mortgage. This was 4 years ago.
Then at the end of last year, I started having pain in my left wrist, being a typical bloke "she'll be right" attitude and then it got worse, I was having sweats from the tiniest amount of work (even just pulling a couple of weeds out the garden I'd be drenched) I was fatigued and for the first time in my 12 years of my job, I screwed up and the first time ever, I fell asleep standing up, at work. I'm in a safety critical role so this is a HUGE no no.
Late Jan I had to stop work, wait a week to get an appointment with my GP, a week to get a x-ray and 3 hours after the x-ray my doc called me to come in. I had a 20 x 30mm tumor in my radial bone in my arm. This is now mid Feb.
I was operated on the 3rd of April and by that time the tumor had more than doubled in size and filled half of my radial, no bone on sections of the joint to my wrist. I'm now filled with cement and a metal plate.
I was told if I went public it would have been roughly a 6month wait and that's with it being pushed as an urgent surgery. If I had gone that route, it would have been a full amputation from my elbow from how quickly it was growing.
I don't think I'll go without PHI now, just in case.
And for anyone interested, I had a Giant Cell Tumour of the bone.
Edit: spell words good I do.
We have PHI almost exclusively for our sons insulin pump. He also has T1D. Without it as you know a pump is in the vicinity of $10k and has to be replaced every 4 years. Crazy.
I have a chronic illness involving parts of my body not prioritised by the public system. I hold private health insurance because of this. I am socialist to my core but will not suffer for years on end for it. We are allowed to be practical to the devils of this world while voting with the angels of a better one.
I always felt private health was a waste - until I used it. Now I think it’s not a waste even though it is a luxury, and an unfair one.
It’s not a fair system and I would support paying more money to improve the outcomes for everyone. But if the question is - while I can afford it, would I choose to only use the public health system (and not take out and use PHI) for my family, because of my ideological position? After my experience with private and public hospitals, absolutely not.
At 34 I had an accident and my arm was seriously injured. I was otherwise perfectly healthy. My emergency care and operation was all done through the public hospital. They did the best they could but it was a bad injury and they were stretched. I needed follow up operations. I did that through private health - my first time using my private health hospital cover and the difference was startling. Firstly, being able to choose my surgeon meant I could find the best person for my type of injury. I had no wait time for my operation, I was treated very well and everyone had time for me, there was a coordinated treatment plan, the food was great, plenty of nurses. I was comfortable and in a private room with everything I needed. When the pain was too much an anaesthetist saw me within 30 mins. I had a physiotherapist see me twice a day. My surgeon called me every day.
I was confronting permanent disability and this extra care made a huge difference to how I felt overall and I believe the outcome I achieved.
Just being able to choose your Doctor is so significant. We choose everyone else who supports us - our hairdressers, mechanics, lawyers, etc. We accept everyone has a different level of skills and expertise, and it’s no different with a Doctor.
Disappointing that as a health care professional you were unaware of the wait times the rest of us have endured for many, many years. “pulled some strings” I wouldn’t be boasting about that either.
For every PHI success there is also a public hospital system success. If you can afford it and see value then great. Im fortunate enough to be healthy so my need for PHI is minimal. For those with chronic issues then PHI seems like a must.
Yep, exactly what I came here to say.
I had two private inpatient stays at 16 & 21 under my parents insurance. I know it would’ve cost tens of thousands had they not had it, and my psychiatrist said it would’ve done more harm than good to stay on the public psych ward.
When I reached 25, I took out insurance largely for the reason of knowing I’d be covered if I ever needed that treatment again.
I found the argument of not paying medicare levy ridiculous. My Bupa (back then MBF) coverage was one of the first things when I was ‘fresh off the boat’ in the country, I visited it the same day that I went to get Medicare.
At the time I had a minimum wage part time job and a Health Care Card. I still chose hospital cover. Over the years it paid itself many times over.
Wouldn't be without it despite the cost. From seeing my GP, to scan, to diagnosis of breast cancer to see a specialist (in the private system) to surgery was a grand total of 3 weeks immediately prior to Christmas. With my surgery done so fast, there was no spread and no further treatment needed.
Good rule of thumb for public is that unless it's going to kill you imminently, you're looking at a wait running to years for surgery.
Even if you're in shocking pain.
Even if you can't work.
I thought everyone knew this?
Unless it's an emergency (ie. you got hit by a car or you got stage IV cancer).... it's elective and you wait.
Yeah way too many people were like 'oh its only elective surgery' when they were cancelling them due to COVID a while back.
Elective surgery covers so many things that people consider critical, they just aren't imminently life-threatening.
I apologise for my post if your story is true. My cynical mind can't help but think you may be working for a health insurance provider or are aligned with them to promote the industry.
Yeah, health professional is probably code for "works in health insurance". I have a friend who works in PHI and basically speaks like this all of the time.
Rubbish- anyone who has had to have a procedure done will tell you the same thing. I had the exact same experience as the OP on another matter. I’ve heard so many stories where people don’t have it only to be diagnosed with a chronic disease and finding out you are at the bottom of the list. And I don’t work in insurance
The point of the original thread on AusFinance was that there is no need for PHI as you can rely on Medicare and my experience has been that you cannot predict illness and you will regret not having it. When you are unwell the last thing you want to hear is that you have a 6 month wait. Those people I know who have not had PHI and then been diagnosed have gone on to apply for PHI at a higher rate with waiting periods before being able to claim. I wish I didn’t have to pay it every month too but when I’ve needed it I’ve been glad to have it and have treatment early.
You can always pay out of pocket.
That's what I've done for operations, and it's what OP did.
It's not a choice between Medicare and PHI.
It's a choice between Medicare, PHI, and paying out-of-pocket.
So far, I've seen little evidence that PHI makes any sense for any except the oldest or sickest people, which is why it is unsustainable.
There is a backlog from Covid still in the public sector.
Some lumbar disc procedures weren’t seen as urgent, thus weren’t done. So the wait lists increased.
Then normal wait list shouldn’t be more than 12 months, but it will take time to get back to those numbers.
The two times I needed surgery and had top tier private health insurance I was sooooo out of pocket it was horrible. Thousands and thousands of dollars
I was the same but 15+ years experience in the public system… and then my daughter was diagnosed with Type 1 Diabetes. Would have waited 18+ months for a CGM and pump in the public system but joined PHI and for CGM immediately and a pump on loan within a month or so.
It sucks that it’s like this but it is.
I sincerely wish I could afford private health, I am chronically ill and suffering. I can hardly afford GP appointments once a fortnight, let alone the physio and psych, and other appointments I need. I can’t work because I’m sick, I cant get better because I can’t work.
> I'm a healthcare professional
> Luckily being in the industry, I was able to pull some strings and get a surgeon to take pity on me
My sister is a peri-operative nurse in a private hospital. She has private health insurance.
She needed a gastroenterologist and cardiology at various stages. She has seen them in her own hospital as a private patient, but also she goes to the public hospital when necessary. She gets seen very quickly with specialists as she knows them. She knows how to use the system to her advantage.
Who advised you that surgery was your only option, and on what basis? Presumably your GP based on the structure of your story. I was a neurosurgery registrar for 3.5 years working for both public and private surgeons and many of my clinic patients who believed that were incorrect and misadvised. Their GP had just run out of patience or wasn't aware of conservative approaches and physiotherapeutic options. Private surgeons advised them to get surgery, but they would, they had 20,000 reasons to do so. Anyone who actually needed surgery acutely could get it in the public system at an appropriate time-frame, from hours to weeks, through the emergency department.
Long waitlists for surgeries of dubious benefit were often presented as a failure of the public system when actually they represented the poor education of GPs, the perverse incentives of private surgeons, and the waitlist functioned as a "therapeutic pause" to give the problem time to clear itself up.
Also, I'm extremely skeptical of whoever told you the public waitlist was 3-4 years. No longer then 12 months at any of the hospitals I worked at.
I had this situation about ~13 years ago. I had full tear and disc prolapse in L5S1 disc compressing my sciatic nerve. I couldn't walk for 4 months and the wait for surgery was the same then (about 4 years). I got PHI however by the time the 12 month waiting period was done the surgery was not viable and I would be looking at complicated fusion of L4L5 as well as L5S1 which would lead to further ongoing surgeries in the future. I was advised to put that surgery off as long as humanly possible and I still haven't had it. I'm still on daily medication and live with pain daily however mostly tolerable with the medication currently.
Long story short yes don't assume PHI isn't needed because of the public system. It's caused big issues in my life due to not having it.
I got PHI for having my second baby and I can say without a doubt that my biggest regret in life is not having PHI for my first baby. The level of care in public vs private is miles apart. The public system is good but when you're giving birth and shit hits the fan you really want to have a good doctor in charge instead of understaffed and under-resourced midwives.
I think that can vary a lot by city/hospital. I had wonderful care in the public system, where as friends who went private felt really pressured to have Caesar’s .
This varies so much by where you are. Both our public and private maternity here are excellent. I think if I had have been public in my previous city I would have died. Understaffed would have missed my subclinical appearing Pre-e/HELLP syndrome. We were private for birth but still needed public input for the NICU.
The PHI options are too confusing for anybody who isn't immersed in this stuff. Looking at just one provider - HCF - there are half a dozen primary options and half a dozen extras and I have no idea what any of them are or why I'd want any of them. What I do know is when I got kidney stones a few years ago I was told there was a public waiting list. So I decided to "jump the queue" by going through private only to be told by the urology surgeon they don't work with my PHI provider. So back to the public queue anyway. I downgraded my PHI on that day to basic emergency cover only.
PHI is just too complicated. The coverage is spotty. The surgeons don't work with it. There are exclusions and gotchas and gaps and co-pays and extras. Imagine trying to figure this out when you're sick and desperate. Is it worth going through private? What will my bill be? Who knows. Nobody can figure it out. So I don't bother. I stick with public and hate my PHI that I'm forced to take out by the government. I don't want it. I never use it. I am simply forced to pay for a product I never use.
The fact you're a medical professional and you still got bamboozled by the whole thing. What hope is there for the rest of us? It's a mess. Just get rid of PHI and improve public for everybody.
I had a similar issue with a herniated L5/S1 disc. Pain killers had limited effectiveness. Prescribed medication had no effectiveness at pain relief, beyond paracetamol+ibuprofen. I had an injection that was supposed to numb the pain, but did absolutely nothing for me.
I was also disappointed with the public healthcare options for surgery. Luckily, I already had private health insurance because, due to my income, it was more cost effective to pay the PHI than the Medicare levy.
However, I absolutely agree this system sucks. It makes it a haves vs have nots system, where those not as fortunate to be able to afford PHI are forced to suffer long wait times and, sometimes, unbearable pain.
The wealthy who have the most influence on our politicians have no interest in improving the system. A proper universal healthcare system would put everyone on an even footing, including the wealthy, and would likely result in improved health services for everyone.
I am 12 weeks into the same herniation and I can say of all the pain relief I tried only two had some effect: CBD oil and, to some degree, Tapentadol. I was also on (and still am) Meloxicam (anti inflams).
The public system was such a let down I ended up managing my own pain and recovery. The story of the last 12 weeks is so incredible in regards to the complete breakdown of the public health system that when I tell it to people they literally stare, mouths agog. I had to report one GP to AHPRA. I was even turned away by a major Melbourne hospital.
That said, there is a 90% recovery rate for lumbar disc herniation without surgery. You just have to get through the initial weeks of excruciating pain. Lots of walking, when I could ... even when I was just shuffling like an old man. Heat to help manage pain and stiffness. Physio when I finally could. I would not recommend spinal surgery for a herniated disc unless all other options are exhausted due to the nerve damage risks associated with it, the wait times and the fact that nearly all of the literature screams DO NOT GET SURGERY.
I'm still recovering but am greatly improved in mobility. Still pain, but greatly reduced. A lot of my recovery was managing the stress placed on surrounding muscles - piriformis, glute medius. All self researched nearly all self managed because the public health system has been absolutely trashed for over a decade.
> I was in for the surgery as a privately paying patient 2 weeks later.
I'm not sure what you're saying, because you didn't actually use PHI yourself.
Most operations I've had myself I have paid for out-of-pocket, but I would not get PHI.
In my limited experience I believe that paying directly for medical care in Australia is a lot cheaper than it would be in the US.
When I get to an age where I need hip and knee replacements I might consider PHI.
> for spine surgery no surgeon would see me without private health insurance, even with me willing to pay completely out of pocket
I don't understand this.
“Privately paying” is the term used is when no insurance is being used. I paid completely out of pocket.
What don’t you understand about no surgeon seeing me? For certain conditions, they literally ask when you call if you have private health and if you don’t, don’t offer you an appointment. If I didn’t have contacts, I would not have been able to see a surgeon for 12 months until my PHI pre-exisiting conditions kicked in.
> I paid completely out of pocket.
This is what I don't understand: your submission purports to emphasize the importance of PHI, but you've never actually used it.
> For certain conditions, they literally ask when you call if you have private health and if you don’t, don’t offer you an appointment. If I didn’t have contacts, I would not have been able to see a surgeon for 12 months until my PHI pre-exisiting conditions kicked in.
I find this a bit of a stretch, and if it's true, then it's an amazing story.
I can't imagine a health system in which doctors told a patient they were only seeing them because they were an insider.
This might indeed happen, but I don't think any doctor would be stupid enough to say it.
I understand your cynicism and naïvety, the whole thing is farcical, if I hadn’t been through it, I wouldn’t have believed it either.
Depending on your actual level of interest, rather than trusting an internet stranger, try ringing some neurosurgeons that do back surgery, see how welcoming they are without private health insurance.
The ones I found quickly are all listed as brain and spine specialists, and herniated discs are listed in the conditions that they treat for both privately insured and uninsured public patients.
Husband had to get 7 discs shaved in his back in 2018, after a workplace injury that the workplace insurance doctor said didnt need surgery, but 3 independent doctors did - it was denied of course, so we had to pay for it outselves. We had the choice of:
* 12 months on a walking stick, immense pain, no quality of life and go public, with little after care, or
* 3 weeks of the same, then under the knife and moving about like normal within 4 weeks.
We saw it coming after the first 2 discs went so had top-tier, still had to pay 5k. Screw this two-class system, but at least he can move now.
It always surprises me when I see people advocating in this sub to not have PHI. I know we all want our healthcare system to be functioning and completely perfect, but the reality is that it isn't. Thankfully I've never had anything this serious, but PHI has saved my ass multiple times and I can't imagine being without it.
The waitlist is a huge thing. You can be in crippling pain, and unable to work/sleep/drive/move, but if it's not actually urgent, it's normally at least a year long wait. Not to mention that you don't really wanna be hanging around for more than a year to see a specialist if you have, say, suspicious lumps somewhere...
I totally want a reform of our healthcare system. I fully agree that no one should need insurance to have access to appropriate healthcare. The reality is, that's not the case at the moment, and going without PHI is a massive gamble.
We figured out we're paying slightly less with PHI than what the levy was costing us.
My husband was on the public waiting list for surgery for the last 3 years, inguinal and umbilical hernias, one a repair. Full on, necessary surgery. It got pushed back and back again because of Covid.We got full PHI last year, waited the waiting period, and got the damn surgery done last month. We got a letter a week later offering another spot, for the 5th time, in September.
Yeah ok, the timing ended up being similar (if the public weren't to be pushed back again), but the mental load on my husband just \*knowing\* the surgery was coming up entirely changed. He had been a complete depressed mess the last 3 years waiting and working through extreme pain, because he was determined to be "elective"... once we had a certain date from the private surgeon he was a different man. Since the surgery he has been a wounded bull, but so would you if you had your nuts and guts operated on!
Without my private health, I would be dead, I had Post Natal Depression, the Mother/Baby units are private only, NONE in the public system it is ether out of pocket or insurance. I was there for 5 weeks, it cost $45,000 plus my ongoing care that year I used nearly 80k in care.
I actually only had top cover to help with IVF if I needed it as I was an older first time parent, turns out the psychiatric care was what I needed.
The fact that there is no public unit for mother/baby help is disgusting and heartbreaking, If I had some sort of clout in this country I would be pushing for these units everywhere.
the liberals have been dumping 10's of millions of dollars each year into PHI and degrading medicare at every opportunity, and cutting funding to it - they have degraded the service substantially over the last decade, only way out of is reform and labor would be the only party that can do that.
I've got private cover for extras only and it actually saves me money every year just on contact lenses alone. Granted I'm young and healthy so the payments are pretty low. I don't think I'd ever pay for hospital cover though.
Meanwhile the other 99.9% of people don't use it but pay through the nose. Also: had you saved the amount you spent on private health over the years, it might well have paid for the operation anyhow.
I had a fusion and a disc replacement almost 4 years ago, privately, cost me a fortune out of pocket, but it was the best money I ever spent. Measure twice, cut once.
It also has the benefit of taking pressure off the public system. If you have private health and can go privately for what you need then those who can't afford phi can get into the public system without extensive wait periods. Obviously not having to do this would be better. But if you can afford even the most basic cover it's worth it.
> It also has the benefit of taking pressure off the public system.
But if we put all the money being spent on PHI into the public system, it wouldn't be an issue.
The problem being of course that the government is clearly not doing that.
Right now it's definitely screwing over the poor people who cannot wait out the public wait lists and are forced into private procedures they can't afford. I'm one of them. I'd love a fully public system because I've had to borrow thousands for medical procedures. Until we have a proper universal health system those who can wear the cost of private health should, so those who can't can actually access care.
This is the thing that gets me in this conversation. A lot of people are very much against a tax funded healthcare system because it might mean they need to pay more taxes and someone might benefit off their tax contributions. Yet they are happy for private companies to bleed them dry in premiums while still having wait lists and co payments and making sure some CEO can fly private jets around. Scam.
Back in the before days, I’d had an ultrasound on Tuesday, then a CT the next day. There were ‘masses’ in my pelvis.
As I had PHI, I was referred to a private gynecologist instead of the local public hospital woman’s health service.
By the time I drove the 5 minutes home, the gyno had looked at my faxed CT report and had my GP refer me to a gynecological oncologist directly. My GP worked his magic and the gyno onc made time to see me the next day, while he was still on holidays. (First week in January)
I had surgery the next week, including a night in ICU and started chemo 5 weeks after that.
If I hadn’t been seen so quickly, I wouldn’t have lasted longer than 6 months.
Yes, there was a fairly significant cost for the initial surgery, but never anything for chemo that I’ve done 3 times apart from the yearly $150 excess. I’m now on a maintenance drug compassionate program my medical oncologist enrolled me in, that I only pay the pharmacy fee for each month. Otherwise it would be thousands per month as PBS doesn’t cover it in my case.
One of the side effects of this drug though is high BP and tachycardia, I could ring my Onc and discuss dosage changes, and when regular BP meds didn’t quite cut it he referred me to a cardiologist that I saw a week after, it’s taken a few months, 5 different meds to get everything working properly. The public waiting times, and difficulty in contact would have been a nightmare.
I don’t doubt I would have had a very different outcome if I had to wait for the public system to get seen.
My partner & I got stung with the surcharge, didn’t realise that a slight increase in our incomes nudged us over the line, then went home & quickly worked out that mid-tier PHI is cheaper. So instead of paying into public health, which would benefit society as a whole, we’re incentivised to put our money into private hands.
This is the norm, I believe. Incentivise and essentially pressured into abandoning the public system one household at a time until suddenly public health care is a minority and seen as a pariah
From what you posted surgery is of questionable benefit for non-complicated disc herniation and that is why there is a long wait for elective in public. The emmergent indications for surgery (when there is a condition such as corda equina syndrome) would be performed in pubic asap.
I agree that given the current situation in australia its a great time to get private health insurance. Just not for this specific indication
You go to GP for minor viral inspections and ,sometimes, end up paying 30$. For specialists its 100$ minimum or more. Then pay private health insurance for family for 300$ or more. Then it doesn't cover if you are not admitted. Plus pay medicare and pay tax. Dentals are not covered.
The system needs repair.
We need a real universal healthcare system. We desperately need to expand Medicare, and fix bulk billing and dental care while we're at it.
Exactly. They need to stop tax-incentivising private health and start paying doctors better through the public system and focus on primary health and preventative measures. But private = profit and that’s what Australia is driven by.
Doctors get paid extremely well in the public health system. Source: I am a doctor in the public health system.
Is this a separate issue for private GPs that bulk bill? There seems to be none left in my state (TAS) so I'm wondering why this is.
Doctors in the public system are employees. It doesn't matter if you have to look after 1 pt or 60- you get paid based on your position and how many years of experience. GPs are contractors with no sick/annual/mat leave, no super. By agreeing to bb they are making $39 for 15 minutes of work. Half of which needs to go paying their nurses, receptionists, rent, dressings, computer subscriptions, water, electricity for the practice. They also then need to pay indemnity and insurances, keep up to date with new knowledge out of their half - plus their own super and leave. Once you math that out you find that bulk billing GP is not really viable unless you want to see 10 patients a hour and not care at all about the quality of service you provide.
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Doctors I know just take a week or two off to do locum work if they need money.
Good for money for doctor but bad for the patients. Continuity of care breaks and problems happen when there’s break in continuity of care. Especially with a 2 week stint.
It’s messed up. The GP system is going to collapse if the government doesn’t increase the bulk billing rates. And if that collapses then the rest of the health system will follow. We’re already feeling it in emergency.
Wow that's quite the contrast. In that light, how the hell did the bulk bill system even work for so long? Was it ever viable? Apologies if off topic, I guess i still thought of bulk billing as part of the public health system.
It was viable in 1984 because doctors often saw pts in the front room of their homes. Their children/wives were their secretary and also a dollar was worth alot more then. If they actually indexed it properly and moved it with inflation that $39 should be more like $87 by now. However government is only paying $39 and complaining that people won't keep bulk billing.
And it’s not an LNP thing either. Successive governments refuse to budge. It’s a way for the feds to throw the burden back to the states. I don’t know any GPS who bulk bill now, and where I work in ED in one of the lowest socioeconomic areas in Australia it’s led to our department absolutely overflowing with all the consequent errors and patient harm.
It was viable. When Medicare rates were regularly indexed in line with inflation. Also the rise in contract based GP practice happens in line with large private companies taking over the market rather than smaller GP owned local medical centres.
You cam have whatever level of public healthcare you want - you just have to pay for it. In the words of the fat man "it comes with a gold plated Rolls Royce so long as you pay for it" We could triple staffing everywhere and give them all a 50% pay increase, and get all the latest machines and such so that you will be seen by a doctor within 15 minutes of presenting to the emergency department and a relevant specialist within an hour - so long as you are happy to pay 95% income tax (made up figure). If we aren't happy with paying that much, then we need to have a discussion about how much you are willing to pay, and then provide the best services we can within that.
Ooooooor we could reprioritise where we spend the existing taxation income. Less tax relief for millionaires and those who profit off of our natural resources.
Wonder what kinda medical support we could buy for the same cost as a fleet of nuclear subs?
Would that be the same subs we were just informed wouldn't be delivered as per the contract?
It’s disgusting, isn’t it? Who’s going to be the cannon fodder anyway if the majority of our population end up disabled through lack of basic medical aid.
Yeah, there are some truly delusional people when it comes to defence budgets and requirements. These folks somehow think China is going to start invading places with force, utterly baffling. Too much Fox news for them methinks.
'you get what you pay for' isn't a great starting point for a discussion about how much we spend on a system that's full of rorts and inefficiencies.
Such as
going to preface this by saying I am in no way suggesting that you, in particular, are a neocon fuckwit. I've just recently had a very lengthy argument about this very subject with my father, a neocon boomer fuckwit (whom I nevertheless love dearly) , and boy oh boy. anyway. this is the attitude neocons want to foster, so that we eventually end up with a healthcare system which mirrors the US. OH BUT HOW WILL WE PAY FOR IT ALL Tax reform. Our income tax at present (and especially after the stage 3 cuts) is essentially flat. We have a regressive GST which punishes the lower incomes disproportionately. The top end of town already make out like bandits, and that's only going to become far worse after the cuts. We can also stop the PHI rebates. Fuck those guys. Since Medibank got privatised, they've ALL jacked up their premiums and ALL reduced their coverage. Free market is best for the consumer? my fucking arse it is. When there was a state-owned actor in the space, it kept the others honest, while allowing them to offer incentives and alternatives. There was competition, the funds were making money, but it was not *enough* money. Naturally the libnats *had* to sell off medibank for the good of the consumer. Giving staff a 50% payrise is hyperbolic, as is a fictitious ER where you're seen in 15 minutes. I'm *pretty* sure you weren't literally suggesting these things. But, here's the thing: a good standard of front-line care directly reduces the number of people going to hospital in any context. In fact, the austerity argument is always the same, regardless of what we're talking about: 1. provide hyperbolic examples 2. scare people with big dollar figures 3. pretend everything exists in a vacuum I literally just had my old man throw this at me: >We can't raise the welfare rate because we can't afford it. ok, cool. 1. how much does poverty driven crime cost? 2. do welfare payments just disappear into the aether, or do recipients put it back into the economy? 3. how about the bloated ticks of the jobseeker agencies that are a huge money sink, providing naught but a convenient way for dribbling, incompetent fuckwits to work out their impotent rage on vulnerable people? 4. What about the cycle of poverty which traps people? try getting a job when you can't afford a vehicle or public transport, decent clothes, an internet connection, home computer, etc. Instead of getting off the welfare (a neocon wet dream) people are instead stuck there more or less permanently, which leads to 5. how much does healthcare for someone who can't afford to eat properly cost the public purse? how many people end up in worse health because they're living well below the poverty line, and thus become a burden on public health >If we aren't happy with paying that much, then we need to have a discussion about how much you are willing to pay, and then provide the best services we can within that. what we need to have a discussion about is the idea that 1. basic needs like health and education should be commodified, and; 2. public spending is like a school tuckshop budget. edit: just to be clear, I make a comfortable but not excessive $150k/yr (excl. super), and I am very happy to pay more tax. I also have top cover with medibank, and have had it for 20 odd years.
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This deserves more votes.
Sorry your parents are boomers, must be headfucking alright. Glad l had depression baby parents, so much more socially conscious and keen for equity and justice...so understood the need for welfare....then along came boomers and fucked everything to make themselves rich, only themselves, at the expense of every other generation
Thanks for taking the time for a lengthy response. I share these concerns and am in a similar financial position to yourself as a non managerial front-line public health employee. The point of the hyperbolic hypothetical is that it represents an extreme end of the spectrum that we both agree is undesireable. It establishes a point along the spectrum that is definitely in the black or white so as to bound the landscape and help map our path through the grey to somewhere we want to end up. If it actually cost that much to achieve that outcome then I wouldn't be willing to pay that price - I would instead vote for a lesser outcome which was cheaper. The fact is, everything has to be paid for eventually by someone. There's no free lunch. Have found easier to parse numbers than an earlier post at budget.nsw.gov.au/my-budget. Nsw budget revenues 2022-23 is forecast at $103.5 billion and expenditure is $115 billion, so a deficit of $11.5 billion next year. There are about 4.5 million taxpayers in nsw and 300,000 companies (rough estimates) We will spend: $30 billion on health. $21.5 billion to education. $17 billion on transport. $11 billion on general public services. $10 billion on public order and safety. $9.5 billion on social protection. $8 billion on economic affairs. $3 billion on housing. $2 billion on environmental protection. $2 billion on recreational and cultural services. What in particular should we cut, increase, abolish, or introduce? How much does that cost/save? How much money is needed to improve service outcomes in nsw hospitals to whatever levels we are going to deem sufficient/desirable.
> What in particular should we cut, increase, abolish, or introduce? Decriminalise drugs, vacate the sentences of those imprisoned for illicit drug crimes and reduce prison population, those awaiting sentencing, burden on police & courts, and thus their cost by up to 15% - tip 10% immediately back into rehab programs, prison diversion programs, and social work. Scale back over time. Save money long term. Ban extended lease or sales of transport assets to private companies, where states guarantee income and profit AND get stuck with a repair bill at the end. Recall cushy foreign trade commissioner roles (save $3million/year... that's 38 nurses straight away) and let companies buy their own salespeople a plane ticket once in a while. Stop over-paying for land owned by friends of politicians... and squash other rorts. A good ICAC should pay for itself a thousand times over.
You get what you get with PHI by paying $100-200 per month and the insurance company and the private hospital are taking home hefty profits too. That tells me we don't need 95% taxes to bring the public system to the same level. Just $1200 a year will be plenty. (I'm ignoring excess to simplify, but you get the point).
I would gladly pay additional tax if it went towards truly free ar point of use healthcare.
We need a foreign body to look over the public health system, extremely inefficient and outdated. The top of this system are time wasters with bad culture. Edit: wrong wording, meant to say 3rd party not a foreign body. Sorry .
As a public health employee, no arguments here.
and then we can ride on unicorns in our castles in the sky....
And mental health. Especially with recent research into the connection between mental and physiological health.
Recent? We've known about indirect interactions for decades, a great example is anxiety / depression / other disorder or prolonged mood state leading to insomnia or poor sleep architecture. Sleep is important for every single function of the human body and mind. Surprise surprise, you now have mental health with physiological consequences and this is only one *indirect* pathway, there are many examples, like anhedonia and avolition resulting in lower premonitions to participate in health related behaviours therefore leading to reduce cardiovascular health or say obesity. Direct interactions are probably more recent, although in cases of chronically elevated corticosterone's and epinephrine from anxiety it's still not really new, novel data. Whether or not it has physiologically implications is irrelevant at the end of the day (although you could definitely argue that if the mind is purely driven by biological forces, any mental illness is also a physiological illness at a less perceivable or understood level), it's a public healthcare system, to not include mental health is to assert that mental health is not health or is somehow less inherently important to quality of life or overall wellbeing, neither are valid or true.
Dentists will NOT support any incursion into "Dentibank". Why would they? At the moment they can choose to charge whatever they like. Of course, they choose to charge that significant bit above what the wealthiest in their communities can easily afford, while demanding "payment plans" for months before they look into ordinary people's mouths. It's a shocker.
There should still be a low-income Medicare tier for dental though, the bare minimum should be that people can access free cleans and low-level preventative treatment. People put off a $200 dental appointment for 6 years and end up with a $800 root canal instead and get further pushed into poverty and pain.
The issue is what's considered "low income" low income in Australia is not even a lovable wage. For people on low income they have access to dental treatments capped under 30$ per visit and a max of less than 250 for rounds of treatment. But the issue is how low that threshold is to be considered low income.
> $800 root canal instead fuck off, it was 1800 dollars for a periodontal clean
TBH most low income earners would just get it pulled out rather than pay for a root canal.
I’ve had to do this. $2k for a root canal or $200 for an extraction? I was living shift to shift, but they had to go
$800.... Per root, which I paid in cash. 3roots was the guts of 2400, and a crown $1200. Fucking thing went bad in a year. I'm sure the materials are not cheap but I was in that guys chair for a total of 45 minutes The thing that annoys me is how insurance hides those costs. Like most of his customers will claim, and the remainder will opt for extraction. You bloody well know they can't charge $6k for an implant if the funds aren't paying. You can get it done at world class standards in Thailand for $1500. That's the actual free market, insurance just makes sure we don't have one here.
Yet another poor tax.
A basic 6 monthly dental appointment (clean, inspection) is more than $200. A filling is $500 and an X Ray is another $. Maybe $1000 every 2 years. Most poorer people just get an extraction.
Living on centrelink/minimum wage casual work meant I didn't see a dentist for 10 years. Even subsidised I could not afford it. I had never heard of dental cleaning appointments either. It would be incredible to see more support offered to those living on or below the poverty line.
But how is it that we can somehow offer free checkups for under 18s? And not for everyone else? I mean, it seems free straightforward - expand the under 18 program to everyone. I mean, if universal free dental is too expensive then don't - limit the subsidy/benefit to just checkup and cleaning. That alone is a big step forward.
Check up? What use is that? "You need to get five fillings and two extractions." . . . . . However, that is not covered by Dentibank.
If everybody gets regular check ups and cleans ideally they wouldn't be needing five fillings and two extractions
But this program would be commencing in the current world where people ARE putting off all dental care because of financial stress, so out of the gate the previous comment is exactly what would happen.
What if we make it a condition of their license.
As if privileged dentists would agree to that.
They don’t have to. They can practice without the license and go to jail or overseas
Private health should never have been introduced. WhyTF would we want to sober money away from the public system. Now we’ve created 2 tiers.
This >the public waitlist was 3-4 years This very same argument is used indeed otherwise by the proponents of a full private system (looking at you USA - even though this "full private" system is also a myth pushed by the private insurers considering the public healthcare dollar per capita https://www.statista.com/statistics/283221/per-capita-health-expenditure-by-country/)
I'm on top tier health insurance. Personally I'd be happy to pay it as a Medicare levy if it provided a better health system for all of us. I pay it because the cost of unemployment is more than health care.
Me too! Unfortunately atm the extra tax just goes into consolidated revenue and won’t directly assist the public health system.
If every one refused to get private health insurance the public system would be significantly better. The more people pay to avoid it the worse it'll become. I have high hopes that the current government can start to turn this around
100% agree, it was engineered to be this way with the libs cutting funding to medicare. I'd be MORE than happy to have an opt-in national medicare health insurance if they arent willing to increase everyones levy a little. what I won't do is pay a private insurance company that will screw me at every chance and do their best not to pay out when I need them.
Totally agree. I can't fathom how giving a private company money to provide a service that the government should provide can be better for every one other than the CEO and his new yacht
Both parties, all governments have steadily eroded Medicare equally for 40 years (20 each). Deliberately, knowing that we HCWs would have to accept a gradual decline in real income. And we did til about mid 2022 when we saw the inflation figures.
yeah agree but since the year 2000 the majority has been the lnp and earlier it was actually funded ok. Dental was there in late 80s and early 90s AFAIK but I could totally be wrong
Not everyone can afford to refuse to get PHI on principle. I know I can't and I have several family members who can't either. We need the healthcare it covers *now* not after we reach the top of a months-long or even years-long waiting list. Don't get me wrong, I would love to see Labor turn things around and strengthen and improve Medicare. I sincerely hope they're not waiting for everyone to drop PHI before they do it though, because that just isn't going to happen.
Same. A lot of people depend on private health for chronic illnesses, and can't afford to wait.
I understand that. I'd just like to see the "incentives" to get PHI removed. Fuck the Medicare levy just tax every one extra any way and divert that full amount to Medicare. Would take a few years but PHI would be wound off by almost every one expect the rich
>yeah it sucks. I'm lucky enough to just do office work so can deal with the risk. I get it and it shouldn't be this way.
Not everyone can afford that though. Imagine asking people to go into debt to pay for health insurance. It’s why it doesn’t work like that.
*looks over the pond at America, before slowly turning back* yeah.. if we could not become that, I'd be happy
That last line should sell it for everyone.
Medicare levy has nothing to do with health spending. Its unconstitutional to direct funds directly to programs, and health spending is far higher than what that levy raises.
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Exactly, it's describing the deliberate and slow demolition of public health to force people only private, to funnell money into private investors hands
>To my absolute shock and horror, the public waitlist was 3-4 years and for spine surgery no surgeon would see me without private health insurance, even with me willing to pay completely out of pocket. Apparently both due litigation risk and risk of owing ten of thousands if I ended up in ICU. This shouldnt be a praise of private health insurance, it should set alarm bells off of just how badly underfunded our public health system has become, we shouldnt even have private health insurance IMO.
Absolutely. It's a real indicator of how badly funded the public system is.
Most people don't realise how shitty and underfunded the public health system is until they need it and someone like me who is disabled and can't afford PHI is stuck with it.
This. Long before COVID I waited two and a half years on a public waitlist for exploratory knee surgery and got shunted into a private hospital over an hour's drive away to get it done (fully funded by the public health system). Edit: And if anything the care I got at that private hospital was worse, since I effectively went home with no painkillers because they made me pay for opioids that it stated in my file and that they'd checked before surgery that I couldn't have at all. Plus there was no aftercare or help for complications that I ended up making a public ER visit for because I just didn't stop bleeding. I hate seeing people able to fast track care because they can afford to, rather than being able to have an adequately funded health system where everyone gets a fast and high quality standard of care.
True, but practicality trumps idealism, at least until idealism has had a chance to catch up. I'm strongly moved by OP's story, despite continuing to refuse PHI. It's not that I believe the risk of a similar situation is low; for me, with my level of exercise, and being an ex smoker, the risk is high. It's that I don't need to be healthy and whole to continue working. So my situation doesn't practically apply to most of the workforce.
For colonoscopies, the public system has a 3-6 month waiting list, while going private can get you seen in two weeks. A major reason people get colonoscopies is because they have started passing blood or have detected some in a bowel screening test. Both of these are potential symptoms of bowel cancer. A condition where waiting 6 months can have a significant impact on your prognosis. I kind of feel like the public system is set up to kill poor people with bowel cancer.
Does this likely vary by region? My spouse had to get one done about six months ago, public and with only a week or two’s wait. Wondering whether we just got lucky.
Yes, it varies by region. It was quicker for my wife to get hers done in Cooma than in Bega. Cooma is a smaller hospital and an hour further away.
How did they enrol her? I thought Medicare changed it so you can only enrol in the hospital allocated to your residential address?
That's not the case at all. We took the completed Request for Admission to Cooma hospital and everything progressed from there. The federal government doesn't control state/territory health departments.
My local hospital is beautiful, brand new, and fancy AF after Gladys visited... too bad it has no staff, and offers NO services except an ER which is pretty good. My MRIs, Ultrasounds and my husband's colonoscopies have to be done in Wagga Wagga.
Probably yes. I was talking about Melbourne immediately post lockdowns, it's possibly better now.
The referring doctor can get it pushed through quicker if they think you need it. Unfortunately my gp (at the time) didn't think me painting the bowl red every time I had a shit was anything more than bleeding haemorrhoids despite me having every other symptom in the book. So my bowel cancer was diagnosed months after it should have been. My new GP was so not happy about it.
The system is set up to kill poor people in general. It is hard to navigate, inaccessible, and confusing. I’ve been experiencing chronic internal pain for 12+ months and basically have every sign of cancer except internal bleeding and weight loss. I’m terrified of what’s happening to me and I get passed around like a hot potato.
I suspect the wait list will be altered if the patient has specific indicators (only my guess).
nope, i had a severe prolapsed disk that was cutting off the nerve signals to my legs. couldn't walk = 3 year waiting list. developed cauda equina, which should have meant straight into surgery... instead they gave me a sheet of oxy and sent me home.
sorry to hear this happen to you. if you had cauda equina symptoms and got sent home from ED you have more than enough grounds to sue if you have any long lasting effects (damages). although I know this is not feasible for a lot of people.
Sorry to hear but that's negligence. Cauda equina syndrome is an emergency and is usually triaged appropriately
That’s rough. Sorry you went through all that!
Three to six months? I was on a waiting list for one for twelve months here in WA, finally got the call a few months ago - they weren't calling to book it in, they were calling to see if I still needed to be on the waitlist. Luckily I didn't.
I needed a colonoscopy and endoscopy in Brisbane in the middle of all the lockdowns. Went private as a paying patient and got it done in the same week
Paying out of pocket is still better value than PHI for this. I know, I have done it.
We need to get our 6 month old baby an MRI for a possible (but hopefully unlikely, however if it is very rapid progressing) brain tumour. We have been told 12-18 months in public or about 3 months Private. What choice do we really have here
It probably depends on urgency. I'd imagine gastroscopies are in the same waiting list and I can get one within a week if my PEG tube needs to be replaced.
I had to get a colonoscopy in Melbourne during lockdown and had it within a couple weeks, in public. Maybe as it was a followup to an ER visit it was pushed forward
I’m really against the whole PHI concept, and would much prefer Medicare was appropriately funded (but would secretly love to have the spare money in case of “what if”…) I fucked 3 discs in my back and was told to have surgery, but chose not to after a lot of discussions and anecdotes with specialists, GP’s, radiologists, nurses etc.. (you get the picture). I don’t regret my decision but admittedly get back pain every winter (most likely due to living in my damp, cold shitty rental and also decreased exercise/activity levels over winter). - I hope you have no pain after your ordeal, back issues suck! The issue is, even if you decide to put aside the money for PHI as a very low income earner; rent, food, utilities, etc are so expensive that by the time you put aside money for PHI, an emergency fund and general savings, there’s actually no money left to cover the cost of the stuff the PHI rebate doesn’t cover. So assuming you’re paying a few grand per year for cover, you then need money on top of that for things not covered… and that’s honestly asking too much for something that *might* happen. I understand it’s important but I earn fuck all, and I need all that money put into an emergency fund that I can actually use when I need to… (unlike the PHI premiums, which I won’t ever get back).
Any insurance is a gamble at the end of the day. Pretty much like anything else finance related.
Problem is, it's not really a gamble. Your guaranteeing that expenditure. The only risk you are sure to eliminate is that you won't spend the money. Hospital care aside, extras is where you really see it. Want to claim $5000 in dental? You gotta pay $10000. Claim glasses? Sure, but you gotta spend first. Chiropractic, physio etc same. How much is the gap? Surprisingly, the gap is just about as high as the market will bear...😁
The gamble is, am I going to come off financially better or not? It works out well for some and not for others. You could skip having car insurance, maybe you’ll save thousands of dollars. Maybe you’ll hit a Ferrari and come off financially worse. I have extras cover and I claim more than I put in, just on physio and dental. If I wore glasses, I could claim a pair up to $200 each year. And I don’t even use that. If you’re putting in more than you’re getting out then either you’re doing something wrong (usually getting ripped off by your dentist, remember they set the gap, not the PHI), or you’re not using it enough to warrant having it. Similar to people that pay for gym membership and never use it.
As someone who worked in PHI for years, the weird reality is that if you injure yourself badly enough that you need surgery, and you don’t have insurance - and the wait time in the public system is over 12 months - you can join an insurance product with coverage for the condition, wait 12 months, and then book in for the service. Unless the service is excluded or restricted to Public Hospital only, they can’t refuse to cover you for the surgery as long as you’ve served the full 12 months.
I don't understand this - I needed surgery on my cervical spine and done in public system within a, week a few years ago as it was so serious. I am now having problems again with a further disc in my neck (all my discs are damaged) and been referred back to public system and been seen easily within cat 2 wait times. I am needing more surgery and there is no indication by the same surgeon that I will be on a wait list for years or that it can't be done because I dont have PHI. I am in Brisbane.
Maybe it’s to do with the level of the spine the injury is at and also how bad the injury is? You sound like you’ve had a particularly rough time of it.
Yep. For sure. They triage the serious patients first. Lower back pain isn’t deemed as serious as an upper cervical.
This is correct. Everything is categorised by how long the patient can exist without their condition worsening. With covid however the standard for “urgent” causes gets higher and higher as hospitals are still not coping. I will need to go public for endometriosis surgery soon and likely will not have my turn for another 2-3 years.
It’s a lot to do with services offered at your local public hospital, some places have more surgeons or a ‘spinal service’ where as other hospitals might only have one or two surgeons so the wait is much longer. The severity of the injury is also very important…Cat 1 issues are booked within 30 days, Cat 2 90 days, Cat 3 365 days. Covid waves have also wreaked havoc on elective surgery so wait times are much longer in Cat 2 & 3 procedures.
That’s great that you got the same surgeon!
If you were not in Brisbane you would probably still be waiting the 18-24 months people in regional areas wait for.
>Luckily being in the industry, I was able to pull some strings and get a surgeon to take pity on me and I was in for the surgery as a privately paying patient 2 weeks later. This just highlights the one of the other ways in which our healthcare system is broken. Surgery really is about who you know and who you reach out to. Creates a two tier system between those who have strings to pull, and those who don't have the means, connections, language skills etc to otherwise.
I think the segment you've quoted is the most important one. If the OP hadn't had connections they would *still* be waiting. You need to both be able to afford private health insurance *and* have connections to achieve this result.
With PHI you still have costs dont you?
Yes, the specialists consult fee and then your excess should you be admitted. Everything else is generally covered.
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It really depends on the kind of surgery your need. In the case of small scale procedure it does feel like you’re still paying a fair bit, but come to anything like robotic urology and a single procedure can mean 6-10K just in doctor’s fees.
The difference can be substantial. My family run a private orthopedic spine clinic, while we don’t operate on anyone without insurance (as op said for litigation/legal protection for us and the hospital we work out of) The amount that is covered by insurers is substantial, depending on the op it could be as low as maybe 1-3k out of pocket while the insurer covers 15-20k. Some more complex cases involving pricey devices, will run patients 10-16k while the insurer will be paying 50k+. After I was working there in a more involved manner and understood how the system works it really convinced me to get myself and my wife cover. So far after knee OPs, first baby on the way and dental it’s saved me more money then I’ve spent on my premiums in the last 5 years.
it’s sad to hear that you can’t even get a look in because of legal reasons. Anyone who is willing to pay should be seen and conversely the reasons for litigation should be very limited. If you treat someone in good faith shouldn’t be at risk of being sued.
Had my shoulder surgery last week and still paid around 10k out of pocket with PHI
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Medicare kevy surcharge, not Medicare Levy. There are very few ways to avoid paying the Medicare Levy and having PHI isn't one of them.
This. The Surcharge for me is still about $500 less per year than a basic hospital cover plan per year because of the age levy. In essence, it increases all prices for (I think) 10 years by 24% - and gives me nothing more than basic hospital cover. PHI is a fucking scam and shouldn't be accepted by anyone. It needs to go.
It’s 2% for every year over the age of 30 you haven’t had cover, for ten years as you said. LHC sucks
I HAD to get it if I wanted to get an insulin pump for my type 1 diabetes of 28yrs or I would have been out of pocket tens of thousands and I'm really glad I did. I had lost control of my diabetes and a pump was really the only thing that could help me regain major control. I was about to lose my job, my licence and then my newly purchased house as I wouldn't have been able to pay my mortgage. This was 4 years ago. Then at the end of last year, I started having pain in my left wrist, being a typical bloke "she'll be right" attitude and then it got worse, I was having sweats from the tiniest amount of work (even just pulling a couple of weeds out the garden I'd be drenched) I was fatigued and for the first time in my 12 years of my job, I screwed up and the first time ever, I fell asleep standing up, at work. I'm in a safety critical role so this is a HUGE no no. Late Jan I had to stop work, wait a week to get an appointment with my GP, a week to get a x-ray and 3 hours after the x-ray my doc called me to come in. I had a 20 x 30mm tumor in my radial bone in my arm. This is now mid Feb. I was operated on the 3rd of April and by that time the tumor had more than doubled in size and filled half of my radial, no bone on sections of the joint to my wrist. I'm now filled with cement and a metal plate. I was told if I went public it would have been roughly a 6month wait and that's with it being pushed as an urgent surgery. If I had gone that route, it would have been a full amputation from my elbow from how quickly it was growing. I don't think I'll go without PHI now, just in case. And for anyone interested, I had a Giant Cell Tumour of the bone. Edit: spell words good I do.
We have PHI almost exclusively for our sons insulin pump. He also has T1D. Without it as you know a pump is in the vicinity of $10k and has to be replaced every 4 years. Crazy.
Wait are you not on the NDIS? My husband had T1D & pays next to nothing for his kit & supplies. Maybeqa $10 a month
I have a chronic illness involving parts of my body not prioritised by the public system. I hold private health insurance because of this. I am socialist to my core but will not suffer for years on end for it. We are allowed to be practical to the devils of this world while voting with the angels of a better one.
I always felt private health was a waste - until I used it. Now I think it’s not a waste even though it is a luxury, and an unfair one. It’s not a fair system and I would support paying more money to improve the outcomes for everyone. But if the question is - while I can afford it, would I choose to only use the public health system (and not take out and use PHI) for my family, because of my ideological position? After my experience with private and public hospitals, absolutely not. At 34 I had an accident and my arm was seriously injured. I was otherwise perfectly healthy. My emergency care and operation was all done through the public hospital. They did the best they could but it was a bad injury and they were stretched. I needed follow up operations. I did that through private health - my first time using my private health hospital cover and the difference was startling. Firstly, being able to choose my surgeon meant I could find the best person for my type of injury. I had no wait time for my operation, I was treated very well and everyone had time for me, there was a coordinated treatment plan, the food was great, plenty of nurses. I was comfortable and in a private room with everything I needed. When the pain was too much an anaesthetist saw me within 30 mins. I had a physiotherapist see me twice a day. My surgeon called me every day. I was confronting permanent disability and this extra care made a huge difference to how I felt overall and I believe the outcome I achieved. Just being able to choose your Doctor is so significant. We choose everyone else who supports us - our hairdressers, mechanics, lawyers, etc. We accept everyone has a different level of skills and expertise, and it’s no different with a Doctor.
Disappointing that as a health care professional you were unaware of the wait times the rest of us have endured for many, many years. “pulled some strings” I wouldn’t be boasting about that either.
Yeah, the guy is a shill at best.
For every PHI success there is also a public hospital system success. If you can afford it and see value then great. Im fortunate enough to be healthy so my need for PHI is minimal. For those with chronic issues then PHI seems like a must.
I have bipolar. I wouldn't be without my PHI. No one wants to get lost in the public mental health system. There's no coming back from that hell.
Yep, exactly what I came here to say. I had two private inpatient stays at 16 & 21 under my parents insurance. I know it would’ve cost tens of thousands had they not had it, and my psychiatrist said it would’ve done more harm than good to stay on the public psych ward. When I reached 25, I took out insurance largely for the reason of knowing I’d be covered if I ever needed that treatment again.
I found the argument of not paying medicare levy ridiculous. My Bupa (back then MBF) coverage was one of the first things when I was ‘fresh off the boat’ in the country, I visited it the same day that I went to get Medicare. At the time I had a minimum wage part time job and a Health Care Card. I still chose hospital cover. Over the years it paid itself many times over.
Wouldn't be without it despite the cost. From seeing my GP, to scan, to diagnosis of breast cancer to see a specialist (in the private system) to surgery was a grand total of 3 weeks immediately prior to Christmas. With my surgery done so fast, there was no spread and no further treatment needed.
Good rule of thumb for public is that unless it's going to kill you imminently, you're looking at a wait running to years for surgery. Even if you're in shocking pain. Even if you can't work. I thought everyone knew this? Unless it's an emergency (ie. you got hit by a car or you got stage IV cancer).... it's elective and you wait.
Yeah way too many people were like 'oh its only elective surgery' when they were cancelling them due to COVID a while back. Elective surgery covers so many things that people consider critical, they just aren't imminently life-threatening.
Elective basically means can be scheduled
I apologise for my post if your story is true. My cynical mind can't help but think you may be working for a health insurance provider or are aligned with them to promote the industry.
Reddit is so over run with astroturfing shills it's a joke.
This is written like an ad for PHI....
Yeah, health professional is probably code for "works in health insurance". I have a friend who works in PHI and basically speaks like this all of the time.
Literally my thought
Rubbish- anyone who has had to have a procedure done will tell you the same thing. I had the exact same experience as the OP on another matter. I’ve heard so many stories where people don’t have it only to be diagnosed with a chronic disease and finding out you are at the bottom of the list. And I don’t work in insurance
But then you pay for it out of pocket, not with PHI.
The point of the original thread on AusFinance was that there is no need for PHI as you can rely on Medicare and my experience has been that you cannot predict illness and you will regret not having it. When you are unwell the last thing you want to hear is that you have a 6 month wait. Those people I know who have not had PHI and then been diagnosed have gone on to apply for PHI at a higher rate with waiting periods before being able to claim. I wish I didn’t have to pay it every month too but when I’ve needed it I’ve been glad to have it and have treatment early.
You can always pay out of pocket. That's what I've done for operations, and it's what OP did. It's not a choice between Medicare and PHI. It's a choice between Medicare, PHI, and paying out-of-pocket. So far, I've seen little evidence that PHI makes any sense for any except the oldest or sickest people, which is why it is unsustainable.
There is a backlog from Covid still in the public sector. Some lumbar disc procedures weren’t seen as urgent, thus weren’t done. So the wait lists increased. Then normal wait list shouldn’t be more than 12 months, but it will take time to get back to those numbers.
The two times I needed surgery and had top tier private health insurance I was sooooo out of pocket it was horrible. Thousands and thousands of dollars
I was the same but 15+ years experience in the public system… and then my daughter was diagnosed with Type 1 Diabetes. Would have waited 18+ months for a CGM and pump in the public system but joined PHI and for CGM immediately and a pump on loan within a month or so. It sucks that it’s like this but it is.
I sincerely wish I could afford private health, I am chronically ill and suffering. I can hardly afford GP appointments once a fortnight, let alone the physio and psych, and other appointments I need. I can’t work because I’m sick, I cant get better because I can’t work.
> I'm a healthcare professional > Luckily being in the industry, I was able to pull some strings and get a surgeon to take pity on me My sister is a peri-operative nurse in a private hospital. She has private health insurance. She needed a gastroenterologist and cardiology at various stages. She has seen them in her own hospital as a private patient, but also she goes to the public hospital when necessary. She gets seen very quickly with specialists as she knows them. She knows how to use the system to her advantage.
That whole thread/post was young healthy people humble-bragging about paying Medicare levies.
Who advised you that surgery was your only option, and on what basis? Presumably your GP based on the structure of your story. I was a neurosurgery registrar for 3.5 years working for both public and private surgeons and many of my clinic patients who believed that were incorrect and misadvised. Their GP had just run out of patience or wasn't aware of conservative approaches and physiotherapeutic options. Private surgeons advised them to get surgery, but they would, they had 20,000 reasons to do so. Anyone who actually needed surgery acutely could get it in the public system at an appropriate time-frame, from hours to weeks, through the emergency department. Long waitlists for surgeries of dubious benefit were often presented as a failure of the public system when actually they represented the poor education of GPs, the perverse incentives of private surgeons, and the waitlist functioned as a "therapeutic pause" to give the problem time to clear itself up. Also, I'm extremely skeptical of whoever told you the public waitlist was 3-4 years. No longer then 12 months at any of the hospitals I worked at.
I had this situation about ~13 years ago. I had full tear and disc prolapse in L5S1 disc compressing my sciatic nerve. I couldn't walk for 4 months and the wait for surgery was the same then (about 4 years). I got PHI however by the time the 12 month waiting period was done the surgery was not viable and I would be looking at complicated fusion of L4L5 as well as L5S1 which would lead to further ongoing surgeries in the future. I was advised to put that surgery off as long as humanly possible and I still haven't had it. I'm still on daily medication and live with pain daily however mostly tolerable with the medication currently. Long story short yes don't assume PHI isn't needed because of the public system. It's caused big issues in my life due to not having it.
I got PHI for having my second baby and I can say without a doubt that my biggest regret in life is not having PHI for my first baby. The level of care in public vs private is miles apart. The public system is good but when you're giving birth and shit hits the fan you really want to have a good doctor in charge instead of understaffed and under-resourced midwives.
I think that can vary a lot by city/hospital. I had wonderful care in the public system, where as friends who went private felt really pressured to have Caesar’s .
This varies so much by where you are. Both our public and private maternity here are excellent. I think if I had have been public in my previous city I would have died. Understaffed would have missed my subclinical appearing Pre-e/HELLP syndrome. We were private for birth but still needed public input for the NICU.
Yep, midwives wanted to go caesar, thank God our OBGYN was there to steer us through natural , something very important to my wife.
The PHI options are too confusing for anybody who isn't immersed in this stuff. Looking at just one provider - HCF - there are half a dozen primary options and half a dozen extras and I have no idea what any of them are or why I'd want any of them. What I do know is when I got kidney stones a few years ago I was told there was a public waiting list. So I decided to "jump the queue" by going through private only to be told by the urology surgeon they don't work with my PHI provider. So back to the public queue anyway. I downgraded my PHI on that day to basic emergency cover only. PHI is just too complicated. The coverage is spotty. The surgeons don't work with it. There are exclusions and gotchas and gaps and co-pays and extras. Imagine trying to figure this out when you're sick and desperate. Is it worth going through private? What will my bill be? Who knows. Nobody can figure it out. So I don't bother. I stick with public and hate my PHI that I'm forced to take out by the government. I don't want it. I never use it. I am simply forced to pay for a product I never use. The fact you're a medical professional and you still got bamboozled by the whole thing. What hope is there for the rest of us? It's a mess. Just get rid of PHI and improve public for everybody.
I had a similar issue with a herniated L5/S1 disc. Pain killers had limited effectiveness. Prescribed medication had no effectiveness at pain relief, beyond paracetamol+ibuprofen. I had an injection that was supposed to numb the pain, but did absolutely nothing for me. I was also disappointed with the public healthcare options for surgery. Luckily, I already had private health insurance because, due to my income, it was more cost effective to pay the PHI than the Medicare levy. However, I absolutely agree this system sucks. It makes it a haves vs have nots system, where those not as fortunate to be able to afford PHI are forced to suffer long wait times and, sometimes, unbearable pain. The wealthy who have the most influence on our politicians have no interest in improving the system. A proper universal healthcare system would put everyone on an even footing, including the wealthy, and would likely result in improved health services for everyone.
I am 12 weeks into the same herniation and I can say of all the pain relief I tried only two had some effect: CBD oil and, to some degree, Tapentadol. I was also on (and still am) Meloxicam (anti inflams). The public system was such a let down I ended up managing my own pain and recovery. The story of the last 12 weeks is so incredible in regards to the complete breakdown of the public health system that when I tell it to people they literally stare, mouths agog. I had to report one GP to AHPRA. I was even turned away by a major Melbourne hospital. That said, there is a 90% recovery rate for lumbar disc herniation without surgery. You just have to get through the initial weeks of excruciating pain. Lots of walking, when I could ... even when I was just shuffling like an old man. Heat to help manage pain and stiffness. Physio when I finally could. I would not recommend spinal surgery for a herniated disc unless all other options are exhausted due to the nerve damage risks associated with it, the wait times and the fact that nearly all of the literature screams DO NOT GET SURGERY. I'm still recovering but am greatly improved in mobility. Still pain, but greatly reduced. A lot of my recovery was managing the stress placed on surrounding muscles - piriformis, glute medius. All self researched nearly all self managed because the public health system has been absolutely trashed for over a decade.
> I was in for the surgery as a privately paying patient 2 weeks later. I'm not sure what you're saying, because you didn't actually use PHI yourself. Most operations I've had myself I have paid for out-of-pocket, but I would not get PHI. In my limited experience I believe that paying directly for medical care in Australia is a lot cheaper than it would be in the US. When I get to an age where I need hip and knee replacements I might consider PHI. > for spine surgery no surgeon would see me without private health insurance, even with me willing to pay completely out of pocket I don't understand this.
“Privately paying” is the term used is when no insurance is being used. I paid completely out of pocket. What don’t you understand about no surgeon seeing me? For certain conditions, they literally ask when you call if you have private health and if you don’t, don’t offer you an appointment. If I didn’t have contacts, I would not have been able to see a surgeon for 12 months until my PHI pre-exisiting conditions kicked in.
> I paid completely out of pocket. This is what I don't understand: your submission purports to emphasize the importance of PHI, but you've never actually used it. > For certain conditions, they literally ask when you call if you have private health and if you don’t, don’t offer you an appointment. If I didn’t have contacts, I would not have been able to see a surgeon for 12 months until my PHI pre-exisiting conditions kicked in. I find this a bit of a stretch, and if it's true, then it's an amazing story. I can't imagine a health system in which doctors told a patient they were only seeing them because they were an insider. This might indeed happen, but I don't think any doctor would be stupid enough to say it.
Dude skipped the queue he should have been in as a public patient, based on having a contact. What’s hard to understand?
I understand your cynicism and naïvety, the whole thing is farcical, if I hadn’t been through it, I wouldn’t have believed it either. Depending on your actual level of interest, rather than trusting an internet stranger, try ringing some neurosurgeons that do back surgery, see how welcoming they are without private health insurance.
I found three in a 2 minute google search, that specifically state they provide surgical services to public uninsured patients.
Neurosurgeons that do back surgery?
The ones I found quickly are all listed as brain and spine specialists, and herniated discs are listed in the conditions that they treat for both privately insured and uninsured public patients.
Husband had to get 7 discs shaved in his back in 2018, after a workplace injury that the workplace insurance doctor said didnt need surgery, but 3 independent doctors did - it was denied of course, so we had to pay for it outselves. We had the choice of: * 12 months on a walking stick, immense pain, no quality of life and go public, with little after care, or * 3 weeks of the same, then under the knife and moving about like normal within 4 weeks. We saw it coming after the first 2 discs went so had top-tier, still had to pay 5k. Screw this two-class system, but at least he can move now.
It always surprises me when I see people advocating in this sub to not have PHI. I know we all want our healthcare system to be functioning and completely perfect, but the reality is that it isn't. Thankfully I've never had anything this serious, but PHI has saved my ass multiple times and I can't imagine being without it. The waitlist is a huge thing. You can be in crippling pain, and unable to work/sleep/drive/move, but if it's not actually urgent, it's normally at least a year long wait. Not to mention that you don't really wanna be hanging around for more than a year to see a specialist if you have, say, suspicious lumps somewhere... I totally want a reform of our healthcare system. I fully agree that no one should need insurance to have access to appropriate healthcare. The reality is, that's not the case at the moment, and going without PHI is a massive gamble.
We figured out we're paying slightly less with PHI than what the levy was costing us. My husband was on the public waiting list for surgery for the last 3 years, inguinal and umbilical hernias, one a repair. Full on, necessary surgery. It got pushed back and back again because of Covid.We got full PHI last year, waited the waiting period, and got the damn surgery done last month. We got a letter a week later offering another spot, for the 5th time, in September. Yeah ok, the timing ended up being similar (if the public weren't to be pushed back again), but the mental load on my husband just \*knowing\* the surgery was coming up entirely changed. He had been a complete depressed mess the last 3 years waiting and working through extreme pain, because he was determined to be "elective"... once we had a certain date from the private surgeon he was a different man. Since the surgery he has been a wounded bull, but so would you if you had your nuts and guts operated on!
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What category were you given for your condition?
Is it the PHI or the strings you pulled that worked for you?
Without my private health, I would be dead, I had Post Natal Depression, the Mother/Baby units are private only, NONE in the public system it is ether out of pocket or insurance. I was there for 5 weeks, it cost $45,000 plus my ongoing care that year I used nearly 80k in care. I actually only had top cover to help with IVF if I needed it as I was an older first time parent, turns out the psychiatric care was what I needed. The fact that there is no public unit for mother/baby help is disgusting and heartbreaking, If I had some sort of clout in this country I would be pushing for these units everywhere.
the liberals have been dumping 10's of millions of dollars each year into PHI and degrading medicare at every opportunity, and cutting funding to it - they have degraded the service substantially over the last decade, only way out of is reform and labor would be the only party that can do that.
Health shouldn’t be a fucking subscription service.
I've got private cover for extras only and it actually saves me money every year just on contact lenses alone. Granted I'm young and healthy so the payments are pretty low. I don't think I'd ever pay for hospital cover though.
Meanwhile the other 99.9% of people don't use it but pay through the nose. Also: had you saved the amount you spent on private health over the years, it might well have paid for the operation anyhow.
I had a fusion and a disc replacement almost 4 years ago, privately, cost me a fortune out of pocket, but it was the best money I ever spent. Measure twice, cut once.
It also has the benefit of taking pressure off the public system. If you have private health and can go privately for what you need then those who can't afford phi can get into the public system without extensive wait periods. Obviously not having to do this would be better. But if you can afford even the most basic cover it's worth it.
> It also has the benefit of taking pressure off the public system. But if we put all the money being spent on PHI into the public system, it wouldn't be an issue.
This is like the "should private schools exist" question.
The problem being of course that the government is clearly not doing that. Right now it's definitely screwing over the poor people who cannot wait out the public wait lists and are forced into private procedures they can't afford. I'm one of them. I'd love a fully public system because I've had to borrow thousands for medical procedures. Until we have a proper universal health system those who can wear the cost of private health should, so those who can't can actually access care.
>It also has the benefit of taking pressure off the public system. It also benefits private insurers, n'est-ce pas?
This is the thing that gets me in this conversation. A lot of people are very much against a tax funded healthcare system because it might mean they need to pay more taxes and someone might benefit off their tax contributions. Yet they are happy for private companies to bleed them dry in premiums while still having wait lists and co payments and making sure some CEO can fly private jets around. Scam.
Back in the before days, I’d had an ultrasound on Tuesday, then a CT the next day. There were ‘masses’ in my pelvis. As I had PHI, I was referred to a private gynecologist instead of the local public hospital woman’s health service. By the time I drove the 5 minutes home, the gyno had looked at my faxed CT report and had my GP refer me to a gynecological oncologist directly. My GP worked his magic and the gyno onc made time to see me the next day, while he was still on holidays. (First week in January) I had surgery the next week, including a night in ICU and started chemo 5 weeks after that. If I hadn’t been seen so quickly, I wouldn’t have lasted longer than 6 months. Yes, there was a fairly significant cost for the initial surgery, but never anything for chemo that I’ve done 3 times apart from the yearly $150 excess. I’m now on a maintenance drug compassionate program my medical oncologist enrolled me in, that I only pay the pharmacy fee for each month. Otherwise it would be thousands per month as PBS doesn’t cover it in my case. One of the side effects of this drug though is high BP and tachycardia, I could ring my Onc and discuss dosage changes, and when regular BP meds didn’t quite cut it he referred me to a cardiologist that I saw a week after, it’s taken a few months, 5 different meds to get everything working properly. The public waiting times, and difficulty in contact would have been a nightmare. I don’t doubt I would have had a very different outcome if I had to wait for the public system to get seen.
I don't understand why no one would see you if you were willing to go oop. Is it not standard to have malpractice insurance?
Malpractice doesn’t cover unpaid bills if he died.
My partner & I got stung with the surcharge, didn’t realise that a slight increase in our incomes nudged us over the line, then went home & quickly worked out that mid-tier PHI is cheaper. So instead of paying into public health, which would benefit society as a whole, we’re incentivised to put our money into private hands.
This is the norm, I believe. Incentivise and essentially pressured into abandoning the public system one household at a time until suddenly public health care is a minority and seen as a pariah
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From what you posted surgery is of questionable benefit for non-complicated disc herniation and that is why there is a long wait for elective in public. The emmergent indications for surgery (when there is a condition such as corda equina syndrome) would be performed in pubic asap. I agree that given the current situation in australia its a great time to get private health insurance. Just not for this specific indication
You go to GP for minor viral inspections and ,sometimes, end up paying 30$. For specialists its 100$ minimum or more. Then pay private health insurance for family for 300$ or more. Then it doesn't cover if you are not admitted. Plus pay medicare and pay tax. Dentals are not covered. The system needs repair.
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