Do You Really Need Private Health Insurance?

congo on 13/06/2015 - 10:18
Last edited 15/06/2015 - 16:24 by 1 other user

Hi all,

Most people have joined Private health insurance to avoid the Medicare Levy Surcharge.
However if you are low income or you have a Medicare levy exemption, is paying $3.5K per year (for family) for Private health insurance worth it?
Or is there better alternatives?

For example, if you have an unexpected injured or become seriously ill, would you just go straight to the hospital (public) emergency?
Or if you have an planned operation, would the cost of the operation be equivalent to paying for the Private health insurance premiums for a couple of years?
Does this suggest that Private health insurance is only beneficial for those who have serious illness?

I currently have Private health insurance but question the need to have one going fourth.
Also would like to know if there are any other better alternatives available, eg. Smile dental plan.

Thanks.

Financial

Comments

  • ilikeradiohead on 14/06/2015 - 12:26
    +10

    TL;DR Get it if you earn over 90k, under that it you'll have to decide whether you want to wait for surgery.

    The main benefit of private health insurance is that you will get things faster. The public system rations out care, so if you needed a knee operation, you might need to wait 2 or 3 years because the public system will only provide so many operations a year, which is fewer than people need it. There are also things like glasses, dental, that sort of thing, which is generally not provided by the public system (except for people with the lowest incomes).

    In the case of a car accident and the like there is no benefit to having private health insurance as all 'life saving' operations are done by the public system, the private system only covers non-life threatening operations.

    If you earn above the cut off for the medicare levy surcharge, it is probably in your interest to get private health insurance as the tax is across your entire income, not just your marginal income, and the marginal cost (the difference between the insurance and the tax paid) will probably be much less than the value you derive from the cover.

    Also, not quite related to your question but some people seem misinformed, hospital cover is provided by State Governments, not Medicare, which is provided by the Commonwealth Government. GPs receive their subsidies directly from the Commonwealth, whereas State Health Departments are run by the States (although the Commonwealth does provide some money directly to State Health Departments), so you can get very different levels of hospital services depending on which State you're in. I think WA has a somewhat 'gold-plated' service, which is on the higher level of 'care' for patients, but also very expensive. #boomtown

    • congo on 14/06/2015 - 13:21

      Good point that hospital services comes from the State, not Commonwealth.
      Hence some States may have it better than others.
      I have heard that Canberra has pretty good level of service.

    • Hoju on 14/06/2015 - 14:19

      i don't know exactly how it works but if you look at a patients admission documentation in nsw it has a funding section that either says Medicare or private fund (or dva, and there may be more)

  • gimli on 14/06/2015 - 13:49

    just suggesting

    • congo on 14/06/2015 - 14:13
      +2

      What is quakeling?

      • gimli on 14/06/2015 - 17:22

        A small one

  • bambooculm on 14/06/2015 - 14:01
    +5

    I have a medical file the size of "Gone With The Wind" and only have extras cover with Medibank Private for optical, dental etc. Everything else is done on Medicare alone. I live in Sydney and my last elective surgery only had a three month wait. If you are earning less than 90000 a year, just have Medicare and extras cover. I live with some chronic serious illnesses, and have survived three cancer operations, all on Medicare. I love Medicare. A good specialist can get you onto a shorter waiting list. If you have a serious or urgent problem, then go directly to a hospital. For anyone on a fairly low income, private health insurance beyond basic extras is crazy. You are flagged as a private patient, and everything is counted and added to the bill. A lot of the talk about elective surgery waiting lists is garbage and scare tactics. Some of the freedom of choice scare stories are also garbage. If you have a cardiac arrest, you will be attended to by any doctor available. Your doctor of choice may be playing golf. Also, your doctor of choice may be on his way to his car while others close you up and tidy up.

    • congo on 14/06/2015 - 14:19
      +2

      Sorry to hear this…
      My brother loss his kidneys through illness and he lives of Medicare. I don't think private health insurance does much for him.

    • mskeggs on 14/06/2015 - 22:07
      +4

      I'm really pleased to hear this (well, not that you are unwell!).
      I hope the public medical system continues to treat you expeditiously when you have serious problems, and reasonably promptly otherwise. Good luck.

  • Qlander on 14/06/2015 - 15:43
    +2

    We are a family of three and every month I put away $200 into a savings account instead of getting a private insurance. Account now has $5000 but this month we both turned 31 and got a letter from Medicare about the extra loading of 2% and have been thinking should we get a private cover or not. It's the little one that makes me think twice. I have till the end of the month to decide however as of now I'm going to continue putting money away into savings account.

    • mrsgruffy on 14/06/2015 - 16:49
      +4

      I decided to go private for my son's surgery to put tubes in his ears when he was 2. We'd waited 6 months by then on the public list and he was really suffering in his speech development. We took a personal loan. It was day surgery in a private hospital, and all up, the cost was $5000. He's 21 now, and that was a lot of money 20 odd years ago. That was a very minor surgery, so you might want to do your homework and consider how much it would cost you to get care for a multiple day stay in a private hospital. It's really expensive, and there are a lot of ancillary expenses you also have to pay for privately when you elect to go private, like the pathology, any drugs given, etc. If we'd waited for his name to come up on the list, and I left him on the waiting list out of curiousity, he would have been 6 years old when he got the surgery. I can't imagine how behind he would have been in his speech development at that point. Because it was ENT surgery, and the list was continually postponed by urgent head and neck cancer surgeries, you can't really argue. Being deaf isn't going to kill you, but it sure can change your whole of life quality.

      • bargainhunter_dande on 15/06/2015 - 14:32
        +2

        Had the same issue with my child. Waited more than 5+ years on public list(Monash)

  • kyttiekat on 14/06/2015 - 17:47
    +6

    I've always used my own savings to pay for items. That said, I've had Extras cover only as I use all the physio / psych / dietetics / dental in a year.

    A few years ago I waited 14 months for knee surgery via Medicare. When the call finally came, it was because someone else had just cancelled, so the surgery would be in 2 days time (yikes!) with a 12-14 week recovery, plus time off work/uni etc. I asked for an hour or two to consider the offer (eg to call family members and see what they thought!), but I was informed I'd have to give my response right on the spot or they'll call the next person on the list. So I said yes. Talk about short notice! I had to drop everything in life.

    This year, I was advised I needed it urgently (but not urgent enough to fit into the next category of urgency, apparently) and the wait is typically another 12 months. It's already been 5 months and my knee condition has worsened considerably, including osteoarthritis etc. This is the only time I've desperately wished I had private hospital cover.

    To avoid going through the same dramas again, I've signed up for hospital cover now. However it's a 12 month waiting period for pre-existing conditions… so it likely won't help me right now anyhow.

    Just something to think about - that elective surgeries can have awfully long wait times, very short notice periods and no flexibility in scheduling your own date, and your condition can worsen in the meantime.

    From a reformed private-hospital-cover-disliker. :)

  • DarkOz on 14/06/2015 - 18:59
    +4

    Both my parents have chronic illness which requires special treatments each year that costs thousands. We pay $4,000 a year for their health cover which is well worth it.

    On my own family side we entered into a health cover 6 years ago because we were expecting children. Besides getting a better hospital bed it was also a precaution for the newborns. Now that the children side is settled(besides the non-life threatening allergies) and we are rather healthy we have downgraded the cover to optionals (dental, optical…). The difference is $2,500 compared to $800.

    My advice is you don't need hospital cover unless you are a high income earner that pays the Medicare levy surcharge or/and you are expecting private hospital treatments/surgeries that costs thousands each year. The Medicare system is sufficient for any healthy person.

    • sal78 on 15/06/2015 - 00:43

      this is what we did too.We have highest level extras only but the premium is $100 a math I think and we claim more than what we pay each year. There's $250 pp optical and we have 2 adults and 3 kids and claim that for all 5 as well as remedial services. Need our massages! and no gap dental. So much better service to go to the good dental clinics. Ours give serve home baked muffins kids get a bag of goodies each visit etc the braces will be the big one and we get $2800 pp.

      my mum has no phi. she has received amazing treatment for breast cancer and she is spending at least 8 weeks in a private hospital from a fall. she's receiving amazing care, private room and they take her to chemo each week. she gets rehab and physio. this i suppose is what all our hard earned taxes pay for and it finally feels a little justified. i would be happy with this level of care.

      it depends on your situation. we had top hospital for ovf and obstetrics. saved thousands and loved the private hospital so much.

  • pitiek on 14/06/2015 - 19:20

    Any suggestion on private health provider with good rate for family basic extras cover?
    looking at remedial massage, prescription glasses and dental mainly…

    Thanks..

    • momov3 on 14/06/2015 - 19:41

      I'm going to suggest Bupa, just because the premium I pay yearly ($720+) which covers 4 extras of our choice, pays for itself by the time I visit the dentist 2wice in a year. And this is only 1 out of the 5 in the family who make claims at the dentist, and 1 out of the four services we are entitled to. There are other claims we make on optometry, major dental, and many many services classified under Remedial. Everyone I know who take out extras cover seems to say the premium pays for itself many times over by the time you utilise the services. There may be other just as good as I am only suggesting the one I know.

      • SlickMick on 15/06/2015 - 11:13

        This wouldn't allow me to escape the medicare surcharge would it??
        I'm sure there's no cover for $720 that is acceptable to ATO??
        (But I haven't bothered to check in years. Are the prices coming down??)

        • congo on 15/06/2015 - 11:58

          To escape the MLS you need Hospital cover.
          Extra cover doesn't count.

        • y on 15/06/2015 - 13:31
          +1

          Bupa Active Saver (the cheapest one I could find) costs about $900 for me (34 yrold male) and includes hospital cover and is enough to avoid medicare levy surcharge.

        • congo on 16/06/2015 - 12:10

          @y: Thanks, will check their policy out.

  • momov3 on 14/06/2015 - 19:22

    I can never understand why private health patients who get admitted into public hospitals as private, get treated 'differently' and get slugged a massive gap fee unless they elect to go in on public system like the rest! Seems like a punitive thing considering they have paid thousands in premiums! In the end, so many elect to be admitted as public patients anyway (on the Medicare purse) in order not to have to pay gap fees.

    • nikey2k27 on 15/06/2015 - 06:36

      You can go private in public hospital

      • momov3 on 16/06/2015 - 13:23
        +1

        Then you're up for gap fees right just because you chose to be admitted as Private? Unless the insurers promise 'no gap' absolutely

    • Melburnian on 15/06/2015 - 20:27

      There shouldn't be any gap fees for privately insured patients being admitted as private patients in public hospitals. At least, there never has been at any of the Victorian hospitals I've encountered. The incentives should be aligned so that people use their private cover even if they're admitted in a public hospital, so that the public system gets more money, without costing the patient any extra.

  • Aust on 14/06/2015 - 19:28
    +8

    As a family with mental illness conditions we will never opt out of PHI.
    The financial year payment summary from medibank for 13-14 for 56 days in metal health wards in a private hospital was $64,000.
    We took on board advice of the public hospital ward staff "please do not use a public hospital for any loved one with a mental illness".

  • BeauKilla on 14/06/2015 - 19:46
    +6

    when my wife had our baby with the public Medicare system it only cost us about $25 for some medication when she left hospital and we had outstanding care throughout the 5 days she was there. whereas a friend of ours had their baby at a private hospital, got shipped out asap and the whole experience cost them approx $10,000. we are in a similar financial situation and I can't imagine coping with that sort of cost just for "piece of mind" thinking that paying more will give your baby a better start in life when it's absolutely not the case.

    • momov3 on 14/06/2015 - 20:04

      yes, the only reason for taking out private cover is the shorter waiting time for elective surgery. It is also the GP who mentions in the referral how urgently this elective surgery is needed. Depending on what is said, you could be waiting 6 months only and not 2 years. It helps too when the GP knows the specialists in the hospital. As for emergencies, we have been faced with this situation 4X (twice requiring emergency surgery) All 4 times, because we happened to see the GP first for a diagnosis, one call by the GP to Emergency rooms ensured that Triage was ready as soon as we arrived to attend to my son. No emergency room wait. I have also read that where specialist surgeons services are required, they are more likely to be found in your major public hospital and not necessarily at the preferred one of your insurance provider. After paying such high premiums for private cover, members are more inclined to choose the insurer's preferred hospitals in order not to get slugged even higher gap fees.

  • Kapinny on 14/06/2015 - 21:01
    +5

    Lisa needs braces….

    DENTAL PLAN

    Lisa needs braces….

    DENTAL PLAN

    Lisa needs braces….

    • congo on 14/06/2015 - 21:12

      The dental plan is part of 'extras', not part of Hospital cover?

      • momov3 on 14/06/2015 - 21:21

        bad news, dental plan involves taking out Extras cover over and above hospital. Hospital cover covers just that - hospital cover and the surgery cost etc… not sure if you still have to pay gap!

        • congo on 14/06/2015 - 22:29

          Sorry what I meant to say is that you can get Extra cover only, for dental.
          And not have to worry about Hospital cover?

        • momov3 on 15/06/2015 - 00:13

          @congngo: I don't know about other insurers, but Bupa does not allow you to take out only 1. The minimum package is the 4 you choose from a list. Very early on I didn't want to take up for remedial , etc and even optometry seemed to only be relevant to 3 members of the family, not all, but there was only an option to take up the 4 package. I'm not sure about other companies - best to google them or call.

  • konazz on 14/06/2015 - 21:59

    We have PHI.

    Top reason: for the hospital cover. I don't have to worry about waiting 2 years for an ankle reconstruction… I was in surgery < 2 weeks after my sporting accident. I've had a few other surgeries. Yes it costs $$$ for the surgeon + anethestist - but i got the problem solved

    Ambulance cover… we go to remote areas + skiing, so having helicopter evac is a necessary thing. I've had to be taken by ambulance twice.

    Extras - not for me (although it was nice having a bucket load of cheap physic during rehab after my ankle) but my wife as she has issues with her teeth.

    We split our plans up - i'm on hospital (inc. ambulance) and wife is on top level hospital (with obstetrics) and mid-extras for dental.

    • congo on 14/06/2015 - 22:27

      isnt it cheaper to get family or couples cover rather than two individual covers?

      • [Deactivated] on 16/06/2015 - 17:08

        Couples is usually the same price as two singles. But kids are usually included for free with couples - not sure how that works with singles cover if you aren't actually a single parent.

  • konazz on 14/06/2015 - 22:46
    +2

    nope. it actually isn't

    Family cover is just double. my wife's top hospital inc. obstetrics = $60.20/fortnight. If I select couple, it goes to $120.40. Whereas top cover hospital, no pregnancy is $53.20 - saving $7/fortnight.

    Nice little money spinner for them (as I'm NEVER going to be admitted to hospital for pregnancy).

    Same as extras - wife needs extras for her teeth (5 fillings this year so far; 2 root canals and crowns last year), I haven't had a filling in 30 years! So we tailor our insurances to our requirements.

    • congo on 14/06/2015 - 22:48

      Good points.
      Thanks, I will remember that.

    • gimme on 16/06/2015 - 10:05
      +3

      YES that's a little secret insurance companies don't advertise. Couple's cover can be more expensive. I'm sure there's thousands of men in Australia with obstetrics cover lol.

      • Ashlea on 26/06/2015 - 14:44

        Yep - couples is an absolute rort! Stay singles until there's kids in the picture.

    • [Deactivated] on 16/06/2015 - 17:09

      Never say never…hahahaha…

  • Davros on 15/06/2015 - 06:52
    +3

    I get my medical and dentistry done overseas in Malaysia, Thailand and Vietnam, nothing major yet but as I spend more and more time there it'll happen one day.
    Often the Dr's are Australian trained, if not, UK, French, US and many of the hospitals outrank Australian ones on world scales.
    I can usually get stuff done almost on the spot and speaking to other westerners who live there they also say that its pretty much same day.
    Costs are minimal compared to here and I get a holiday as well.

    • SlickMick on 15/06/2015 - 11:16

      Yes, that's the other answer. If you're put on a wait list, you might have an option of getting your treatment as part of a family holiday. (ie the family gets a holiday, while you get surgery).

      • momov3 on 15/06/2015 - 11:39

        the family gets a holiday, while you get surgery

        but not much of a holiday for you :):) and the poor wife who has to look after you!
        I do believe though that it may be cheaper overseas but what recourse if anything goes dreadfully wrong where your travel insurance cover is concerned?

        • Davros on 16/06/2015 - 07:49
          +1

          "but not much of a holiday for you :):) and the poor wife who has to look after you!"

          Be the same here, difference there is I would be in a better hospital and better room and when back in my apartment I would have visits from a doctor or nurse to check on me, at least there was when I had a minor procedure done in Malaysia a few years back.
          When I was back on my feet I found lounging around the pool with the wife drinking cocktails far more enjoyable than listening to the neighbours screaming kids and barking dogs

          "if anything goes dreadfully wrong"
          Yeah, because nothing ever goes wrong in Australia right?

          "Queensland's 'Dr Death' linked to 80 deaths"
          http://www.theage.com.au/news/National/Queenslands-Dr-Death-…

          At least in Asia I can see the history and training of the Dr. who is doing the work and make an informed decision and as I said earlier, in many cases the hospitals outrank Australian Hospitals on a world scale.

  • pitufon on 15/06/2015 - 08:52
    +1

    I am pretty sure my private health insurance either loses money or breaks even with me (figure of speech, I know they don't really lose money). I pay extra for dental and optometry, which I claim fully every year.

  • TailsK on 15/06/2015 - 09:16

    I think private health cover is worth it, especially if you have children. While we have a decent public health system, there are some advantages that come with private. One of the biggest is being able to avoid waiting lists for non-urgent procedures. Of course, the other thing to remember is that you should take advantage of your health cover (i.e. use what's available to you). You might find you have a bunch of benefits you weren't aware of (like discounted medication, etc.).

  • max19832002 on 15/06/2015 - 09:50

    try budget direct health insurance ,medium cover for about 215$ a month gor a family of three.
    HCF is good too.

  • [Deactivated] on 15/06/2015 - 13:45
    +6

    I'll keep it short;

    I've had private cover for 30 years plus. Hardly used it and regretted the money I paid out over the years

    Last year I got seriously ill. Knocking on heaven's door stuff

    I finished up in public hospital emergency departments, carted from one public hospital emergency department to another to another, doped up on morphine and antibiotics.

    After seven days of this, somewhere in my stupor someone asked if I had private cover. I did.

    Bingo; all of a sudden everything changed and I could not have wished for better care.

    The invoices for private hospital care came to $38K.

    So, if you plan not to get sick, don't bother with private health insurance. The rest of you, take out basic hospital cover.

    • leiiv on 15/06/2015 - 14:06

      Are you saying that you would have died if you did not mentioned the private cover? What did the $38K exactly do?

      • [Deactivated] on 15/06/2015 - 14:32

        Yes. Re the 38K, I spent 8 and then another 7 days in intensive care. Beyond that another 8 days in a private room. The I.C.U. fees is what costs.

        To clarify the I.C.U. & private room charges, they included medical (doctors & nurses) care, radiography, operating theatre etc. My excess to pay was $500.00. The specialist surgeon & anesthetist was not included. I had to cover the gap between their fees and the medicare rebate.

  • montorola on 15/06/2015 - 14:12
    +1

    I reckon best thing about having private health (extras) is the cheap remedial massages, can't get enough of them!

    • Serapis on 15/06/2015 - 15:39

      That plus the free dental and sports rebates cover mine

    • Donaldhump on 16/06/2015 - 07:54
      +1

      i joined ahm in april last year, and powered though 48 massages to get my 1500 worth by june. it cost me 800 bucks but i was getting them on my lunch break and felt like a boss.

      • montorola on 16/06/2015 - 12:02

        Haha well done! If anyone knows any other good massage friendly phi's let me know!

  • leiiv on 15/06/2015 - 14:18
    +1

    The problem with our public-private cover systems are that they are not connected. I you don't have a private cover, you pay nothing when you go to public hospital. But if you have a private cover, you need to pay extra (the gap) when treated as a private patient in a public hospital.
    It is ridiculous that you already pay for both Medicare Levy and the Private Cover AND still need to pay for the gap every time you go to GP or hospital.

    • congo on 15/06/2015 - 15:19

      Yeah, but going from what GuiGuy said above, Private cover is what saved his life.
      Without Private cover, he could have died in the public system… quite sad and not very fair…IMO.

      So it looks like all we need is basic hospital cover.
      And if you do end up in ICU, you still have to pay the gap and excess and other associated costs…

    • gimme on 15/06/2015 - 17:58
      +1

      You have the option to be treated as a 'public' patient if you like and pay no gap. If you choose to be treated as a private patient in a public hospital (presumably because of certain 'perks' OR to 'jump' the queue) then it's not that shocking to assume there will be certain gaps.
      In some cases (I know from 1st hand experience) the difference between a private patient and a public patient in a public hospital is a vanity pack!! I still chose private patient because they assured me there wouldn't be any gap so I figured it's better to take the pressure off the public coffers since I have Private cover anyway. Although it was Medibank and at the time they were a govt owned insurer so I don't think I saved the public any money lol!!

      • momov3 on 16/06/2015 - 13:31

        In fact I read that the reason why the government 'punishes' the private patients who choose to go public at the hospitals. Apparently, since you bothered to take out private cover, you should choose to be 'private' in public hospital otherwise you are going on the Medicare train. Believe it or not, after the high premiums you pay, you are doubly punished with gap fees for overcrowding the public hospitals for a non-elective treatment. Really, private insurance is taken for one and only one reason - to skip the waiting line. And what so annoyed me when I asked for basic cover was that I was told it would exclude this operation, this ailment, this surgery, this and that - everything it excluded was everything I am likely to need in older age! There is no escape from the highest cover if one wants to be covered for the main ailments in older age.

  • Jackson on 15/06/2015 - 18:51

    No

    • congo on 15/06/2015 - 18:54

      Because?

      • Jackson on 15/06/2015 - 19:37
        +1

        Because the thread was TL/DR so I though I would give you the straight dope :-)

        The reasons are:

        We live in a country that has among the best public health care in the world and everyone is automatically eligible for it. You often can't get better health care for serious issues, and often if someone has something serious happen while they are on a private health holiday they go straight into the public system because the private one simply can't deal with it

        If you have some other ailment, it can be beneficial for your quality of life, or speed of treatment or even just the option to be treated for non-essential surgery etc., however there isn't a huge chance of this because of the large amount of things covered by the public system, and by definition all insurance does is spread the cost. It's purpose is to take those unfortunate souls and make sure the rest of society is providing for them.

        The problem is we end up with two systems, which isn't that efficient. So what you end up with is a system for the important things and another for the less important. Coupled with the fact that private doctors tend to charge more for their less regulated part of their industry, and the fact that the insurance system isn't 100% efficient (I discussed this above) then you have your answer.

  • sal78 on 15/06/2015 - 20:36
    +1

    bear in mind that even with hospital cover.. if you only had to go into hospital just one time with a cost of $500 excess or the option to go publuc with no out of pocket expense. treatment being exactly the same with the only negative of having to wait an extra mth or so for availability. bear in mind non urgent but if dr wrote urgent on referral then we have to move patients around to fit in urgent case even for public patients. a lot choose to go public because a saving of $500 is still a savings. in situations like that really makes me wonder whats the point of phi.

    and yes i work in a private hospital in admin. phi is really expensive.

    in my previous job i was a practice manager at gp clinic. we had weekly visiting psychiatrist, cardiologist, renal physicisn and gynaecologist. very prominent specialists. the cardiologist the director of a big public hospital and the psychiatrist is the director of psychiatry at a big public hosp. they bulk billed at our clinic 100%. waitlist only 2 to 4 weeks. we didnt advertise because they had enough patients through referrals from within the very busy clinic. our patients were expedited to public hosp if required.

    you need to find a good gp and good clinic. there are loads of ways to receive good quality care. care plans gets you free speech therapy. i use phi because i had it but i still had gap. plenty of government dental clinics for kids that are free.

    phi is a peace of mind but sometimes i cant help but wonder whats the point? dont we already pay enough in taxes which is one of the highest in the world.

  • Melburnian on 15/06/2015 - 20:37
    +11

    As a doctor working in public hospitals, I would go straight to a public hospital emergency department for an emergency or unexpected illness/injury my GP couldn't manage. The care is better than in private, for things like car accidents.

    Private health insurance hospital cover is only for avoiding elective surgery waiting lists, e.g. for knee reconstruction, colonoscopy, etc.

    Private health insurance extras cover is only for people who do the maths and find that they get more out of it than they pay, i.e. not many people. Most people are better off just paying for their glasses, dental checks, etc. out of pocket, than buying extras cover.

    • bambooculm on 15/06/2015 - 21:49
      +1

      I support everything Melburnian says. It is a common sense view. The specialists have some control over their own elective surgery waiting lists, at least in NSW.

  • OzzyB on 15/06/2015 - 23:37

    And now for a new angle - what do you think healthcare will look like in 20, 30, 50 years time?

    The reason I ask this is because we are currently debating public vs private healthcare in today's environment, but the loading of not taking up private insurance when young may start to distort the economics in the not too distant future.

    My thoughts are that the population demographic is aging, therefore there will be fewer people to pay for the elderly, who by virtue of good medicine live longer with more chronic illness. Either tax will go up until not sustainable, or there will be a concerted effort to reign in spending. Although the public system is excellent at the moment, there may be more and more restrictions on what is considered urgent, and the type of equipment (capital expenditure of the hospital) or medication (newer drugs more expensive).

    Universal healthcare is great in theory, but consider the NHS system in the UK. I daresay not as good as the Medicare model, far more red tape, and the tax that is paid to support that is much greater. Alternatively, the American model which is also very dysfunctional. I am very thankful that the Australian model so far makes the best of both worlds, but wonder how long this is sustainable for.

    Bearing this is mind, in 20 years (which is not unreasonable if you are middle aged), do you think that public healthcare will continue to be a good option, or would you then have to consider private insurance with additional loading (on premiums that are only going to go one way)?

  • AMLagonda on 15/06/2015 - 23:41
    +1

    hmmm we are on Ozbargain I would have thought most here wouldnt have private health insurance, I dont, the people I see that have it seem to get these huge bills every time they do anything….
    I believe in the public health system for all my basic needs (never had to pay for anything anyway), just got to keep ourselves healthy and brush our teeth a lot.

    • momov3 on 16/06/2015 - 13:34

      If only just the teeth. But what about the hips and knees and heart - one day they fail. Hopefully drop dead straightaway without needing open heart surgery, and that too is classified urgent and hopefully warrant immediate service at a public hospital.

    • Ashlea on 26/06/2015 - 14:48

      Keep in mind that OzBargain seems to be home to a lot of high income earners. If you're over the 90k threshold for the MLS, private health insurance is a bargain.

  • Donaldhump on 16/06/2015 - 07:51

    good for dental

  • soza on 16/06/2015 - 13:23
    +5

    I am a nurse, my wife is a nurse and we both work in the public system. i would say that only about 20% of nursing staff have private cover when compared to the 50% national average. To me this shows how good the public system is, in fact its one of the best in the world and it’s a fallacy to believe going private equates to better care.
    It’s the same surgeons and specialists that treat you private or public, even with private cover specialist treatment comes from the public hospitals…you may get a private room and a free newspaper but that’s about it.

  • momov3 on 16/06/2015 - 13:43

    If you all recall recently the government phased out Medical Expenses Rebate for amounts over $2,500(approx) whereby you get 20% back for any expenses over that amount per year. It was the government's way of 'forcing' more citizens to go on private cover. What was happening was that those who did not have private cover were claiming 20% rebate of the medical expenses over $2000+ and it did work out cheaper than the high premiums they would have paid over many many years. Although the rebate covered specific medical expenses only, anyone who did their own income tax online could claim an annual medical expense figure that was unlikely to be audited. It took years for the government to figure that one out.

    • sal78 on 16/06/2015 - 15:44

      thats when specialists caught on and increased their fees. thankfully i did ivf before the price hike.

      oz is one of few countries thats affordable for ivf during that time. for $6k you could have at least 2 fresh cycles and a couple of fets which would have a good chance in a pg (25% chance same as a normal pg). in asia, usa eyc it's $20k just for 1 attempt and $5k for fets.

      • momov3 on 16/06/2015 - 16:36

        IVF not covered by private health cover right? But you could claim then under net medical expenses over $2000 or therebouts. There was a time the threshold was $1400 I believe. No more now, the govt is forcing everyone into private insurance esp the coercive condition of loading as you get older, which makes the older citizens who never had cover even more afraid to take up because they will be slugged even more with the extra loading. Although they have a reason for this penalty, it sure is a further detriment to the ones who would have considered. Congratulations and I hope you now have a bubba or 2 in the family.

        • sal78 on 16/06/2015 - 19:04

          You need hospital cover for IVF because there's day surgery required for the egg pick up. Have to go under general too. But that's only for fresh cycles. Still I did it 3 or 4 times. Yes during my time it was $700 for family and $1400 for individual i think.

  • duchy on 16/06/2015 - 15:20

    Yes I do.

    And everyone earning more than 90k should get it as well. Medicare Levy surcharge gets way too expensive.

    Example (ATO website):
    Josh is 35 years old, single, and does not have the appropriate level of private patient hospital cover. In 2013–14, Josh's taxable income is $90,000.
    When Josh completes his tax return, he also completes the income test section of the tax return and declares:
    reportable fringe benefits of $20,000
    net investment losses of $7,000.
    Josh's total income for Medicare levy surcharge purposes is $117,000, which makes him a tier 2 income earner for calculating the Medicare levy surcharge. The amount of Medicare levy surcharge is only calculated against taxable income and reportable fringe benefits.
    In 2013–14 Josh's Medicare levy surcharge liability is:
    ($90,000 taxable income + $20,000 reportable fringe benefits) x 1.25%
    = $1,375.

    While he can get GMHBA insurance for less than 1000$/year.

    • Gorodemon on 17/06/2015 - 17:12
      +2

      Josh is an idiot and he should've engaged a better accountant to reduce his total assessable income to >$ 90k/year. There are a myriad of legal avenues to reduce your assessable income such as purchasing investment property (negative gearing) or you could start a small business by purchasing a boat to ferry asylum seekers from Indonesia to Australia. In addition to that, you're entitled to a $20,000 asset write-off which you could claim against your boat purchase. The passage fees paid by asylum seekers is a non-assessable income since it's a foreign income. As a icing on the cake, you could be earning an extra USD$ 5,000 per trip as a payment to turn your boat around back to Indonesian waters - (Thanks to our beloved PM, Tony Abbott).

      In conclusion, Josh is still an idiot!

  • momov3 on 16/06/2015 - 16:26

    Very interesting that there has so far not been any recommendation for Medibank! Whereas before it used to be the monopoly and the most taken up.

    • sal78 on 16/06/2015 - 19:12

      it still is for me because a few of our providers are only affiliated with medibank private so i have MP top extras cover. We use more than our premiums each year so it's well worth it. It's only $110 p/mth. there's lifetime cover of i think 3 yrs on hospital meaning you can take a 3yr break and your premiums will not be affected. But have to wait list again.

      I think people should take advantage of this when they are still fit n healthy. Especially family cover which is $300+ a mth.

  • Husky on 16/06/2015 - 20:50
    +1

    I work in the public health care system and while you are covered well in the case of a TRUE emergency, I would NEVER go without private health insurance and you are an idiot if you do. My best friend required a $70,000 operation at 24 years old due to lungs cancer, which was all covered. not to mention the public health system was going to do a cheaper operation that would have had lasting physical consequences and prevented him from working in his chosen field.

    My father would also be dead without private health insurance, as at 55 he got bladder cancer, but thankfully after the first symptoms he only had to wait 7 days for a cystoscopy which showed them it was a very aggressive cancer and he had it removed several days later. At the same time met a gentleman using the public system that had waited 3 months for the same cystoscopy. My father told his oncologist this, who blankly said he'd be dead if he had waited that long.

  • skinny on 16/06/2015 - 20:58
    +1

    I consider the most important thing in life is health (ozbargain is no 2). In Australia, Medicate is very good and covers for most emergencies, but I have seen people who have been waiting to have surgeries done and emotionally wrecked due to delay. If you value your health, take a private health cover that you can afford so if you need it, you have it.

    Not official, but you get better treatment as a private patient in a public hospital.

  • easternculture on 16/06/2015 - 23:28
    +1

    I have no problem accessing the public hospital system. If i ever need to have surgery, i have a few strings i can pull to get in faster.

    I only have extra's cover via AHM. Im Paying $33 per fortnight but im getting it all back (not paying any out of pocket payments)

    $250 for contacts.
    $900 for orthodontics
    $500 for dental ( 3 X Scale and Clean per year, 2 X Fluoride application, 2 X whitening Kits)
    $250 health improvements (which i use for gym membership (after getting a letter from my GP)
    $200 for Orthotics & Orthopaedic Shoes (Which i get 1 or 2 pairs of birkenstock clogs for work)
    $300 for Podiatry which i get custom made foot inserts for my flat feet
    $400 for Massage (I get 10 X half hour sessions per year - AHM pay $33 and i pay $7)

    There is more extra's but i have no use for them.

    So basically i pay ~ $860 per year and use $2700 that i would have paid anyway

    • pyramid on 16/06/2015 - 23:30

      EC,you should make some wiki kind of thing for this one.

      • easternculture on 16/06/2015 - 23:37

        I will. Hopefully when i get some free time to concentrate.

  • KnifeEnthusiastBoi on 17/06/2015 - 01:25
    +1

    It all depends on you, what kind of person you are. If you have any health conditions that run in the family, need glasses, dental treatment etc.

    My dentist is of the opinion that health insurance is just a business that makes money off you. but there are times when you need hospital cover, etc and youre gonna be out of pocket a lot of money.

  • freelife on 17/06/2015 - 10:30

    I had a surprise tumour last year and surgery cost $60K. Glad I had private health insurance.

    • congo on 19/06/2015 - 12:53
      +2

      Isn't this free under Medicare?

  • fruit on 17/06/2015 - 13:01

    Just a note to those with a prostate my dad's removal (I forget the technical term) with a robot wasn't was barely covered under medicare because it was "cosmetic".
    Private health insurance brought it down from 40k to just under 20k.

    While we are at it, for those with a family history get checked yearly after you turn 30.

  • Billy Bob Hick on 17/06/2015 - 14:25
    +2

    Insurance is a waste of money…. until you need it !!

  • Blackpuddytat on 18/06/2015 - 10:14

    I joined MBF (Now merged into Bupa) back in 2000 and im glad i did. I required a prosthesis that is waitlisted on the public system to function properly, which is not normally an issue, unless infection or malfunction crops up. Having private health allowed me to have safeguards and flexibility in case i required the prosthesis to be changed within its 7 year lifespan, something public waitlists may not allow for in my case.

    It's this reason alone that i still maintain private health.

  • Cluster on 18/06/2015 - 14:21

    Is having insurance worth it? It would have been for a friend, who had a rather painful condition that needed surgery to fix. It wasn't life threatening so he was put on a public waiting list. He got the operation for free but had to wait six months, sometimes doubled over in pain and barely able to move because of the condition.

    If he had private health insurance it's possible (depending on level of cover) he would have received treatment much sooner.

  • congo on 18/06/2015 - 22:15

    From all the comments, it sounds like all you will need is "Basic Hospital cover".
    In case you or your family runs into health issues, this cover would greatly reduce your medical bill plus your waiting times.
    The cover can also waive your MLS if you earn over $90K.

    Sounds about right?

  • docpol on 19/06/2015 - 10:24

    Does anyone have any experience with Australian Unity? Five-star Canstar rating but quite poor reviews. On the other hand, GHMB has decent reviews but I didn't see it in the Canstar rating. Just looking to change to the cheapest one for tax purposes and Australian Unity (Basic Private Hospital Cover) is only ~$5 more expensive than GHMB (Public Hospital Cover only) per month. Not sure which one to choose.

    • leiiv on 28/06/2015 - 16:55

      Is the "public hospital cover only" eligible for tax purposes?

      • docpol on 28/06/2015 - 18:10

        I'm not sure but why wouldn't it be? Anyway, after further searching, ended up with NIB basic hospital cover - cheapest amongst the ones I looked at, 5-star Canstar rating and decent feedback from the online community.

  • spychiatrist on 06/03/2016 - 19:10
    +1

    The price rise for PHI is coming. I was told that I can skip Hospital Cover, WITHOUT LHC penalties for 2 years. I will stop with the Hospital and retain Extras. I am convinced that Medicare will take care of me. Had a boss once who got a life-threatening illness that require complicated operations and after-surgery care. Even though he has PHI, it was never used as everything was covered by Medicare.

    • knk on 07/03/2016 - 17:40

      Life threatening medicare I"m sure will cover you.

      But for non life threatening things, reconstructions of joints etc you'll be out of luck unless you want to wait 5 years.

      Case in point, I did quite a bit of damage to my ankle. I could hobble around, but not put any weight on it for a good 2 months. Also couldn't drive manual which made life a little hard at the time.

      All I could do on the medicare end was see a GP, who had to refer me to an orthopedic surgeon at my expense. This surgeon then sent me to get an MRI. I was ~$600 out of pocket for the 2 visits and the MRI to be told I had done damage to the ligaments. I was also told I'd need a reconstruction to stabilise the ankle . At the time I didn't have private health and couldn't afford the 10-13k it was going to cost me all up.

      I opted to get private health, wait out the year and at the same time be referred to the public system for surgery. It took 1 year and 8 months to have an appointment with a surgeon via the public system and I waited at the hospital for 5 hours before I saw him and it was a 10am appointment. It was an absolute joke.

      In the end through physio and rehab I opted to forego the surgery however it's never been quite the same and is not 100% stable. If I had private health I could have had it done on the spot.

  • tonyjzx on 07/03/2016 - 17:31

    I only have liabilities for myself and for me, its not worth it.

    I have no outstanding health issues. My regular health costs are less than quoted monthly premiums.

Login or Join to leave a comment
Login Join