Are you going to ditch your health fund next year ?
https://www.dailytelegraph.com.au/business/is-the-public-hea…
Paywalled article, please google the title “Is the public health system so good you don’t actually need private insurance?”
Thanks tsunamisurfer
It works mostly like this.
When you have private health insurance the government will cover you for 75% of the MBS fee, and your private health insurer will cover the remaining 25% of the MBS. Now you will have doctors/surgens/nurses/hospitals that charge more than the MBS. This is where the gap comes into play. Lets say your anesthetist chargers $2,000, and the MBS fee only covers $400. Medicare covers $300, and your health insurance covers the remaining $100. You are left to pay the remaining $1,600.
No one talks about is being self insurer. You can self pay for the whole procedure and Medicare will still cover 75% of the MBS leaving you to pick up the remaining tab.
Has anyone used the public system for dental? 100% bulk billed?
It's free but public dental is a joke. It's overloaded, and emergency only. The wait time for a check up is 12 months. Also, you aren't covered for public dental unless you're low income. By low, I mean very low. You have to have a health care card.
Even if you're a low income earner if you care about your teeth (by that I mean you intend to get it checked regularly, and get fillings done if needed, not wait till your tooth hurts before seeing a dentist), go to a private dentist regularly. If you don't, you'll have problems and they will be expensive.
My wife had to stay in hospital for 6 weeks due to her pregnancy complications, 4 weeks in Private, 2 weeks in public (own room). All paid by our private health insurance, I shuddered when I saw how much my health fund paid to the hospitals.
As a tax payer you're welcome we paid 75% of the MBS fee.
“Is the public health system so good you don’t actually need private insurance?”
Everyone thinking that it's a good idea to ditch private health insurance will be guaranteed to make the public health system "no longer so good you don't actually need private insurance".
It's a riff on the prisoner's dilemma.
The question you should be asking yourself is why do people dont see value in the Private Health Insurance?
Which socio-political angle did you want me to approach this from?
Libertarian/capitalist: Because the public health system is too large and covers far too many non-essential items that it's effectively competing with private health providers in a way that's anti-competitive and unfair because the government has an obvious advantage in both resources and not needing to even break even.
Socialist/Social Democrat: Because healthcare is fundamentally and inherently an essential public service which is not suited to being managed or provided by private enterprise so it's inevitable that private health providers are unable to provide a competitive value proposition compared to a functional public system.
Other Anti-corporatist: Because private companies exist to exploit workers and price-gauge customers, so so long as they're able to extract rent profits from the system at minimal cost, they have no incentive to improve and/or change.
Tin-foi hat: Because lizard-people. (It's designed for reptiles so no wonder doesn't work for us).
I'm happy to pay more in tax's that everyone gets the best healthcare. I do have a problem with paying private for health insurance where the profits aren't put back into the healthcare system.
Yes the government is wasteful, but I would rather one entity be wasteful than have 50 others. Hell at-least with a public run entity you can lodge a FIA over their ass and get public data where a private firm will never release that information.
I'm happy to pay more in tax's that everyone gets the best healthcare.
I hear a lot of people say this, but this misses (at least) two major issues:
You paying more in taxes, unless you're Bill Gates, comes nowhere near enough to provide everyone with "the best healthcare". Don't overestimate yourself; and
Not everyone agrees with you - others might agree to pay more only for their own healthcare.
Yes the government is wasteful, but I would rather one entity be wasteful than have 50 others.
Problem is: I don't have a choice in whether to pay taxes or not, but I can choose to go with the most efficient, value-worth private option so that I'm not affected by the wastefulness of the "50 others".
@doodo477: I literally quoted you. That's the exact opposite of a straw-man argument. You can't just throw out the name of a logical fallacy as though it's an argument on its own, you know that right?
@doodo477:
Why is that a straw-man argument?
I find statements like the above no different to, "you're wrong, I'm right".
You've explained nothing, refuted nothing, claimed victory(?).
I wouldn't call everyone to quit immediately. I don't have private hospital insurance - happy to use the public hospitals. However, 3/4 people wear glasses in my family, so optical is a must for us. As is the importance of having dental.
Having some extras for services that you genuinely need may save some money for you in the long run
With two children, we wouldn't be without it. We are probably also far ahead in terms of procedures done, particularly when you take into account spinal surgery for a teenager - PHI payout was well over $80,000. One of us could stay with her the whole time, all meals included. No excess from the hospital. Surgeon's gap was $499, his assistant $119. Biggest expense was the anaesthetist - a tad over $3,000. We were quite freaked out about that one, but fusion is extremely complicated surgery and he had a few assistants with him, monitoring a lot of extra things.
In addition, I've had two wrist surgeries and two caesars and husband has had an arthroscopy, tonsils and appendix removed. We aren't contributing to the profit.
I think the real problem is that we allow health practitioners to go private and charge such exorbitant rates. Especially dentists. They laugh all the way to the bank.
Hahaha, wait what? You oppose the idea that health practitioners are allowed to practice privately? You'd prefer that all doctors and dentists and other health practitioners literally be drafted by the government to work in the public system?
Drafted implies they are forced to work in healthcare. That is not the case. It's also not what I meant. I think a cap should be put on the rates they are allowed to charge as some pricing is literally highway robbery. Your argument to this may be that it would discourage quality healthcare, to which I would respond there is already capped pricing on a number of existing privately operated but essential public services, which have permitted percentage increases every year and function just fine.
as some pricing is literally highway robbery
There is a public health system. No one is forced to go to private health practitioners. They can charge those rates because some people are willing to pay those - whether for better service, timelier service, better equipment, better after-care, or other factors.
there is already capped pricing on a number of existing privately operated but essential public services
Name one where there aren't high barriers to entry which limits competition making legislated price-caps relevant. Not the case here.
@0blivion: The public system is arguably worse because the private system exists and flourishes without bounds. Yes, many people including myself are willing to pay for private. I do so because I do not have confidence in the public system. There are countries where the private system is actually not needed. Imagine if the millions (billions?) paid for private health insurance premiums every year went towards a better public system instead.
I don't think you've considered the crux of the issue. If I, if I were a dentist, wanted to perform a root canal for a patient, and the patient agreed to pay me $1,000.00 for it, where in the hell does the Govt get off thinking it could or should be involved in that transaction?
The public system is arguably worse because the private system exists and flourishes without bounds.
This is bullshit. If the public system was better than the private system - and it should because again, the government has far more money than any company and no need to break even - no one would spend money in the private system.
Imagine if the millions (billions?) paid for private health insurance premiums every year went towards a better public system instead.
I can - it would be wasted by the government same as the billions of taxpayer funds it already receives and wastes. Your logic is nonsensical: "Yes, I know the govt wastes a lot of money, but if we give it MORE money, it won't waste that!"
Edit: There is a place for both a public health system and a private health system. Just as the government should provide meal tickets for bread and milk, but NOT five-course dinners, in the same way the public health system should provide essentials but NOT elective procedures and extras.
@0blivion: The public system sucks in part because the government is happy (and wants) us to keep forking out for private healthcare, so it can as you say waste the money elsewhere. So I agree that the government as it is now would absolutely waste the money. That actually highlights a deeper issue with our country and government(s) as a whole. I am not proposing this as an idea that would work in isolation.
Fair enough, but I personally believe the problem is an insurmountable one of: Government is inefficient and should stick more to regulating the market, than taking part in the market. The bigger the government, the more waste (and especially so in democracies though no system is immune), but I like Singapore's example both generally and in regards to healthcare.
Generally: Singapore's government believes in private-market(esque) based systems where the government sets stringent but clear rules, and creates systems for easy compliance with those rules.
Healthcare: https://en.wikipedia.org/wiki/Healthcare_in_Singapore: It has a public healthcare system that works on a mix of mandated savings, and differing levels of public subsidies, but the main take-away is that it's NOT a free healthcare system.
I find this perspective so interesting. People are willing to spend hundreds if not thousands of dollars on mass produced goods, hundreds on their hair (yes, women), on consumables, etc etc.
Doctors bust their guts to get into medical school, bust their guts to pass medical school, work ridiculous hours in which they are faced seeing absolutely horrible shit that they don't get time to process, they then have to bust their guts to get onto a training program, which alone can take years (neurosurgery and orthopaedic surgery come to mind), suffer through the training program of even longer hours, suffer through the training program exams which have exorbitantly high fees and fail rates alike, suffer through resits, finally limp through fellowship, and then have to find a job at a public hospital which are as rare as hens teeth, and then do some private work to recoup some of the thousands of dollars they have lost in training fees, college membership fees, and exam fees, all of which are thousands each, every year. All so the public can saunter through and say they want their money for their electronic goods/handbags/haircuts and that they are highway robbers.
They do all this training not for the money, because there are far easier ways to make money than being responsible for someone bleeding to death in front of you, but because they love their work, and most importantly, so they do no harm when they come to qualification time.
I have no problem with private practitioners, you can shop around for price and you can also elect to go public if you can't afford it. We actually have a pretty great healthcare system with lots on the table for everyone. The tragedy for me is that we pay a huge medicare levy and then to get decent insurance, have to pay hundreds of dollars a month on top of that. So much of the public money for healthcare goes on bureaucratic and inefficient admin that doubles up at every hospital. In the public hospital system, in some states, doctors have to reapply for their jobs every year, are told not to count on being rehired, and are encouraged to 'apply widely'. In applying you have to have a resume, references, cover letters, selection criteria, and then there are admin people at each hospital as well as other doctors, going through this massive application load every year, only for most people to get rehired, and the occasional bad egg to be weeded out because the system is full of people who are too nice to want to actually performance manage the bad eggs. The cost of doing that alone must be huge, which could be halved if we had to reapply every 2 years. I could name many more instances of costly bureaucratic ridiculousness in the system but my point is that private practitioners aren't what cost the public money.
And the private system IS very boundaried, there are nowhere near equal services to the public system, there is nowhere near the level of research output, nowhere near the level of peer oversight and nowhere near the level of teaching. It may not be visible to the public eye but the public system, at the major tertiary centres at least, enjoys a very very high standard. That's why specialist training is so incredibly gruelling.
Just as the government should provide meal tickets for bread and milk, but NOT five-course dinners
Politicians get those but.
If you want to see what happens when you force people to work for less than they are worth, have a look at the UK.
Doctors are leaving the profession to work in Australia and the USA taking years of experience with them. Nurses are simply quitting to work jobs with much less stress. Several week wait to see a GP is commonplace.
Don't blame the employees if the government doesn't want to fund the public health system properly and you have huge out of pocket expenses.
Touch wood I haven't needed private health insurance since coming off the family plan many years ago.
However when I was on the family plan I had a few times where having private health insurance was a very good thing to have. I needed some bones and ligaments stapled/nailed back together after a motorbike accident many years ago and was able to get into St. Vincent's with one of the best hand reconstruction surgeons in Victoria.
The surgery coupled with the rehab sessions gave me 90+% of the function and mobility back in my thumb. A family member did the same injury (not from riding) and went through the public system and has around 50% of the function and mobility. I shudder to think what the out of pocket cost would have been without PHI for that surgery and rehab, and if I ever do an injury like that again I will want the best possible care again.
I've been without PHI for too long. I'm looking at getting it back next year as I'm starting to get outdoors a lot more, and also tax reasons.
I hope you're uner 30, the 2% loading for 10 years suck.
My parents are paying through the nose
31, but I made the cut off.
“To avoid paying a LHC loading, you need to purchase hospital cover by 1 July following your 31st birthday.“
http://www.health.gov.au/internet/main/publishing.nsf/conten…
Looks like anyone with a birthday after the 1st of July gets a whole extra year of no loading. Bargain!
Dont use medibank. Do your research for what you need
Just saw what my brother was paying (extras and ambulance cover)… made him move to CBHS - a commonwealth bank, friends and family can join.
Its non profit, but is at the premium end nowadays, but at least the benefits are better. My brother (mid 20s) is now paying less for more/better coverage
Less likely that people with it will now ditch it. Very difficult decision to make whrn you've paid into the system for many years and if you come out, you will be penalised to go back in for over 30s.
Personally I don't have it
A friend of mine here in Japan got a wisdom tooth removed for less than $40AUD, with the national health insurance. Without health insurance, it would be around the $500 mark (unconfirmed).
It clearly is a failed system to be so expensive and uncompetitive with the rest of the world. I wouldnt support it by buying into it. Insurance companies and banks are taking a cut of the payments you make each and every time.
It has created great wealth for private practitioners, surgeons, hospitals and insurance companies, but has barely relieved the burden on the tax payer (still paying 75% of (the mbs portion of) private medical expenses) and public hospitals and facilities are still used for private patients.
In many cases, you are paying to jump a queue that never used to exist and paying fees that are very inflated.
That and emergency wards attempt to admit you as a private patient instead of a public patient because they can charge you through the nose. All private health funds have clauses that say you cannot use your health insurance in a emergency ward.
The cost of my basic private health fund is about the same as the twice annual dental check-ups and teeth cleans it covers so i don't mind paying for private health cover.
Wow. That is very cheap. And it even includes dental fully reimbursed? Which PHI are you with? I want to join that one.
Had a shoulder arthroscopy last month. Thanks for the private health insurance I didn’t have to wait 10 months in the queue and didn’t pay $10k hospital theatre fee for my operation.
How long have you had PHI for?
Few years, maybe 5.
I have cover solely for the extras.
About 2 years ago I had been extremely sick off and on. Neasua, vomiting etc every morning for weeks on end (It progressed slowly over a year period until it got to the point I couldn't even work). After heaps of different tests, doctor recommended a endoscopy and this is why I am keeping my private health insurance.
Hospital wait time for endoscopy = 18 months at the time I applied.
Private hospital wait time for endoscopy = 2 days. Although I did have to call around.. The 4 that I called prior to getting an appointment was around 2 weeks.
Within 1 week I was on medication and treating the condition.
I like mine for the extras cover especially for my daughter. I regret getting obstetric cover, I went private for that and the PHI didn't cover anything but the hospital stay and private obstetricians fees are in the thousands so it wasn't value for money. I was in a public hospital anyway (no private nearby) so while I got a single room, there was no magical treatment. I'd rather just pay the obstetrician rather than the insurer. I get that if there is complications with birth and delivery it might be useful, but friend's experience has been that when there HAS been complications, they've been forced out of the public hospital (with full service ICU and NICU) into a private facility with less acute care meaning they'd just be transferred back to the public if things got worse anyway. I try to use up all my extras so I feel like I'm getting something back.
I find it's very good for children though, as waiting lists to see private paediatricians can be years long. I had to get mine in to see an allergy specialist and even with PHI the wait was 4 months.
Private health insurance isnt always a waste of money but i'd say for 85% of people it is
That's how all insurance works.
I've said this time and time again - do people not understand the point of insurance? Insurance protects against risk. It's not there for you to gain value. Over the life of your car, any car, you will pay more in car insurance premiums than get paid out in claims. That's not a reason to ditch your car insurance. Same for home and contents, same for income protection, or renters' insurance, or even life insurance.
The difference is if you rear end a Ferrari with your 1998 Corolla the insurance company will lose out they insurance company makes up for these unlucky situations but overall turning a profit health insurance companies don't run like that.
Private Health insurers almost NEVER LOSE out even if you claim after 20 years of paying premiums you still have to pay a 'gap' even with top level cover (which is a load of bullshit)
Private health insurance is shit in Australia because of the 'tax benefits' they can provide junk policies and people will pay for it because of the tax benefits.
I work in Health care both private and public next time you are at your Doctor/Physio/Dentist/Nurse ect ask them if they have private health insurance if they are being honest they will say 'No' at least the majority of the time. - (even though we get a discount on it)
Car insurance is a numbers game on average insurance companies come out on top of course it is a business but if you dont have insurance and to have a accident and can afford the repairs (Most so of the other peoples car) you could be in trouble. Though 85% of the time car insurers get the better of the deal the other 15% they really dont, compare that to health insurance 85% the health insurer gets the better end of the deal and the other 15% it really isnt that bad because the individual will have to pay large sums of money too protecting them from over claiming etc
I dumped my Private Cover earlier this year. I originally took it up just before I turned 31, to avoid the 2% loading (per year) that is applied. I did not want to end up paying 70% extra, when I eventually do need it (around 65).
However, then I discovered: "Once you have paid a LHC loading on your private hospital insurance for 10 continuous years, the loading is removed." Source
So it isn't "lifetime loading" as we were led to believe.
Now I plan to join around 45 and pay 30% extra (15 years at 2%) for 10 years, which is far cheaper than paying 100% of premiums for the next 15 years.
I now only have extra's cover, which more than pays for itself in reduced dentist bills.
cheaper when you dont need it. if you have a medical issue or private health need during those 10 years to save money, what then?
Alls well if you can predict medical issues at 65 and joining then. if that were the case though everyone would just wait until old age to get health insurance. the problem is it's unexpected.
Then I use the public system.
Best answer. People are so quick to write off the public system like it doesn’t exist, yet look at what happens if you get seriously ill - straight into a public hospital to be triaged with people with PHI.
I did the exact same thing - sat down, calculated everything and there was no likely scenario where having PHI worked out better. So I dropped it too as an over 30. I was paying $85 a month for what felt like no benefit and that was a better legacy policy than what was available for the same money today. It barely covered dental, had a heap of exclusions and didn’t cover important stuff.
The system here is broken, and this is coming from someone who has experienced the pleasure of truly universal healthcare without a private system. The world would be a better place if we all had it.
I did not want to end up paying 70% extra, when I eventually do need it (around 65).
The loading is capped at 50%. You will pay that for 10 years.
If you don't think you'll need it until 65, it's worth not paying it until closer to that age. You will have to pay 50% extra for 10 years, or 5 years worth of extra cover, but you'll save more than 5 years worth of cover by not buying it for 30 years. Assuming you won't need it. No one can be sure.
CORRECTION: The loading is indeed capped at 70% not 50%. If you begin taking it at age 65, you'll pay the maximum loading.
Private insurance so we don't have to pay the extra tax. Its worth it though. I claim around $500 a year.
My primary concern is for the future of the public healthcare system. Right now it is a large budgetary drain, yet this is with a large percentage of the population in the "positive bracket" (that is, working age whom are providing funding via taxation, yet claim much less), with little in the "negative bracket" (elderly and young children, whom provide no taxation and not only are a cost, but a large one at that). As the population ages, we will see a larger proportion of the population in this "negative bracket" and fewer in the "positive bracket" which is indeed problematic.
Having seen the public healthcare system first hand, it is simultaneously under an overwhelming demand and also not using funds most efficiently. For example, whilst running a food business, keeping wastage to a minimum can be rather easily obtained with proper procedures for communication (e.g preventing incorrect orders) and processes in place. However, in the hospital environment, there are many things that must be necessarily disposed of due to infection control, and many other things that, if used more efficiently, would not cost so much. An example of this would be providing a particular device that helps patients with respiratory concerns; it comprises merely of a bottle, some water, and some tubing. Now, whilst the bottle is largely inexpensive, the tubing is usually an individual packet that must be opened, cut to size, then the remaining tubing disposed of. This is the only way to create this device efficiently and safely, however generates wastage. Of course, this wastage occurs every second in every facet and is impossible to stop.
The government really needs to push towards higher taxation (sadly) now, in order to generate a pool of funding to help support the healthcare system as we see this shift towards the "negative bracket" majority. If not, there needs to be some radical changes (or perhaps these will be inevitable, even if such a funding pool is created). These could include altered care based on health outcomes; for example, the >$1000 per night cost of keeping someone in a hospital might not be justified for an elderly individual with poor health outcomes (even with optimal recovery) and we may see more hardline approaches towards justification of treatment, e.g Allow patients X number of days when health outcomes are as poor as Y, with any further treatment requiring private funding directly out of pocket or from private health insurance.
It's not a situation anyone wants to see, but when you're spending a large amount of funding on treating an individual whom may only achieve ~60% of pre-morbid functioning and live for a couple more years (at best), which could be used to treat multiple younger individuals whom have decades of life and contributions remaining, then it becomes a hard justification when you are forced to pick one or the other.
I have a bit of a problem with the assertion that we're spending too much money on the elderly because they're not contributing taxpayers. Our current generation of elderly patients have worked hard their whole lives, have paid taxes their whole lives, and have underutilised Medicare by comparison to the younger hospital inpatient. I don't see them as a single data point during admission, if you ask for their stories, the majority have worked very hard in low paying jobs, i.e. factories, and earned every thing they have while paying taxes all along the way. They have made huge contributions to the public purse over time.
If you look at your 50 year old multimorbid patient with the full spectrum of problems who've been costing Medicare thousands since the age of 35, who will go on to cost thousands more, with largely lifestyle related problems that cost a fortune to treat (complications from smoking, alcohol, substance abuse, never ever seeing a GP, never seeking psychological help), I would argue that they cost far more.
As for children not being contributing taxpayers, again I don't think this is a good example because the goal for them is to grow up and become taxpayers, and contribute to the public purse.
There's enough nihilism about the elderly in healthcare, they're a cheap and easy target and they are not the problem here. They have earned the right to their healthcare, especially the current generation who have largely been battlers their entire lives.
I don't think the solution is to try and cut costs by picking and choosing which patients you treat, or working out who is more 'deserving'. Is the elderly patient who has worked hard their whole life, never going on the dole or a DSP less deserving than the 40 year old alcoholic getting a liver transplant? Equal access to healthcare is a basic human right.
To cut costs, health needs to be improved at a population level, reducing smoking (which I'm proud of this country for leading), alcohol abuse, eliminating obesity and improving psychological healthcare. In the meantime, I have no problem with paying higher taxes if those taxes are going into health, I'd rather pay for that than an effing coal mine.
i think many of those comments saying insurance is useless as they're healthy and what benefits…. same as travel insurance, most peple never use it, but tell that to those lumped iwth thousands of dollars of overseas medical expenses when something went wrong.
I still haven't used my car insurance much but pay $600 a yr for a car that cost $14k like 3-4 yrs ago…
I'm with HBF and was thinking what i get out of this… $85 a month as a young gen y. Fast forward to last month and a simple jump changed my life. grabbed a bball mid air being passed , as i usualyl do, landed and it allw ent to shit. after a few weeks i got the life changing news that my acl tore.
Before this I tumbled down mountains learning to snowboard, i played badminton for hours. i played bball fro hours. ran, active. Not an athlete but i felt invincible. Sure, i coudl goto public and wait but private now gives me the elective surgery option of who i want to choose. I have hbf preferred surgeons, but am thinking of going with the 'big names' who do the footy players etc. I m aybe $1k-2k out of pocket but the private hospitals stays are generally covered.
In the end if i went public i would have an unknown surgeon, also someone who may be under their guidance (in public the surgeon can supervise, in private they must do your surgery). Not to mention if i wasn't as picky and i was my family, they would just choose an orthopaedic surgeon who are a preferred hbf provider - and i wouldn't have out of pocket.
A guy i met at the winery on the weekend had 2 x total knee replacements (had no acl reconstructions in his day). $30,000 a knee, or maybe botH? either way he paid hardly anything out of pocket, chose his surgeon (works at the same centre as the 'big names' i was tossing up for mine).
So yes - you don't need private health insurance. and your unlikely to get injured, run over, or die. But heck, shit happens. If your unlucky, then you'll have financial stress to worry about. I now wish i bought income protection, as i always thought I could work… i only bought disability (TPD and death) to cover my passing or disability. but never thought i could have 'complications' from surgery and not be able to work etc. now thats a 'small' possibility of surgery. although i hope to god i turn out like the 95% of people who just have a few weeks off.
To the user on the first page talking about healthy people getting no benefits and having no home insurance - most stupd thing ever. And i hope no one here is cheap enough to save money at the expense of their personal health, or even that of their family. This is one thing I would tell my parents, their "previously" stubborness to buy travel insurance when returning to theirhome country puts me at financial ruin should I need to cover their medical costs. Would i leave them hanging - i doubt it, but it could ruin me if i needed to find money. So stop being selfish and insure yourself. Really - if you can't afford to buy home insurance, travel insurance etc, you should reconsider travelling in the first place, or owning a house. THe cost is minor ir comparison.
edit: private health also gives me $21 back a physio session. After going through 2 x a week in my first few weeks post acl tear, it quickly added up as the sessions are usually $79-100 for most physios. That's $58 out of pocket. Now i've seen 'other covers' where instead of say $120 a month now, if i bump up to $180 i would get say $48 off my physio sessions. at 2 x physios a week post surgery, and the 'annual limit' being say $1,500 as opposed to $200 now, there are savings on being higher cover. with no private health you would get nothing back.
Not to mention you get tax implications of no private health past your 30s. you also get a 25% rebate on private health. with my looming costs i am using gap saver, so say i want $600 of gap saver - akin to loading up my hbf card with credit, i shoudl theoretically pay $600 x 75% = $450, to access $600 of medical credit.
You're falling into the trap of equating health insurance with something like car insurance.
Health insurance is more like a payment plan; you are forced to make payments (premiums) so that, at a later date, if you have expenses these will be reduced. However, given the balance of premium cost vs coverage by private health insurance, you're almost always better off paying "premiums" into a bank account and paying for expenses independently with these funds, when they arise. Often, the amount covered by the insurance companies is minimal percentage, unless you're paying high premiums, at which point you're effectively still paying for it anyway. The balance is such that paying what you would spend on premiums into a savings account will be more than enough to cover complete payments for things (as you alluded to) like Physio, with plenty to spare, in all but extreme circumstances.
Conversely, with car insurance, a minor nominal excess will prevent you from a lump financial outlay; it is rare that your car insurance premiums will add up to a value that is greater than what the cost of a high-end repair or write off would cost. That is to stay that only a very high-use private health insurance individual will financially benefit, whereas a much greater percentage of people will benefit from car insurance. Of course, then you have the extremes like home insurance, where people may never recover from losing a home without insurance.
I agree with what you said but doing some maths using figures that he provided..
The balance is such that paying what you would spend on premiums into a savings account will be more than enough to cover complete payments for things
Let's use 30k for a knee replacement. He says he pays $450 a year after rebate. That is 66.7 years of premiums you'd have to save into your bank account to pay for one knee replacement.
I don't think knee replacement is considered an extreme circumstance. Arthritis happens to a lot of people when you get older. That cartilege will wear out after many years of wear and tear. It's not uncommon for you to have used up your lifetime supply. You'll be in a lot of pain when bone scrapes against bone, and there is no cure. If you have to pay for knee replacement that's 25k per knee, 50k for both knees. Or you wait 2 years for public hospital just to get onto the waiting list, and then a further year before they finally operate. If you can grin and bear it for 3 years, ok.
Even people without PHI have health insurance - Medicare. You can’t compare the two.
i'll get taxed if i dont have private insurance…. :(
Unless the tax exemption is 90%-100% for your health insurance it is not worth it.
Sorry i meant the medicare surcharge . Is that what your comment about?
Duh.
Paying for private health care entitles you to a tax exemption on the medical surcharge*.
So unless paying for private health care entitles you to a tax reduction of 90% to 100% on the levy it is not worth the cost.
Especially seeing how Australia has free health**.
Besides look at it from a financial view point, private health does not actually decrease the levy.
Instead it substitutes the cost of the levy with the cost of private health care and a reduced levy rate.
In the end you wind up paying more for nothing substantial.
*Technically you receive a tax reduction.
**Private health is designed for countries without a free system such as United States.
@Atazoth616: If you earn 90k, the MLS is $900. If he can get basic cover for cheaper than that, it's something for nothing. Even if it isn't much. May as well. Obviously the more you earn, the bigger the saving.
The only cover that is worth the money is ambulance. Otherwise, you are better off having a account with regular deposits for health emergencies.
I've often been tempted by this but there's a logistical side that prevents me from doing it. Once you have PHI, when you end up in hospital, having it can open doors very quickly for you - i.e. going to private rehab, being transferred to a private hospital where you stop getting bumped off surgical waiting list, more rapid access into nursing homes. When you attempt to pay in these situations, no one seems to know how to action it because it's just not offered as a viable avenue, and there's no processes or policies in place to do it. It would be really nice if this was set up properly to allow people to do it.
Primary reason of having health fund at the moment is getting Laser Eye Surgery. Since there are extras all around (eg. dental), might as well do it
The only reason Australian's public health system still working is that the PHI is locking with the tax, if you don't buy PHI (minimal level) you will pay more tax than the money for PHI
Unless you think you won't make much money higher than the tax threshold for PHI for the lifetime.
Im still not familiar with how these work. I have an upcoming dental surgery in 15months and having looked through the general information from most insurance companies it appears to be more expensive? It appears that my premium would be around $1200 a year but it only covers around $1000 for the entire year after as there is a limit. Does this mean I am actually losing $200. *note I saw that the limit increases after time but my surgery is due in 2019 so I do not think its worth?
Yes. Major dental usually has a cap too low to cover the actual cost of the surgery. Not worth it for dental alone unless you're able to claim other things like optometry.
You also might have a waiting period of up to a year depending on provider, so that might be a $1200 guaranteed loss before you can even begin getting anything back.
What surgery do you need done in 15 months?
If you are buying a $1200 premium just for dental, you're wasting your money. A premium like that is only worth it if you have a lot of things to claim. If you need only dental, it's cheaper to pay for it out of pocket.
To give you an idea, my root canal + crown cost me about 4k. If you can only claim 1k, you will be paying $1200 + 3k. That's 200 more than I paid.
A dental implant could cost 8k. You're still going to be paying most of it out of pocket.
The best solution is to take good care of your teeth. This is something you can fully control, unlike the rest of your body which has many more parts and much more complexity.
There is also the option of "medical tourism". This is where you travel to other countries where the surgery is much cheaper than here. Places like Thailand who offer very comparable service for a fraction of the cost (a few hundred). If you're getting a dental implant, this is very worth considering. But it comes with drawbacks of let's say if you need to go back because you have a problem, well are going to fly back to Thailand? Similar to warranty of grey imports.
Thanks for your reply and I am just geting a bite correction which is about $17000 total. I paid for the braces upfront as I figured having to be put onto a waiting period of a year is not better than the 10% discount from upfront payment. As I said the treatment would be done in about 15ish months so the 3 months claim from the braces and the $1000 from the surgery itself does not seem right.
Without being able to read the article, isn't this a simple numbers problem that varies for everybody.
For everybody earning over a certain amount, its a false economy to go without private health as you end up paying more in surcharge. So I'm assuming the article is talking about extras.
Well it costs my family an extra $700 to have extras. But me and my wife both get two free dental examination / teeth clean and the wife uses it to get some new glasses / contact lenses each year (she does have to pay 40% here though)
I would say that would equate to more than $700 of value right there. Plus we both have used it to do the odd major dental surgery in some years and gotten money back.
For us, that seems to be good value.
I was in an ambulance before in an emergency on the way to hospital.
I mentioned to the paramedic that I had private health (which I was paying $200/month for) and he gave me two options:
a) Go to a private hospital, but I'd have to pay $300 minimum (not sure what the other costs would've been after admission) or
b) Go to a Public Hospital for free.
It was an easy choice.
I've always perceived private insurance for elective surgery.
I suspect on an emergency you're better off in the public system at least to start anyway.
I dunno, maybe i'm wrong. Happens sometimes.
I suspect on an emergency you're better off in the public system at least to start anyway.
I heard that years ago too - apparently the public hospitals are better equipped to handle an emergency much better than a private hospital.
Not sure if it's still true today.
a few years ago, friends mum cut her finger off and presented at local private hospital emergency.. they were put on an ambulance to a public hospital. :P I guess it wasn't equipt for Microsurgery
Not too surprised - probably have more experience. Same reason hospitals in Chicago have some of the best gunshot trauma treatment specialists and procedures in the world.
Choice of specialist surgeon v some pimply Registrar cutting into my beautiful body.
Nup, i'll take the first thank you.
Shame it's costing me a small fortune…
depending on procedure you could have a private surgeon performing procedure within a public hospital. Just have to pay for private surgeons consultation fees. thats what I did.
Hehehehehe this gave me a chuckle and is probably mostly true. Except at Auburn Hospital, when I was there there was a plastics registrar who was a fully qualified orthopaedic and plastic surgeon in Europe but had to retrain from the beginning in our system even though he was highly published and respected. He was amazing to watch!
Yes, it varies depending on the hospital.
My understanding is all the specialists go to Prince of Wales Public in Randwick for obstetrics as they're meant to be super duper.
I personally have no idea … it's just what i heard at the pub.
I can confirm that - pub + random on Ozbargain = winning advice!
How well do you know your surgeons? Because if I was given a choice, I'd have no idea who to choose.
You ask someone who does know.
In my case i may well be in a privileged position with a family member in the game.
But for others, the GP is the gatekeeper to specialists.
That makes GP's quite powerful (and why specialists are always nice to them), and if they're experienced and capable they'll know who to refer you to.
Sorry, looks like i know more than i was letting on…
If you have a reasonably priced policy with "extras" then it pays to keep it. Hospital cover alone - not really. But need to consider other options such as the 2% increase in premiums for each year over 30 years old and the 1% tax levy for not having an insurnace policy. So it pays to kep your policy
But it's never just 2% is it.
anyone have access to the actual Morgan Stanley report ?
My advice (as someone who works in the insurance industry [but not health insurance]) is to read up on what you're getting and what your situation in life is. If you are happy with paying monthly for the statistically very likely circumstance that you're going to be needing to get patched up, then go for it. If not, well, you do you :) That also goes for every other kind of insurance out there.
$32 a month, how old are you?! That’s insanely cheap, junk policy territory!
26 :P
I started having PHI when I was under my parents' policy at the age of 16 and continued ever since. Argued our way into the fact that although the policy was a bit of an older one, I was still entitled to have the same kind of cover as a single independent adult.
It's basic extras 70 with Medibank. I'm not nearly enough high risk to need anything to do with hospitals (Have used it the once when I was younger) but I should take advantage of what my work has for me once I get myself a scooter XD
Please help. Would like some assistance if it's worth getting PHI? I'm still confused with the MLS bit..
I am 34, 80k a year. Never had PHI. One 5 year old child about to start school (she lives with her mother) Active in gym, work in headoffice doing office stuff.
I have been considering getting PHI, but is it worth it at my situation? WIll I be paying more tax etc? Sorry for the newbie questions.
Thank you for your assistance
Sit down with excel and calculate it all mate, it’s the best way to see in detail if it works for you or not. You can even build scenarios to see the long term tax effect - e.g drop now, pay the levy, retake at 40 with loading etc…
You are under the MLS threshold of 90k, so you don't have to pay the 1% MLS.
Get PHI if you think you'll be needing it, or want to be insured against the possibility of needing it.
Don't get it to save money on tax because you won't be unless your partner earns an obscene amount of money.
Thanks
if ur confident enough ur the top x% "healthy" people in the community. u can essentially insure yourself.
As someone who's never been admitted to hospital, I don't have any advice that isn't obvious. If you earn enough that you can afford it comfortably, get it. Don't be stingy. If you're a low income earner and it's hard to make ends meet, don't. If you're in between, that's when decisions are tough. If you don't like risk, I would go for it, unless you live a very 'safe' life style (i.e. mostly indoors). Even then you're not immune to needing elective surgery.
I don't have it but have been wrestling with the idea of getting it for maybe 10 years now. I'll get by financially if I buy cover, but it's not an insignificant expense either. I'll probably end up getting it eventually.
Lostn, do you know wresting and struggling over the matter for may be 10 years is really a cost- a cost of unnecessary stress and worries. If you have family, that unnecessary cost past and shared by them too because they love you. If I were you assuming you are able financially , just go ahead to insure yourself. You are more valuable than your car and house.
I recently had two relatives go through quite traumatic incidents that needed them to be in the hospital for weeks. One was in private and on in public. It convinced me to keep private.
What were the overwhelming negatives of public care?
One was a very sensitive issue where the person needed the physical and emotional support of the family through the whole thing. With private they had her own room as long as it was needed and family was able to stay by her side the whole time. It was hotel like as far as food and the rooms went and the quality of service was outstanding. Her spouse also got a decent benefit to cover their out of pocket expenses from the same fund.
In the second case they were in public, in a tiny room with 6 other people seperated by curtains, the food was tv dinners and the service was understandably stretched. I can't imagine having to go through the first scenario in public if the quality was even slightly like I saw in the second.
Adam explains all of this really well here:
Adam Ruins Everything - The Real Reason Hospitals Are So Expensive
Hospitals should be regulated, just like child care should be. Not every industry is regulated.
Interesting, I'll read into it.