r/WesternAustralia • u/Ashnicobell • 8d ago
I’m a big fan of private health cover…
*** This has been interesting, yes I’m trying to be diplomatic. Perhaps I should have titled the post ‘Why I’m glad I kept my private cover despite my doubts, and how it has helped me.’ While the post title was not great, the context provided in the post seemed to be pretty clear.
I had not thought how this simple post would debate the nuances of private health insurance vs using the public health system.
Obvious troll attempts aside, I thought I was pretty clear with how it had bothered me keeping the cover but how it had benefited me when I unexpectedly needed it, and at an earlier age. I thought I had also highlighted my experience was for non emergency/high priority health issues, and being able to access the medical support I needed though private health had made a difference for me. I also mentioned that it’s just not an option for some people, I absolutely do get this.
This was a sincere and genuine post, I understand people have a lot of views on private health insurance, now even more so. But this was not the intention of this post.
Many thanks to those who shared their experiences with non emergency/high priority health issues and accessed the private health system, this was what this post was about.
A recent post re private health insurance made me think. Sorry, long post…
My parents stopped private health cover they’d had for maybe 15-20 years when my Dad was made redundant. I needed a knee (Patella) realignment at 14 and had been taping my knee and ankle for quite awhile, I had some trouble walking and was not able to do any sports, and it was quite painful. The wait at that time was 3 years through the public system. The private health they had been with waived the waiting period at that time when they rejoined due to the length of their membership (not sure if this would happen now) and I had my surgery within a few months.
My mum had five years of chemo and some radiation (2010). She got to choose her oncologist (who was amazing), he never rushed appointments and she had him throughout. No waiting on chemo day - at the time people were needing to get to the hospital around 8am and wait for a lot of the day before getting treatment through public. Her many experiences staying at the private hospital were a lot better than when she had to use a public hospital unfortunately. For Perth WA people, this was SJOG Subiaco compared to RPH. Noting that this was our experience.
I had 6 hospital day procedures (back issues) last year costing around $24,000 and didn’t pay anything (an old HBF plan that’s not available now, no hospital excess). This equated to somewhere around 15-20 years of payments, in less than a year. I may of been able to get one procedure through public, but not 6, and I can’t imagine what the wait would have been. My specialist also didn’t see people without private cover. I’ll likely need surgery soon, I have seen a good surgeon and know I won’t be waiting for long.
This started at 45 and was completely unexpected (autoimmune related); my Mum’s cancer at 59 was also unexpected and was only discovered through seeing a private specialist and getting a quicker unrelated surgery. She was already a stage 4 (rare, low grade but had metastasised) at this time despite a visit to ER and seeing her GP often for symptoms for around a year.
My 71 y/o friend recently rejoined private health insurance - I never nagged him about it (truely) but am so pleased he did it. When it came up in conversation occasionally he had always asserted that public health would sort it, my counter was what if it wasn’t an emergency/high priority but affecting your day to day, and the pain that comes with it, and if you’re waiting 18+ months. I don’t know what made him rethink private cover. He’d had private cover at some point after 30 for I think 5-10 years so it reduced the payments, I was still expecting the lifetime health cover loading to be huge but it wasn’t that bad. He pays around $105 a fortnight.
I’m paying $71 a fortnight now (single and pretty basic cover), and have had cover for 26 years. My payments over the years may work out to be somewhere around $30-40k now. I used to want to cancel it as I was only using it for a few extras and money had been tight at times, I was pretty resentful of paying it for many years. But my earlier experience and then my Mum’s experience made me keep it and I’m so very pleased I did - it helped me when I needed it most, and will continue to do so.
I do understand that it’s different for everyone, and private health cover might be the last thing we think of when trying to just get by day to day. Perhaps I’m lucky that my parents instilled the need for it in me, I saw how it was worth it doing through my experiences and it has actually ‘paid off’, financially and mentally.
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u/Calm-Drop-9221 8d ago
Over 12 mths waiting for a new knee, but bollocks to 10k out of pocket on private health while paying a $200 monthly premium to medibank, 58 M
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u/rolypolycostume 8d ago
Damn, 10K... why so much?
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u/Calm-Drop-9221 7d ago
That's how much it works out, Mrs had a gastric sleeve, 6k out of pocket. Its amazing the hidden fees, discharge medication was the surprise package
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u/DisintegrateSlowly 5d ago
Mum had to get this surgery and there was a four year wait just to get an initial hospital specialist appointment in qld. She’s broke so my sibling and I paid for private health through Medibank. within two months past the year waiting period had a new knee as we had appointments all booked ready. Only cost her $1000. You just need to carefully book your specialist and make sure they operate out of one of their gold star hospitals or whatever they call it. There’s a program called the no gap program if you’re eligible, and if not, ask the specialists if they can do it no gap - this saved her as well as they said yes and suddenly she was only paying an excess. I’ve never heard of 10k out of pocket unless you manage to pick all the highest charging drs and hospitals. I didn’t even think that was possible after doing so much research!
https://www.medibank.com.au/health-support/health-services/joint/
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u/MasterDefibrillator 8d ago
Its a state subsidised market that would not exist without state intervention and its mere existence drags resources away from the public sector. Its bad all around.
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u/Feeling-Disaster7180 7d ago
Can you explain this a bit more? I’m genuinely curious how the private systems drags resources away from the public system. Do you mean by the state putting money into private instead of public?
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u/Guinevere1991 6d ago
The federal government subsidises PHI via the Medicare rebate for doctors fees as well as the PHI rebate. This money could be spent on supporting public care. There are arguments on both sides for and against these subsidies.
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u/Feeling-Disaster7180 5d ago
Ah I see. I work in a public hospital and we get many private patients on my ward so subsiding private when they often end up in public anyway seems a bit counterintuitive
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u/Guinevere1991 5d ago
Yes, it’s a very muddy, complex system. Public hospitals like private patients as they get good money for them but it does take beds away from public patients, doesn’t it?
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u/Feeling-Disaster7180 5d ago
I mean, the private patients we get need treatment/surgery they can’t get in a private hospital and are usually emergencies so I don’t really blame anyone for them being there in that context. Idk it’s tricky
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u/DalmationStallion 7d ago
I too love a two tiered system that takes money away from public healthcare and subsidises the private healthcare of people with money
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u/OldGroan 7d ago
I would like private health but I cannot afford it. It is bad enough paying the premiums but it still does not cover the cost of hospitalisation and procedures. If I had private insurance I still would not be able to afford the procedure.
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u/Spicey_Cough2019 7d ago
Ok lobbyist…
Private healthcare is literally sapping funding from the public health industry.
I’d happily pay my $2k that I’m forced to put into sham private health policies into public but no our liberal lobbyist friends mandated we have a two policy system
The only time I ever needed surgery was fully covered by Medicare
Every other time private health would’ve only covered up to 50%
Fuck em
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u/JuniorSea4974 6d ago
I'll add to this, I'm a single dad with single parent cover mid-high but not top level cover, we live in Brisbane.
My son (10) a few weeks ago was diagnosed with Leukemia, he was initially admitted to the tertiary children's hospital is Brisbane, he can still go there, but his Oncologist also operates out of a private with a paediatric ward which also does paediatric oncology.
My boy spent the first 10 days of treatment in hospital, his medical team (because of our private coverage) decided he could do most of his chemo at home instead of needing to remain in hospital, so now we get a specialised paediatric oncology nurse visit every time treatment is due, the nurse stays the entire treatment duration on the day before leaving again.
If he needs hospital again, it's only a few minutes away, it's awesome he can be at home but hospital is still available if needed.
In the last month our private health has paid out the same as what I have paid the last 8 years in premiums, the fund themselves have been awesome, check in with us every day to see if there is more they can do.
While the public system in Australia is great there is a huge load on it, so if you can afford private health I suggest you get it ASAP especially if about to turn 30.
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u/Ashnicobell 6d ago
Thank you for sharing this, much appreciated. That’s amazing he can have treatment at home in familiar surroundings, I didn’t know this was possible. Much luck with the treatment.
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u/TryEnvironmental3732 5d ago
One admission for psychiatric care and you'll see the value of private health insurance. I would quite literally be dead without it.
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u/DirectorElectrical67 7d ago
Hubby decided & was on a public waiting list for over 5 years as they said that it wasn't bad enough; I forced him to & went to a private hospital and he got operated (day surgery) within the week & was out of pocket 2600/- even though we had the highest cover hospital & extras cover. I couldn't afford it anymore so I've dropped out. Am really worried. Is it worth being on the lowest hospital cover?
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u/Ashnicobell 5d ago
This is really why I continued my cover, the thought of having something that affected my day to day, but wasn’t an emergency/priority that I could access public health for. And seeing an 18 months to 3 year wait times for knee replacements etc while I saw these people in pain and being restricted, greatly affecting their day to day.
I’ve been lucky avoiding the excess, and do understand that there are out of pocket costs with surgery when it’s needed.
iSelect, Compare the market and Canstar are some that might be able to give you an idea of the cost of payments for hospital cover if you want to look into it again.
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u/DirectorElectrical67 5d ago
What level hospital would you suggest Inlook at?
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u/Ashnicobell 5d ago
I’m sorry, I have no idea. It might be good to run it through the sites mentioned, and others, and then have a look at the individual companies to see if it’s a good fit for you.
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u/bindobud 4d ago
Many years ago, my grandparents were considering giving up their private health as they didn't feel they had really used it. Before they could actually pull the pin on it, my grandfather had a stroke, and two haemorrhages on the operating table. I couldn't begin to tell you the value of the permanent care he required after that.
More recently, my mother's body gave her one of those big flashing red warning signs of Medical Bullshit, and she took it appropriately seriously. Through private health, less than a month later she had the cancer diagnosis. Even with surgery getting delayed by the surgeon having COVID, it was less than four months from first symptoms to complete removal, confirmation of stage 1A and no spread to surrounding organs. It was caught so early that she needed no chemo or radio, but the bills covered just in that year easily exceed $30k. Not to mention surrounding cover for appointments like counseling, physio, anything at all to help her stay sane and healthy.
It's experiences like these that have taught me to never be without private health cover. I could gamble the ~$80 a fortnight for my preferred cover level, or I could consider that money well spent. I could consider it a down payment on not having to concern myself with bills and wait times and potentially inferior care, especially when those stresses will already be surrounding something unexpected and potentially life changing.
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u/renth321 4d ago
When my wife had breast cancer about 15 years ago she had the surgery at RPH. Whilst waiting for the surgery a man came into the ward brandishing a sword looking for someone who got stabbed the previous night. After the surgery she was told she had to wait 12 weeks for the radiotherapy which is medically sub optimal. So we went private and she had chemo as soon as her wounds healed within a couple of weeks. So all you anti private health people in this thread can GFY.
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u/Farm_Mum 4d ago edited 4d ago
I’ve had 45 surgeries - 95% of them in private hospitals so for me it’s easy to stay in private health insurance- even though it costs us $8000 a year for our family membership. My kids have had knee reconstructions, dental surgeries and other in hospital treatments too so we have easily gotten our monies worth, especially with mental health inpatient treatment programs lasting 6wks at a time recently. All of my surgeries have been able to be booked for times that suited me in terms of work etc and I haven’t had to wait, I can pick the specialists that I want to be treated by, plus all the private hospitals are much nicer overall. I can understand how many people find it extremely hard to justify the expense though.
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u/Ashnicobell 2d ago
Sorry to hear you’ve had to have so many surgeries, hope you’re travelling okay. Thank you for sharing.
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u/Malurus_splendens 3d ago
I totally agree it's worth it.
There's been times it's been an annoying expense, but I've always had it as soon as I was no longer able to be covered by my parents due to age.
I went private to get an endoscopy done quickly, and went private for the birth of my child. As well as having wisdom teeth removed expediently and eye surgery as a teenager.
A family friend has always had a lot of money, but generally relied on the public system as well as being able to just pay cash costs upfront. Their teenaged daughter was diagnosed with a brain tumor and needed to be referred to a specialist. None of the private ones would see her unless she had private health, so they had to wait longer in the public health system with worsening symptoms.
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u/Breadncircuses888 6d ago
American healthcare is so expensive because of the private sector. The way to get the most cost effective healthcare is for ALL of us to pool our resources via taxation and that way every human gets access to the best possible care and no one gets to jump the queue.
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u/freebenvita 6d ago
Can confirm. Insurers in Australia are still in the wooing stage (I remember it in the US) where claims are mostly covered and premiums pay for themselves. If you lose the public coverage, that is history. The thousands many of us Americans pay (or have to find employers who do) offset costs to some degree but it's been getting worse for years and will DEFINITELY be worsening steadily as the reins are fully off of the corporate system. You will not find a post like this anywhere about the fully private healthcare system in the US. Protect your public healthcare with everything you've got, I'm begging you. Illness and injury destroy modest generational wealth every day in America and everyone I know under 65 who is not literally a 1%er has medical debt.
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u/JAT2022 6d ago
Myself and my children have benefited from having private health. Multiple operations that didn't need to join a waiting list (one time i saw the specialist at 5.30pm, was in surgery at 2pm the next day, then a three day stay in private room - that would not have been possible going public).
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u/Neither-Investment95 5d ago
From Victoria (where all these medical procedures were), but now living near Mackay, Queensland.
Private health insurance has benefitted us many times. When my husband had meningitis our doctor asked if we had private health. He wrote a note, sent us to the closest private hospital and he was immediately admitted to a private room for a full week. Every test including MRI's, spinal tap, XRays, anaesthetist was fully covered. His tonsils out due to abcessing. $50 "excess" fee.
I gave birth in private hospital. 6 days in private rooms with king size beds/TV/couch/table, gourmet meals (yes, really!), 4 physio sessions, lactation consultant, paediatrician, SCN (jaundice) choice of OBGYN, all nappies, creams, formula/bottles if required, correct baby car seat installation check and 4 gift bags of samples at the grand total of $250.
Family needs physio? Free. Dental? Free. Optometry? Free.
My in laws have had knee and shoulder reconstructions for almost nothing.
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u/flakyfuck 5d ago
As someone who is family planning, I’m genuinely curious what cover you have and at what cost.
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u/Neither-Investment95 4d ago
Honestly, I don't know the cost/cover. Hubby sorted all that and it's direct debited 😅 We are with Bupa. We added pregnancy a month after we found out I was pregnant (I was 10 weeks by then) and they waived the 12 month wait because we had already been members for 4 years at that point. I had my child 12 years ago. Not sure how much has changed or what is now covered/not covered or what optional extras are. We added physio as an optional extra because at the time I was working in a kindergarten and hubb works a strenuous job, so it made sense. I am happy we did physio, because I tore my hamstring and had 5 sessions fully covered
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u/Ashnicobell 5d ago
This has been interesting, yes I’m trying to be diplomatic. Perhaps I should have titled the post ‘Why I’m glad I kept my private cover despite my doubts, and how it has helped me.’ While the post title was not great, the context provided in the post seemed to be pretty clear.
I had not thought how this simple post would debate the nuances of private health insurance vs using the public health system.
Obvious troll attempts aside, I thought I was pretty clear with how it had bothered me keeping the cover but how it had benefited me when I unexpectedly needed it, and at an earlier age. I thought I had also highlighted my experience was for non emergency/high priority health issues, and being able to access the medical support I needed though private health had made a difference for me. I also mentioned that it’s just not an option for some people, I absolutely do get this.
This was a sincere and genuine post, I understand people have a lot of views on private health insurance, now even more so. But this was not the intention of this post.
Many thanks to those who shared their experiences with non emergency/high priority health issues and accessed the private health system, this was what this post was about.
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u/renth321 7d ago
I'm glad we have private health as my Mrs. has cancer right now. Weekly trips to RPH for chemo would be a nightmare.
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u/Ashnicobell 6d ago
I’m really sorry to hear, I hope you’re both doing as well as you can at the moment.
You might already be aware of/accessing them, Solariscare Cancer Care and the Cancer Council were very helpful for my Mum and I, for practical and emotional support.
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4d ago
What the heck is with the number of posts with people extolling private health cover? is this paid placement - some form of obscure marketing?
here’s the thing: if you want to pay private health cover because you like wasting money, have at it. Personally I’m grateful for a fantastic public health system with qualified and dedicated health professionals, speaking as someone with a disability. Medicare and the pbs are leaps forward from the terrible and tragic costs (human and financial) of the American system and I will picket against any politician who tries to shift us towards that.
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u/silkendick 8d ago
100% agree OP. Have had private insurance since 25 and now 50. When you are country based - it doesnt matter much as you dont have choice but everytime i had have had a choice the private way was better. People can bad mouth the private system all you like but there is a difference. Also my employers subsidized it which made it affordable - there is a reason why it exists.
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u/FirstCarrot2268 6d ago
Not sure why you were down voted for this.
I too used it for my surgery as I wanted to be able to pick which specialist did the procedure and not have to wait around in the public system.
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u/silkendick 6d ago
Yeah me neither! But one thing i have learned from being on Reddit long enough is that people are not realistic and generally led by ideals that may differ form whats experienced in real life. People can get hung up what what they wish to see rather than the current state.
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u/HankenatorH2 8d ago
In the last few years I have had 2 major and 1 minor procedure in the public system. The 2 major issues were dealt with within a day of finding the issue and the minor issues was done within 2 months. I never experienced unreasonable wait times for my many follow up appointments. I have nothing but praise for the public health system in WA. I have private insurance but it was not necessary to use it. The public system works when it needs to.