Every time I do the maths I think I'm better off having no cover at all. (I'm over 30 and make good money so I have to have it, blah blah)

I've a friend who swears by top cover platinum everything. I'm the opposite. I calculate the money I save is greater than the cost of worst case, which would be something like cancer and the public system, and unlikely.

A cabbie told me once that both his sons went to hospital for similar disasters. One flashed his private health card and paid. The other didn't pay a cent. Obviously this is a very vague story from a cabbie, but I kinda half believe it. If i ever use my cover for dental or physio or whatever I get sweet **** all back, compared to the premium.

Anyone got any experience?

About 10 years ago I was up on private health costs. A few surgeries and rehabs meant Id made up quite a few years worth of payments in savings. A few years since Ive been about even for the year with claiming physio, fitness classes etc. Im with an expensive fund with top extras, but the flip side is they pay pretty good contributions on the things I use. If they reduce their contributions I will reassess as it is starting to get a little too stingy.

As for having health insurance in the first place, yes, you can get most things done for free, but there's no choice of medical practitioner, often waiting lists and shared hospital rooms seruously suck when you're in pain. I feel with an active lifestyle private health insurance is a must. Then there is the moral aspect of whether you think you should pay for things, or you pay enough tax that should look after it etc etc. I'm not touching that one as I have mixed thoughts on the topic.

I had private and had a op in public. My gp told me not to mention private. Ive since dropped private because I cant afford it right now but have ambulance cover. You really must have ambulance cover. Its cheap compared to what an ambulance costs. Even healthy people can sometimes have emergencies needing ambulances. A trip of a few kms cost me 800 luckily it was covered by insurance.

Haven't the government skewed it so that even if you make no claims, you are better off with private health insurance?

I thought they set it up so that the medicare levy surcharge makes it better to have health insurance even if you never use it. I think some funds provide a product that meets the requirements, but is otherwise just there for people that want the minimum cover.

One thing that annoys me is that they give you two years of time where you can go without cover without being hit with a higher premium when you get insurance again. If you exceed this, you need to pay extra premiums and then I think it takes ten years (?) before your premiums go down to what they would have been if you had continuous cover.

Which means, even if you are not earning the same level of income for a while, you need to pay for health insurance so that you don't pay a premium excess when you go back to insurance.

..and of course premiums keep going up, and the health funds argue they need to, and at the same time they argue that the government needs to force people into insurance to bring the cost down. Sounds a bit strange that they argue prices will go up unless people are forced into it, yet when people are forced into it, the prices still go up.

I would argue, you may as well make the health funds like any other business and use medicare as the safety net. If people don't want to pay for private health insurance, let them wait in queues.

Evlpanda, are you sure you come out better without joining a health fund?

I found myself in hospital a few weeks ago after seeing a specialist. I didn't question private vs public (mainly because it didn't occur to me to do so), but went private in any case. Didn't pay a cent, but I did elect to not have foxtel and all the other frills on offer. I am happy with the outcome, but I haven't any other experience to compare to.

I only have experience with private but I would not be game to cancel it. I figure if oldies wait 2ys for an operation and keep getting cancelled, what chance do we have going on pubic waiting list for a sports injury op?? They'd call that real low priority just cos a 40 y/o can't get on the water lol

All 4 times in hospital for an op I have been treated like a king and not paid a cent. Even when I had to go public (emergency surgery) both times I have told them I was private and got a single room and stuff which is a big help when recovering. If you've had very uncomfortable surgery the last thing you want is 3 other people in the room and all their rabble visitors.
OTOH, the public hospital can't give me a bar of soap and a toothbrush when I am a private patient FFS. That's very ordinary.

I broke my LH of bicep tendon a couple of years ago... went to the doctor who said to me that I could live with it or otherwise pay $15K for an operation which would no guarantee it would be the same..I still can do 12 straight pull ups and 2k swimming without it and I am 50, but with insurance I guess he would booked me in straight for an operation no questions ask.

another exemple of my missus few years ago doing colonoscopy and she got her bill dropped straight away when they found out that she didn't have a private insurance and would pay from out of the pocket

I have it but think it's class divided as private education , not everyone can afford such luxuries, shouldn't our high taxes pay for high class health, sadly I think you'd have a better chance of recovery from seriouse health issues with it than without

I have it but not the hospital cover.

Had kidney stones and was admitted to hospital, looked after great, had the same guy who I would have had if I was private.

I did have a shared room but was only in for the day. I actually do not know what the big deal is with having a private room???
( I actually thing they can b dangerous, you are not checked on every 5 mins and if u take a turn for the worse (and cannot ring your buzzer) what then, with a roomie they can ring for you or shout)

Also you may be very surprised how many, of rather how few Drs are at private hospitals in the evening.

You need to watch out for the meds bill when private you can be surprised with what is not covered.

like all things you make your choice and take your chance.

Insurance payments just keep adding up and forever increasing, house, contents, car, kite , dogs, death, tpd, employment and health!!
Just glad I do not have a bike, cat, boat, and a second house

I had a sore gut a year or two ago, thought nothing of it, joked about eating an off pie. Was still whinging the next morn, when I didn't feel like any brekky the missus sent me to the doc. He took one look and sent me directly to emergency room of Redcliffe hospital. Apparently they don't fk around with appendicitis, my bum literally didn't hit the seat in the waiting room. In 3 minutes I was on a stretcher with a drip in the arm etc.. Had to call the missus from there, sorry love not at the docs any more.. and I'll be here overnight so can you bring a bag? Anyway after waiting all day and having a CT scan, they said "our surgeon only does old school, 10cm scar. If you go private they'll do it keyhole. Your choice." Now at this point I'd been in a grotty room (I'm not being snobby here, if you look around at Redcliffe public you can see the budget cuts, there's no money for paint, 3/4 of the lights are left off, all that stuff) with 3 others all day with this awful mulleted loudmouth bogan and his clan talking top of their voices all day about the contents of a woman's weekly, mostly. Took me about half a second to decide. After I moved to private, had own room & bathroom, all the mod cons, total luxury.

Last year, smashed elbow. Ambulance to Nambour public, similar story.. Great staff, pity about the ferals that end up there. Better condition. Same deal, after listening to some meth head yelling all avo with security permanently stationed next to him trying to keep him quiet, got the choice to move over to private. No brainer, next 3 days in total luxury.

So for me, it's paid off generally - even though both times there was some excess to pay, totally worth it.

Downside - had to have 2nd surgery on elbow - NIB declined to pay at all, apparently they only cover accidents for 3 months then you're on your own.
The surgeon only works out of the private hospital so i had to pay full fees out of my pocket (aside from some measly medicare contribution)

There's always a fine print clause with insurance.

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dmitri said..


another exemple of my missus few years ago doing colonoscopy and she got her bill dropped straight away when they found out that she didn't have a private insurance and would pay from out of the pocket

That seams to be the other side of it, the price gouging and over servicing of people with insurance. Just look at some of the stories from the USA with procedures costing tens of thousands of dollars more if you have insurance. There really needs to be a royal commission into the health industry.

My cousin had premature twins. She was a public patient. They needed a ridiculous amount of intensive care, specialist doctors, etc. The doctors she had were the best available, as it was a difficult case. If she had been private, she would have had the exact same doctors, but would have been out of pocket about $20K in the end.

When you have an emergency, you will get whoever is there at the time, whether you are public or private, except you'll cop a big bill if you say you have private insurance.

The thing I hate the most is that they ask if you have private health insurance, and then assume you want to use it, and you end up paying the gap. I have taught my wife and kids that if they are in emergency and asked who they have private health insurance with, they are not to say, and simply answer "public patient". The next day, after they have at least stopped you from dying, then you can reassess and see if you are happy with the doctor who is assigned to you, or whether you want to get your own doctor using your private insurance.

On the flip side, a friend broke his jaw playing football, and got taken to the local hospital by the ambulance. When the nurses on duty found out what had happened to him, and who the doctors were that were assigned to him, they warned him to go somewhere else. His private health insurance saved him from having a bum job done with his jaw.

There is sometimes room to negotiate with surgeons.

After putting a Stanley knife most of the way along my thumb one afternoon and needing more than just a few stitches I ended up in a private hospital with one of Perth's primo (meaning expensive) hand surgeon. My first encounter with him was late evening (last op for the day) just before the op was to happen so there was no chance to barter

The op went well and all was well until a week or so later the bills started to arrive. I was going to be out of pocket by about one and half thousand dollars even after my private rebate. I was on sick leave from work for a few weeks so I had plenty of time to start ringing around to determine why I was getting so little back between Medicare and my health fund. It turns out that my "Hollywood" surgeon charges at the top end of the scale and the very helpful health fund lady I spoke to said that quite often a surgeon will discount his fee if asked nicely.

I spoke to the surgeon's receptionist and expressed my surprise at the out of pocket cost for the op and she told me that she would speak to him to see what they could do for me. The end result was that he was happy to drop his charges to a level where I would only have to pay about $700 all up

I guess it pays to haggle if you can !

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Harrow said..
On the flip side, a friend broke his jaw playing football, and got taken to the local hospital by the ambulance. When the nurses on duty found out what had happened to him, and who the doctors were that were assigned to him, they warned him to go somewhere else. His private health insurance saved him from having a bum job done with his jaw.

^ This.

When I broke my foot and got referral to Surgeon, nurses gave me a quiet word about the Dr I'd been allocated. Couple of calls to local health people I know well and got similar response. Changed Surgeon and sorted out. Dr Hack doesn't get anymore cutting time at local hospital anymore.

Had to pay for Anaesthetist though as he wasn't on "the list" for my provider, 2nd op I checked before hand and only paid for the newspaper at the hospital.




2nd bub was dropped in the "public suite" - nurses very apologetic afterwards that we weren't directed to the "Private Suite" on our arrival.
Given we were at the hospital less than 7 minutes I was just thankful we didn't have her in the "private suite" of the front of the car or the "Public suite" of the car park.

My private hospital did room service.

Gourmet pizza and a glass of a nice Sem Sauv Blanc - on top of opiates - does life get any better?

Almost makes you wanna get injured.

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sotired said..
Haven't the government skewed it so that even if you make no claims, you are better off with private health insurance?

Yes, and I am better off, because I have to have private health (Just like I have to put 10% of my income into super, which is mostly the stock market - queue heavyweather).


I suppose my question should have detailed that, and that what I was asking was do I go platinum or tin cover? But reading all these stories ...i'm just as confused. There seem to be so many exceptions to any rule-of-thumb. Some people had great experience with public, others greate experience with public and not mentioning their private cover, and others had much better experience with private.

Perhaps the costs associated with running private health and making them profitable might better go towards public health - blanket flat percentage rate for all?

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evlPanda said..

sotired said.. Haven't the government skewed it so that even if you make no claims, you are better off with private health insurance?

Yes, and I am better off, because I have to have private health (Just like I have to put 10% of my income into super, which is mostly the stock market - queue heavyweather). I suppose my question should have detailed that, and that what I was asking was do I go platinum or tin cover? But reading all these stories ...i'm just as confused. There seem to be so many exceptions to any rule-of-thumb. Some people had great experience with public, others greate experience with public and not mentioning their private cover, and others had much better experience with private. Perhaps the costs associated with running private health and making them profitable might better go towards public health - blanket flat percentage rate for all?

im pretty sure the stat is if australia continues its rate of spending on health it will equal DGP by 2050. thats why we dont spend more, or have a flat rate type insurance.

private health....
in an emergency you are better off with public.
sports injuries, where you walk into a consultant specialist, need physio, ortho, occupational therapy etc. and book your surgery private far better.
having babies? private far better (so long as not premmie or something out of the ordinary where costs will be massive) then public better.
as you age you tend to need stuff like your colonoscopies, gastroscopies, back issues etc all much better with private.
probably not much sense now but when you are older might start paying.
do you have a family? kids etc expensive little fkkrs. sometimes they need stuff done. also women can have their own problems with their gear

For life threatening or injuries then public is the way to go.

For just about anything else you will wish you had private insurance. I have friends/family who have waited for years for stuff and they have been virtual cripples or invalids while waiting. Those with private cover just rock up, get the procedure done and out within days.

Think of waiting for a knee or hip replacement. Bad back or neck pain. Joint problems. Heart arrhythmias and palpitations.

Private health insurance is like all insurance. The only time you wish you had it is when you need it.

That's why I vote left

The public system is great if you have an emergency. A medically defined emergency, not what you think is important. Get stabbed, smashed up in a car, premature labour/birth, heart attack, you'll be looked after really well in the public system. If your condition is not an emergency, sporting ligament ruptures, arthritis, migraine, back pain, cardiac insufficiency then you want to be private. The outcomes are completely different, not because of the care that you receive, but because of the time difference between injury/illness onset and treatment commencement.
Understand that person giving you the care has nothing to do with the maintenance of the facility, either public or private.
It is all about the timely response to non medically urgent health. And cancer can be considered non-urgent depending on the type, and based on 'normative data' ie typically this cancer takes this long to kill you so we will treat you at this stage (dependent on public or private)..
It is what lets you sleep at night that will help you make a decision.