[SoxyMama]

SO I would like to know, as I've been discussing this out with my husband. We have never had private health insurance and can't really easily justify it.

I'm a victim of the pathetic times in the public health system - with stage 4 endo and bowel endo I should have had a bowel reconstruction and complete hysterectomy years ago, but still not even on a waiting list (was, thrown off it as specialist quit that hospital, went to different hospital they then said couldn't offer it, now at a different hospital and meet again on Monday). I have other bumps (lipoma, liver tumour) but they are both benign. Hubby fears he may have skin issues as he has suspect moles. Now my DD who is 5 and starting to worry about her weight and health and now 2nd UTI in short time, and our response from the children's hospital was to make us aware of the 'wait' times to even get an appointment.

So what if something was radically wrong, like if they DID find a cancerous tumour? Does the hospital react, or are you left to die? In the 18 months I thought I was dying with my endo stuff (couldn't eat, walk and in so much pain could barely move) I was told all sorts of things, from 'you need to walk more to get your bowels moving as they're clogged up' and 'you're fine' (from gyno) and all sorts of other go home and take some panadol. It took my OWN fighting of the system and meet with specialists outside the public system, to get into the system to get a laporoscopy and get a diagnosis finally. And I'm still no closer! Though its not so bad at the moment.

But what if something really went wrong? What if the phone call they left was wrong 'We think the tumour on your liver is benign still' - I mean what does 'think' mean? If they did find one day it was now cancerous would they do something, or are you still left on wait lists?

I guess I'm trying to justify is private health worth it, for the amount that you pay. Or if something went really wrong you would be treated efficiently by the public system?? I can bare with the pain and non-essentials so long as things aren't terminal. But wondered what they do when things do go bad?? Like what if my husband did get his moles checked and it did come back with a bad diagnosis? Would he be effectively treated in the public system? Or are you put on wait lists still?? And how long are those lists even for more urgent matters??

This post has been edited by Katakacpk: 12/04/2012, 06:09 PM

[Winterdanceparty]

I think the public system is all about triage and waiting if they don't think you are an emergency. I would never give up my Private Health Cover and never give up the fact that I am covered 100% in a private hospital. We are now on the pension and it is a struggle, but I would rather live on bread and vegemite than give up this cover and be subject to all the horrible things that go on in public hospitals.

[lizzzard]

There will probably be people on here that are far more knowlegable than I on this topic, but my understanding is that the public system is based on a needs-based triage model... so the neediest are put first. This *probably* means that if things were really dire, you would be cared for...as long as capacity wasn't all used up with others who were in equally precarious medical conditions....that is the risk you are taking.

[HollyOllyOxenfre...]

I've seen things move quickly both in the public and private system when it came to things like cancer, which in both cases I'm thinking of was unfortunately terminal. It all depends on so many factors though - what your public hospitals and doctors are like, what the demand is like in your area and what your private services are like. There would still be waiting lists in the public system, but my understanding is that when things are serious you're moved up to the top of those lists.

For me, a lot of the advantage of having private cover is that I'm able to choose who treats me. I had sinus surgery a few years ago when my sinuses got so bad that I was getting constant migraines and had many days when I couldn't drive due to vision problems. In the public system I would've been waiting 6-12 months for the surgery because it wasn't urgent - instead I saw my GP, got cat scans and a referral to an ENT surgeon and was operated on within four weeks of my initial appointment.

I've always looked at PHI as insurance, just like house or car insurance - you don't want to need to use it, but if you do you're glad it's there. I don't think it can really work on a value proposition. We get a decent amount out of our PHI most years, but it was really only last year when I had DS in the private system that we would have got more out of it than we put into it IYKWIM

[stopwhiningatme]

We have private health insurance for the precise reasons in your post. If one of us requires non urgent medical attention, we want to know that we'll get it straight away. I'd hate to end up with a non urgent (but very painful) condition and be forced to languish on a waiting list. I don't really think about 'choice' of doctors. To a large extent, you just put your faith in whomever you've been referred to, don't you? It's not like you can really assess their ability.

I wish the public system was better funded (and included dental) and provided a good service to everyone regardless of income.

[Nora.]

We have private insurance but can't afford to use it. It's ridiculous. I need my gallbladder out but the out of pocket expenses are just beyond our means at the moment.

[soontobegran]

The public system in Australia is a wonderful but less than perfect system. There are waiting lists for non urgent cases and immediate treatment for emergency or life threatening conditions.
Unfortunately pain and discomfort does not take a high priority unless that pain is threatening your life.
This is one of the very unfortunate shortfalls of the system which such a high percentage of Australians rely on.
If your symptoms indicate a life threatening condition you will get an immediate appointment and your investigations and treatment will be done in a timely manner so your condition will not further deteriorate.
If a test comes back which indicates cancer you do not wait.

The beauty of having PHI is that you can shop around for a doctor who can effect immediate care of a problem that is making your life miserable yet not life threatening. You have choice to not put up with pain and discomfort but it costs.
I liken PHI to home and car insurance, you have it and spend a lot of money on it, you will almost always have an excess to pay and will often go an entire lifetime without making a claim on it but it sure is nice to know it's there if you need it.

It is a tough decision OP.

[PrincessPeach]

The public system in Australia is a wonderful but less than perfect system. There are waiting lists for non urgent cases and immediate treatment for emergency or life threatening conditions.
Unfortunately pain and discomfort does not take a high priority unless that pain is threatening your life.
This is one of the very unfortunate shortfalls of the system which such a high percentage of Australians rely on.
If your symptoms indicate a life threatening condition you will get an immediate appointment and your investigations and treatment will be done in a timely manner so your condition will not further deteriorate.
If a test comes back which indicates cancer you do not wait.

The beauty of having PHI is that you can shop around for a doctor who can effect immediate care of a problem that is making your life miserable yet not life threatening. You have choice to not put up with pain and discomfort but it costs.
I liken PHI to home and car insurance, you have it and spend a lot of money on it, you will almost always have an excess to pay and will often go an entire lifetime without making a claim on it but it sure is nice to know it's there if you need it.

It is a tough decision OP.

This sums up my opinion nicely.

Also a lot of private health funds have agreement doctors - so no out of pocket costs!

[AvadaKedavra]

The publi system is fantastic at dealing with urgent things, and less good at non-urgent things - things that might make your life incredibly miserable, but not be a danger to your life (e.g. endometriosis, joint replacements etc). I have had both public and private care and I do not believe the quality of care provided to be different, but there are real limits to the ability of the public system to deal with chronic and non-urgent conditions. That being said, there is a real limit to the private systems ability to deal with really complex situations - complex or rare diseases, very sick patients etc.

Whether or not you will benefit from PHI depends on you as an individual. I don't think there's a huge difference in maternity care, or 'minor' emergencies like a broken arm or an appendicectomy - except that private will cost you and public is free. If I needed a major operation I would go public. If I had a chronic condition requiring hospitalization and could afford it, I'd go private. If it was for a chronic condition not requiring hospitalization then I wouldn't bother with PHI as it doesn't rebate outpatient care and you could just see a private physician anyway.

[howdo]

I would never rely on the public system alone. I recently paid about $600 out of pocket for a $9000 operation. I know how much it costs because someone else without private cover enquirer about the cost at the same facility because she was stuffed around on the waiting list and effectively bumped off it. The list, I was informed by my GP is 2-3 years in the public system.

I am now getting physio for my post operative care and am mostly pain free. The other person is now suffering from a secondary condition that makes them ineligible for the original necessary care until the secondary condition is under control.

I will always keep PHI.