Private health cover’s mass exodus continues

‘Of course it’s concerning, we know people are finding it hard to cover the cost of the premiums, and private health is perceived as expensive,’ says peak body chief.

Private health insurance exodus

The percentage of Australians with basic hospital cover has dropped to 45 per cent, its lowest level in more than a decade, as almost 30,000 people dumped their policies in just three months.

The latest Australian Prudential Regulation Authority (APRA) report revealed that health premiums rose almost 2.8 per cent over the June quarter – faster than wages and inflation, and out-of-pocket costs are continuing to hurt hip pockets, reports the ABC.

“This is a continuation of the same trend, the same spiralling down trend we’ve been referring to for many months now,” said Australian Medical Association president Dr Tony Bartone.

“We need to address the issues underpinning this decline to ensure equity and access to the public health system.

“Our public health system is predicated on a specific amount of work being done on the private system – that is relieving a lot of pressure on public systems.

“If that was to fall over tomorrow, that would [create] an enormous burden, an enormous burden the public system could not cope with.”

Even the private health insurance industry’s peak representative body is concerned but feels that members will still benefit by hanging on to their cover.

“Of course it’s concerning, we know people are finding it hard to cover the cost of the premiums, and private health is perceived as expensive,” said Private HealthCare Australia chief Dr Rachel David.

“People are getting value for their money, particularly if they hang on to their private health insurance for the long haul.”

Australians pay an average of $315 in out-of-pocket expenses for each hospital visit and an average of $151 in specialist gap fees which varied greatly depending on location.

Canberrans forked out the most for specialists, paying an average gap fee of $271.40, while South Australians paid the least at less than $70.

The Grattan Institute’s Health program director, Stephen Duckett, has a theory about why people are dropping their health cover, pointing out some obvious flaws in the industry.

“People paying health insurance for years and years, suddenly need to use their health insurance, they go to hospital, and they end up with these surprise bills,” he said.

Taking out health insurance is something people in their 20s and 30s grapple with, but what about older Australians who are deciding whether to keep it?

“Then they get really, really annoyed, and this doesn’t help the health insurance industry. People find they’re not covered, and they drop out.”

A spokesperson for Health Minister Greg Hunt said the Government was working to improve the sector.

“The Morrison Government is delivering the most significant reforms to private health insurance in over a decade, which is making insurance simpler and more affordable for Australians,” he said.

“Work has already commenced with the healthcare sector to identify and implement the next wave of improvements for private healthcare.”

In the most recent Retirement Matters survey, 69 per cent of the almost 5000 respondents had private health cover, 81.5 per cent of whom hoped to keep their cover for life. Of those without cover, 73.3 per cent said they were once insured.

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    COMMENTS

    To make a comment, please register or login
    MICK
    22nd Aug 2019
    10:07am
    Its the ultimate gamble. On the one hand 'what if....'. On the other hand you can save almost enough money to pay off a small mortgage. What do you do?
    Answer: look at the genes and your lifestyle then make a call. We went for the no health insurance option but this may not work in our favour forever but then who wants to live forever? Ok some of us do. Enjoy.
    Chris B T
    22nd Aug 2019
    12:20pm
    The one Thing they or anyone else never brings in the conversation about Private Health Insurance.
    1. Set aside the amount you are/were contributing, over a period of time you would have enough for the knee/hip replacement.
    2. Being a patient in Private and Public Hospital best to be avoided if Possible in equal disbelief.
    Cowboy Jim
    22nd Aug 2019
    3:14pm
    Chris B T - the thought crossed myself many times about being self-insured. We should have a health fund of close to $100'000 after 25 years in private health (paid $5270 for the two of us for another year). Being on a part age pension it would now mean a loss of $300 per fortnight because of deeming. So as long as we can pay the premium we shall stay with private health. Do agree that on the full pension there is no way anyone could afford it, maybe allowances could be made for age pensioners paying for private health but I do not hold my breath.
    MICK
    22nd Aug 2019
    3:54pm
    Agree Chris. This is our philosophy but bear in mine there are some ailments which are ongoing and beyond most of us to subsidise. From my point of view that's when one has to accept one's fate rather than try and extract another couple of months or years in a no win situation where nature is going to win anyway.
    Chris B T
    22nd Aug 2019
    3:58pm
    Cowboy Jim
    No claims, prefect health entering retirement Phase Lucky You.
    Elective Surgery is one thing, Medicare Covers Rest.
    Never been digging in pockets for Extra Payments but I've haven't had Elective Surgery.
    The Surgery or Procedures and oncology fully covered by Medicare all within a month, sometimes within in a week.
    I have waited longer for consultations.
    I pulled out of Health Fund nearly 40 years ago.
    Medicare paid everything, Hospitals is something else State or Private hard to find a kind word.
    Spelling errors hopefully OK Now
    {;-)
    Cowboy Jim
    22nd Aug 2019
    4:57pm
    Chris - not THAT lucky either. Got $21'000 off the insurance and paid gap payments of $6000 but even so, still would be better off with self insurance, have to admit, something wrong with you and you speedily are attended to in private cover - no waiting list.
    sunnyOz
    23rd Aug 2019
    12:48am
    Cowboy Jim - correct about the 'deeming' of the money. A friend of mine recently got caught with this. For years she has boasted about not taking out Private Health Insurance, but putting money into a separate bank account. BUT - when she applied for the Aged Pension, dear old Centrelink rubbed their hands with glee and took this money (around $55,000) into account. She argued it was set aside for medical treatment which she knows she will eventually need, but no, bad luck. So damned if you do and damned if you don't.
    Paddington
    25th Aug 2019
    10:50am
    Cowboy Jim, we are full pensioners and we are insured. It is $35 per week each with Mildura Health.
    I think it may be about priorities as we do not travel overseas as many on here do. Eating out and take away coffees are not in our budget.
    $35 can be saved by buying specials, and watching each dollar.
    We say don’t ask for extra as we don’t have it. Many are happy just to swipe the card even the ER which helps the public hospital.
    There are actually some decent doctors and surgeons. We have a $500 excess but that is all.
    Paddington
    22nd Aug 2019
    10:38am
    We are holding onto our private cover because we believe we cannot afford not to. The waiting lists for so called elective surgeries are very long in some areas. You insure your home, you insure your car, people even now have pet insurance. So why not insure yourself.
    For many people it is a matter of priorities. To us, it comes in as important as food. We do not eat out or go overseas or even have the latte which seems to be so valued. We don’t live in an area where it is exorbitant to reside which means rates are ridiculously high for a start. Holidays mean going to see the grandkids. Values and priorities dictate how we spend our pension.
    If you have funds that you can use for a $20,000 operation then it makes sense not to have private cover. But those people should not clog up the public system. Keep the public system for the poor and the homeless.
    Mondo
    22nd Aug 2019
    11:24am
    Paddington, the point is that it doesn't stop at the private insurance fees. If you use private insurance for a medium sized operation you also often need around $10,000 in the bank to cover specialist gap fees. Have the same operation in a public hospital and it costs you nothing. The difference is not only what we pay annually to the health fund it's what you need in reserve to cover gap fees and that can sometimes be several times the cost of annual private health care. We have this week paid a gap fee of over $12,000 for my wife's operation, the hospital had both public and private sections and the same surgeon operates in both. I had to pay the gap fee before I could claim anything from Medibank and I am expecting less than $1,000 back.
    TREBOR
    22nd Aug 2019
    12:32pm
    Unfortunately the private patients clog up the public hospital system, Paddo - most of their operations take place in public hospitals... the only thing that would change without private health care would be the order in which people are done for some things... mind you, that brings under the microscope the ethics of those doctors who allow some to suffer needless pain for longer while they shunt up the dollar payers... disgusting behaviour.
    ray from Bondi
    22nd Aug 2019
    1:08pm
    I do not call it insurance, insurance covers you for most of the expense and does most of the work, have a car accident and after the excess there is no more to do your car is fixed with hopefully the minimum of trouble, have a medical issue and you have to ensure everybody is paid individually, then have your refunds for whatever, When I was covered I received back less than half and had to do all the work, my wife wants to be covered as mentioned here as she has a serious illness. If you have a serious problem on the public list you wait and wait and wait, sometimes with fatal results and can be sent to the back of the list in favour of somebody with COVER, that happened many times while waiting for my heart surgery, but the one thing that sticks in my craw with private COVER is that they do nothing you have to do it all and they just sit there counting their pennies.
    Viking
    22nd Aug 2019
    1:17pm
    Spot on Ray!
    Sundays
    22nd Aug 2019
    3:42pm
    I’m sorry Paddington but unless you have cash reserves Private Health won’t help. To avoid extra fees you have to use the specialist affiliated with your health fund which may not be your first preference. There will still be extra costs even if you use their doctors. We have a seperate medical account on top of private health but I don’t know how people only on the pension would manage. This is why people with private health often go public in an emergency. They’re not sure if they will be able to afford the extra hospital costs
    Mondo
    22nd Aug 2019
    5:23pm
    Sundays, you are right but there are some operations where there are no specialists listed by the health fund. I had a spinal op last year, Medicare said I could have saved a heap if I had used their preferred surgeon. I asked who he was, they said 'we don't have a preferred spinal surgeon. But if you'd had another type of operation you would have been okay.' Sometimes you don't have time or ability to chase up and visit alternative surgeons, especially in a wheelchair, sometimes they just aren't available. Then you secure the right surgeon only to find that the hospital anaesthetist charges you $2,000 over the odds.
    The healthcare fund's excess is meaningless, it's only the starting point.
    If you look up any list of top earners surgeons are right at the top of professional earners. I don't begrudge them that position but some private fees are excessive compared to the public equivalent.
    Paddington
    23rd Aug 2019
    8:21am
    I have control of that. I don’t go through ones who overcharge. They know we are pensioners and many keep the fees to what is covered by our fund. It has happened with an oral surgeon. It has happened with regular specialist in and out of hospital.
    If I were to use the public system I would swipe my card. Usually go to the one private hospital though.
    You don’t use what you are told. You tell them.
    They quote upfront, so you go elsewhere if they quote too much.
    We find it is good value thus far.
    .
    Mondo
    23rd Aug 2019
    10:06am
    Paddington, you may think you have control of the situation but you don't. There are some procedures where it is almost impossible to find an experienced surgeon who prepared to operate for the scheduled fee. Many operations are required urgently and there is simply insufficient time to find a cheap surgeon, that's even if you want one messing with your body. If you think you can predict what medical care you might need in the future, good for you but I was bullet proof too until I ended up in a wheelchair prior to a very experienced and expensive neuro-surgeon operating on me.
    floss
    22nd Aug 2019
    10:50am
    Most people just can't afford it, simple really.
    Tanker
    22nd Aug 2019
    10:57am
    Despite claims to the contrary by vested interests our Health System is broken. Probably the major reason is that so much of it is driven by profit seeking.
    The cost of health is care is increasing around the world but the addition of the profit motive drives those costs further. The open ended charging by doctors, mainly specialists, really seriously affects patients costs as does the multiplicity of health funds. Competition is good but too much competition with the admin. costs of each really does not work in containing costs.
    The privatisation of Medibank, which while in Government hands did provide a brake on health insurance costs, was not in the best interests of consumers but was driven by ideological considerations.
    The solution is not simple especially for a Government dedicated to right wing ideology and we will probably have to continue to see greater pressure on our underfunded public hospitals.
    TREBOR
    22nd Aug 2019
    12:35pm
    No competition with cartels of doctors - perhaps not so oddly the best and most fair-minded ones I've met have all been 'traditional' Anglo-Celtic in origin.... apart from my current GP who is Sri Lankan and bulk bills everyone, and has patients lined up into the paddock outside...

    Anyway - it's a classic example of the 'business model' having once again failed to produce the goods...
    Tanker
    22nd Aug 2019
    10:57am
    Despite claims to the contrary by vested interests our Health System is broken. Probably the major reason is that so much of it is driven by profit seeking.
    The cost of health is care is increasing around the world but the addition of the profit motive drives those costs further. The open ended charging by doctors, mainly specialists, really seriously affects patients costs as does the multiplicity of health funds. Competition is good but too much competition with the admin. costs of each really does not work in containing costs.
    The privatisation of Medibank, which while in Government hands did provide a brake on health insurance costs, was not in the best interests of consumers but was driven by ideological considerations.
    The solution is not simple especially for a Government dedicated to right wing ideology and we will probably have to continue to see greater pressure on our underfunded public hospitals.
    Sen.Cit.90
    22nd Aug 2019
    11:06am
    The Grattan Institute’s Health program director, Stephen Duckett, has a theory about why people are dropping their health cover, pointing out some obvious flaws in the industry.

    “People paying health insurance for years and years, suddenly need to use their health insurance, they go to a hospital, and they end up with these surprise bills,” he said.
    S-D got right this in my case, I dropped out after many years of membership for this reason.
    Mondo
    22nd Aug 2019
    11:35am
    That's exactly right, you think you are covered just like with any other insurance, you think your "excess" is the limit bit its not, its only the start, the 'excess' is meaningless, its only what you have to pay on top of your fees to even walk into a hospital. The gap fees are the killer and can amount to several times annual insurance costs.

    What's making it worse is that public hospitals are getting patients to use their private cover for public care. My local hospital 'intimidates' patients to use their private cover, it claims it desperately needs the $5million it collects each year in private fees to run the hospital. It has no private facilities but offers a free newspaper and use of the TV in return for private cover, its scandalous. Imagine what that's costing the insurance companies multiplied by over 700 hospitals nationwide. This is all adding to private health costs.
    TREBOR
    22nd Aug 2019
    12:36pm
    Clearly a broken system, Mondo... sad, innit..in the midst of plenty a gulf is yawning, and none has a remedy for it... medical system - heal thyself!
    TREBOR
    22nd Aug 2019
    12:37pm
    Heeeey - I got TV for free..... and the only cost was the accommodation for three days unable to drive ... and that was subsidised for me ... all public...
    GeorgeM
    22nd Aug 2019
    8:24pm
    Sen.Cit.90, this is one of the few times I can agree with a Grattan Institute comment.

    However, I note that they haven't mentioned the real causes of these "surprise bills" (not in their genes) - the greed of Doctors charging enormous uncontrolled fees, the unviable Medicare Fees which doctors (and their Unions) won't accept, and the greed of Private Insurance to create profits (and bonuses for the CEO) at all cost, irrespective of how many people leave this so-called, fake Insurance product which is nothing but a con to refund a defined & limited part of your costs, with you the customer (instead of the Insurer) bearing the Risks for the extra costs.

    Govt needs to get serious and a) Cap the Doctors Fees, b) Set realistic Medicare Fees, and c) Force all Private Insurers to cover all medical costs in full, i.e. NO GAPS other than say the 15% of Medicare Fee Rates. Not too hard!
    john
    22nd Aug 2019
    11:08am
    Rachel David says people are getting value for their money, well that is nonsense, and typical of people who sound like corporates with profit on their mind. I pay $4784.00 dollars a year for top hospital and extras, but hows this one for extras, dentist, got a temp filling,one small front tooth, cost of this delicate job ( as it must be something deep and special) is over
    $700 .00, Medibank will give me under $500 rebate , but I have been told that I will pay out of pocket $245 dollars myself, I'm retired I have waited several months and as yet have not gone back for the proper work, because I haven't had a spare $245 dollars to spend on a tooth!
    My point about this private health care is I pay extras which they advertise and some of the rebate is well covered but you still pay a fair amount for dentistry, even with cover, top hospital gets you all the bed time you need , when that happens, yes. But all Xrays etc seems to have different rules, where by when I had a hip replacement several years ago there were little extras that were not covered, and its how the Health Insurers work out their covers and their high or lower standard of covers , per what the poor old customer pays, it is somewhat like how Foxtel manipulate the pay TV packages set up. You have no real choice , you get what you get, and you damned well pay for it in many different areas when in reality we should not be paying a cent, after years and years and thousands and thousands of dollars, my family me and my wife now, have had private cover for 40 years or more, can you imagine how many thousands of dollars we've handed Medibank.It is in multiples compared to what we have cost medibank in rebates, and that is why it feels like profiteering?????? I think generally the public are kept in the dark over real costs and overpofits etc, and especially the TV commercials that are run by these health funds, how many millions of dollars has been spent on Television advertising, it sounds like profit making corporatisation of the health industry. I can see the whole country looking at other ways , perhaps just saving their premiums in their bank, and then of course hoping they have enough saved if something drastic happens,and the way specialists and surgeons... (SOME)... charge many occasions people are going to be left very pocket short! The government of which ever colour needs to do something very soon about the premiums and the delivery, because $184 dollars a fortnight for my wife and I is nearly unaffordable and will be sooner than later. Then the public health will be on its knees while health insurers will take whats left and run! Thats how I see it, we are sitting on a health disaster here, we'll be like America!
    Tanker
    22nd Aug 2019
    2:57pm
    Perhaps that is the plan John to change our health system to be like that in America. It is a fact that certain political groups, like the IPA, believe that is how we should go.
    Tanker
    22nd Aug 2019
    2:58pm
    Perhaps that is the plan John to change our health system to be like that in America. It is a fact that certain political groups, like the IPA, believe that is how we should go.
    jaycee1
    22nd Aug 2019
    11:08am
    My family were in a private health fund for years. Then my husband needed to go into hospital and we were slugged with massive out of pocket fees.
    After almost 30 years of only claiming, every three or four years, for glasses for myself we would have more than three times paid for my husband's operation. Why should we even have had to pay ANY out of pocket fees?
    The final straw was when they refused to pay for the frames for my new glasses as 'they weren't frames' How the blazes did they expect the lens to stay on my face if the frames were NOT FRAMES????
    Told them there and then to cancel our cover.
    TREBOR
    22nd Aug 2019
    12:40pm
    I get my glasses from California - top class titanium frames/frameless, and two pair for $75 delivered... sometimes cheaper ..... might be getting some more soon... good to have a couple of pairs lying around...
    debs
    22nd Aug 2019
    11:08am
    I had top private health insurance with hospital and extras. It never paid back more than $200 on my glasses and never more than one third of dental!
    Then I had a ruptured brain aneurysm. I didn't die, I didn't get a choice of doctor or hospital (the first one had no ICU beds) I was in hospital for 3 weeks and was discharged with no rehab or follow up care. And for that privilege I had $12,000 in GAP payments. So NO I don't pay exorbitant premiums and next to nothing back. we're better off putting that money in an account and saving for the emergency
    Mondo
    22nd Aug 2019
    11:10am
    I don't know where they get these average figures of $315 and 151 from, they are certainly not my experience. Last year Medibank covered less than 10% of my specialist hospital fees and I paid around $9,000 for the surgeon and anaesthetist plus over $3,000 annual fees to Medibank.
    If I insured my car 'comprehensive' and I needed $10,000 in crash repairs and the insurance company paid only $800 towards it, I would be asking what's the point too.
    A major problem is that surgeons and anaesthetists are charging private patients far more than they charge Medicare for public hospital operations. The operations are exactly the same but the charges are not. Fix this and half the problem is solved.
    Annie
    22nd Aug 2019
    11:30am
    Totally agree. I have been on top cover and extras. Out of pocket expenses for an operation and 3 days in hospital approx $6000.00. The year before out of pocket expenses of over $3000 for one tooth that required specialist for a root canal. The gaps you have to pay are ridiculous and due to those I am seriously considering pulling out. Getting to th3 point it’s not worth it and yes I have taken out health cover since the mid 60’s.
    Rosret
    22nd Aug 2019
    11:36am
    Yes.
    Onemore
    22nd Aug 2019
    11:22am
    What was the profit that NIB made a few weeks back?
    ollie
    22nd Aug 2019
    11:27am
    Its not rocket science if you want to keep your lights on and eat at least one meal a day you need to get rid of something you cant afford families are struggling and it will only get worse
    Onemore
    22nd Aug 2019
    11:28am
    I wonder what the increase in immigration has done to public hospitals, or have all these immigrants, asylum seekers, boat people and the like.
    I suppose they all have private health cover, so they would not be a drain on the system.
    Rosret
    22nd Aug 2019
    11:41am
    On the plus side they must be healthy to emigrate to Australia. On the minus side they are producing lots of babies at a young age.
    On the plus side many are doctors, dentists and other medical professionals. On the minus side they still charge like wounded bulls.
    TREBOR
    22nd Aug 2019
    12:43pm
    Infrastructure in the migrant hotspots is sliding down the tubes as we speak - lack of a valid plan ... soon they will be drowning in their own faeces in the major centres due to lack of water and overflowing sewer systems... the stray dogs will eat well...
    Rosret
    22nd Aug 2019
    11:32am
    I received a letter in the mail stating NSW private hospitals charge more per night than other States therefore NSW private patients will expect are large gap from now on.

    Its the gap that makes private insurance unaffordable.
    Troubadour
    22nd Aug 2019
    1:34pm
    You got that right - on top extras and you still finish up paying almost 2 thirds in payments - with a $500 bill you still finish up paying around
    $340. The amount you get back seems to be getting less and less.
    Karl Marx
    22nd Aug 2019
    11:49am
    What a load of rubbish. The private health authority is always complaining about people dropping out, always lobbying the government for increases year in & year out, cutting back on what you can claim etc etc to protect & increase profits for their stakeholders without any consideration with policy holders. They have yet to address a major issue concerning policy holders & that's the gap they have to pay. There should be no gap or very little gap to pay, bottom line.
    Specialist/Dr charges etc should be reeled in to a fixed price sey by the industry & or government.
    "A spokesperson for Health Minister Greg Hunt said the Government was working to improve the sector.
    “The Morrison Government is delivering the most significant reforms to private health insurance in over a decade, which is making insurance simpler and more affordable for Australians,” he said.
    “Work has already commenced with the healthcare sector to identify and implement the next wave of improvements for private healthcare.”
    More rubbish from a government hell bent on protecting these companies without addressing the real issues faced by policyholders
    Maybe it's time the government started up again it's own private healthcare scheme & contracted hospitals, doctors, specialists etc to a fixed rate & put into place legislation that this government run private scheme cannot be sold off.
    But it won't happen unfortunately.
    Karl Marx
    22nd Aug 2019
    12:03pm
    The government run healthcare system would also be run not for profit.
    Also I don't see why the current private health funds can't contract hospitals, doctors, specialists etc to a fixed rate so no gap is paid by the policyholder. Rates can be reviewed each year just like an EBA.
    Pretty much the system is broken & not value for money.
    Triss
    22nd Aug 2019
    3:26pm
    Stands to reason, Karl Marx, if subscribers are down 10% insurers have to up the insurance by 10% otherwise they’ll get it in the ear from investors.
    Mondo
    22nd Aug 2019
    5:32pm
    If its a money making concern for the Canadian Teachers Pension fund to own so many of our private hospitals and to run some of our public hospitals then there must be more than a quid in it for them which means we are paying extra in Australia for our healthcare to provide a profit to Canadian pensioners. If there is that sort of money in it then why don't our own superannuation funds buy the private hospitals. At least we would be getting the benefit from the profits made!!
    Triss
    22nd Aug 2019
    7:26pm
    I’ve often thought that myself, Mondo, but our governments are only interested in selling our properties, sometimes for less than they’re worth.
    inextratime
    22nd Aug 2019
    11:58am
    I have private health cover for many years and it did mean that I did not have to wait to have three separate operations for cancer. If I had to join a queue I may not have been around today. I did pay the gap for each op and the for the 52 weeks of the chemo chemical. However one surgeon sat me down and explained the reason for the $4000 gap for one of the ops. He said that the money he received from Medicare did not even come close to covering his costs one of which was compulsory indemnity insurance which he said got taken out of his bank account monthly regardless of his work load. He said the whole thing was a political football between medicos and the government who refused to increase their rebates to the surgeons. I still have private health care 13 years after that last op but as I get older I wonder of its worth it. In that 13 years I have paid out nearly $30 grand. I think the Health Care companies want older people to bail out as they become more liable to make a claim as they age.
    TREBOR
    22nd Aug 2019
    12:49pm
    Life-threatening cases are at the top... I've had three cardiac hospital visits and on each occasion, in the public system, I've never waited longer than one month and the treatment has been top class.... last time was to probably THE teaching hospital, and the staff are exceptional .... even the 'trainee' surgeons are first rate ...

    Somedink iss rotten in dar schaat off Denmark... somebody is spreading porkies around about private v public - for seriously discretionary things, maybe it's nice to not have to wait with a painful carbuncle - but how urgent is that in real life compared to other issues?

    Simple triage says a carbuncle can wait a while.... hearts and cancers can't ... and don't unless there are other circumstances involved...

    Hmm - seem to be seeing an increase in brain tumours... hmmmm ..
    Onemore
    22nd Aug 2019
    1:16pm
    Yes, me included, after a major cancer op 9 years ago I want to give this rort the boot but now it is really insurance for me as well.
    inextratime
    22nd Aug 2019
    11:58am
    I have private health cover for many years and it did mean that I did not have to wait to have three separate operations for cancer. If I had to join a queue I may not have been around today. I did pay the gap for each op and the for the 52 weeks of the chemo chemical. However one surgeon sat me down and explained the reason for the $4000 gap for one of the ops. He said that the money he received from Medicare did not even come close to covering his costs one of which was compulsory indemnity insurance which he said got taken out of his bank account monthly regardless of his work load. He said the whole thing was a political football between medicos and the government who refused to increase their rebates to the surgeons. I still have private health care 13 years after that last op but as I get older I wonder of its worth it. In that 13 years I have paid out nearly $30 grand. I think the Health Care companies want older people to bail out as they become more liable to make a claim as they age.
    Putney
    22nd Aug 2019
    12:06pm
    I have been fairly happy to pay for full cover until just recently. The cost is becoming astronomical given that I no longer work.
    I am at that age where a lot of my friends have had surgery in the public system and have been very happy with the outcome. Even though most can afford private cover they choose to use public. I would be happy if the insurance companies would cover all costs and have no expensive gap or the government give tax relief to those paying for full cover.
    Putney
    22nd Aug 2019
    12:06pm
    I have been fairly happy to pay for full cover until just recently. The cost is becoming astronomical given that I no longer work.
    I am at that age where a lot of my friends have had surgery in the public system and have been very happy with the outcome. Even though most can afford private cover they choose to use public. I would be happy if the insurance companies would cover all costs and have no expensive gap or the government give tax relief to those paying for full cover.
    Onemore
    22nd Aug 2019
    1:02pm
    Exactly, what is the point of having private health cover, if you still have to pay out at the end of it all.
    I reckon that when more people leave private health the government will have to act, of course too late for the people that have left but will make it better for those still in it.
    Of course the younger generation have got the smarts and not falling for the con.
    SuziJ
    22nd Aug 2019
    12:08pm
    I have extras cover only. This covers my glasses, chiropractor, dental, physio. I haven't had hospital cover since the late 1990s - just can't afford it on a pension.
    fishy
    22nd Aug 2019
    12:19pm
    Would love to have it but it's not going to happen as money is real tight anyway living in the country on the far south coast of NSW anything happens they will lift you to Canberra and it would have the best of everything looking after them politicians
    TREBOR
    22nd Aug 2019
    12:50pm
    Bega boy (listed as Snowy River Men)? I got the chopper from Bega to Cambra Hospital once... brought back memories....
    TREBOR
    22nd Aug 2019
    12:29pm
    System on life support from government and palliative care from the taxpayer is best left to quietly pass on .....
    Intellego
    22nd Aug 2019
    12:35pm
    The private health insurance industry has killed the goose that laid the golden egg with its rampant greed. The government should bolster the public health sector and let the insurance companies go to the wall.
    invisible sock
    22nd Aug 2019
    12:49pm
    If two people have the same procedure, one with no insurance & the other with insurance, does the Hospital charge Medicare the same amount as the Health Fund?
    If not, this maybe why premiums are becoming so expensive.
    TREBOR
    22nd Aug 2019
    12:53pm
    I think they do ... with private however, the surgeons have to pay a rental on the OT ... that would account for part of the extra costs... public of course the surgeons get free use of the facilities....

    Funny way to approach a business if you ask me... but there must be a profit in it for the docs to perpetuate it ... though I would have thought the amount they are paid for an operation was sufficient.... some also have teaching positions and are even professors etc - they don't really need all that extra few dollars ...
    KSS
    22nd Aug 2019
    1:56pm
    It's not about what they charge Medicare. Medicare dictates what it will pay for any given procedure or visit. In the public system the doctors, specialists etc agree to accept that given fee.

    However, outside the public system, doctors are simply small independent businesses with all the overheads that comes with; like paying other staff, office premises, bills, tax, super, Insurance etc. Some have hospital access rights and agree not to charge their usual fees to public patients and limit their fee to the medicare rebate. Private patients pay whatever the usual fee is. Insurance is meant to cover the difference between the medicare rebate but insurance companies also negotiate with the service provider to reduce (but not eliminate) those usual fees. Which is why every insurance company have a list of preferred providers they work with. Choose one not on that list and you will pay even more!
    KSS
    22nd Aug 2019
    1:31pm
    The so called changes recently implemented in an effort to simplify cover has meant that things that you previously could opt out of e.g. pregnancy and childbirth (useless for the over 55 woman) have been moved to top cover along with other items such as hip replacements that used to be in a lower level. Of course along with this redistribution of items covered comes a higher premium on top of the exhorbitant annual increase. The headline increase is never the increase you pay of course and the older you are the more you pay and the more people arre frightened of losing it.

    The agressive attitude of hospitals is nothing shrt of bullying you into using private health cover even for an emergency event. And of course with that comes very high out of pocket expenses. If the out of pocket charges were truly $315 then no one would moan about it. Add a zero and you are far closer to the mark. And not just because the surgeon may charge more, but because you are charged for every cotton ball, every dressing, every pill, the anaesthetic, the newspaper, the TV, the headset...........

    Everyone is coverred by medicare. Private insurance should cover everything over that with a small excess like car or home insurance as others have detailed.
    Viking
    22nd Aug 2019
    2:35pm
    There is a very simple solution to all of this. But firstly let's get this point right, private patients are equally entitled to use public facilities as are public patients. They have probably paid at least as much as public patients in Medicare levies.
    The solution is to allow patients to opt for private facilities (not surgery) only in public hospitals that have private facilities. The surgical care is the same whether public or private. Don't allow public hospitals to charge private unless they have the facilities.and don't allow doctors to charge private fees where the patient has elected to have standard care under the normal hospital surgeons and doctors.
    Sundays
    22nd Aug 2019
    3:51pm
    I agree completely Viking.
    Mondo
    22nd Aug 2019
    6:02pm
    This is the solution! It will fix most of the problems with overcharging.
    Older lady
    22nd Aug 2019
    2:47pm
    People seem to forget in the public system you have students doing surgery on you and the Dr supervising. In private you have the the experienced Dr that has done that operation many many times doing the operation. For me that’s the reason I have private. I do not want someone learning on me. I want the best well practiced surgeon.
    I’ve worked In Theatre in Public and private. So I know what happens. But I’ll say no more as don’t want to scare you.
    Tanker
    22nd Aug 2019
    3:07pm
    Yet if the chips are down and there is a serious problem patients can be transferred from Private hospitals to Public ones.
    Perhaps it could be under such circumstances the Private Hospitals profits would be affected so they shoot the patient over to the Public.
    Tanker
    22nd Aug 2019
    3:07pm
    Yet if the chips are down and there is a serious problem patients can be transferred from Private hospitals to Public ones.
    Perhaps it could be under such circumstances the Private Hospitals profits would be affected so they shoot the patient over to the Public.
    Sundays
    22nd Aug 2019
    3:55pm
    What about women conned into believing they are paying for the best obstetrician, only to find the midwives delver the baby. Also, the facilities for emergencies are much better in a public hospital. For example, no xrays after hours in most private hospitals
    Mondo
    23rd Aug 2019
    10:38am
    Sundays. You are quite right even to the extent that the standard instructions when you are discharged from a private hospital is "if you have any complications from this operation, go straight to the emergency department of the local public hospital." So all care and no responsibility so long as you pay our exorbitant fees!
    Paddington
    25th Aug 2019
    10:57am
    Yes older lady I have heard some horror stories too.
    Sundays, the midwives are probably better actually. I have had xrays after hours in a private hospital. Not a tiny hospital but a big one.
    Triss
    22nd Aug 2019
    3:14pm
    These unacceptable fees are not for our health care. The more patients can be conned into paying exorbitant gap fees and extras the more money investors collect.
    Triss
    22nd Aug 2019
    3:22pm
    Public hospital or private hospital you’re still at risk of getting a hospital transmitted infection which can extend your hospital stay or kill you.
    Nika
    22nd Aug 2019
    7:13pm
    It's not health insurance, it's prepaid health which if you don't use you lose it each financial year and if you need more than each allowance you pay, plus the exorbitant gap. Should never have been privatized like all our other assets. We are dropping out. Can't afford it.
    Paddington
    25th Aug 2019
    10:39am
    The problem is so many dropping out will make it impossible eventually for everyone.
    Can you afford $35 a week? That is all I pay with Mildura Health.
    Briar
    22nd Aug 2019
    8:34pm
    I have always had private medical insurance from when I lived in Uk in my 20's. It was just something that I continued when I moved to Australia in my 40's. I am now in my 70's and still have private medical insurance. Along the way through the years I have used the insurance for my children and for me, and have been very happy with the quick treatment we have received. I have paid the premiums as they increased over the years and have thought seriously about cancelling the policy as the premiums escalated and I never claimed apart from the odd dental and physio. Then a couple of years ago I had major health issues. The treatment I received very quickly, and the bills my insurance paid, more than covered the premiums I had been paying for so many years. As I am now in my seventies, I will continue to find the money to pay the premiums, even though I am angry that they increase at a higher rate than the CPI. But being able to access the best medicos quickly and those of my choosing, are worth a lot. I qualify my statement with saying that I am not a wealthy retiree as I live on a part UK pension and a part Centrelink pension, but the money I pay for my health insurance premium is now as important as my power bill.
    Paddington
    25th Aug 2019
    10:35am
    Agreed! We pay $35 each a week and it has served us well. We skip eating out and buying bottles of wine or travelling overseas.
    We let the doctor know we are unable to pay beyond our cover.
    The government has caused a lot of this by not paying the doctors properly and reducing each year their share of the fees.
    People using the public system who are wealthy and able to travel and are capable of paying something towards their hospital care need to take responsibility as well. If you can pay don’t clog up the public system.
    Shop around each year for the best deal or ask your insurer for a better deal.
    Bombers
    24th Aug 2019
    11:04am
    The trouble with even the new grading of cover, like Gold, Silver and Bronze is that only the Gold Cover is good for hip/knee replacements! Also when I asked if I could exclude covers I didn't need or want, the reply was "your high premium cost also covers other people who use the system more than you"! Its like people now going to Kayo for just sport, rather than paying at least double to have Foxtel for the same product!
    Mondo
    24th Aug 2019
    11:16am
    Bombers I guess the rationale is that people who need pregnancy services don't need hip replacements and vice versa so it all equals out. It does however add to the distinct impression that we are not getting value for money, which we are not. `
    Suze
    26th Aug 2019
    7:18am
    I have always been in the top cover and have to wonder about the new grading system.
    I find now I am covered for less and charged more.
    I am no longer insured for items which I have been insured before ?


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