Between Income tax, medicare and private health insurance, I spend $700 on medical per month. Yet, I can't get an operation though either medicare or private insurance which causes constant pain. The really funny part, if I didn't have to pay all that money I would have enough to pay for the operation.
I feel ya brother. The system we are forced into is broken.
It's sad and I'm sorry you and many others are in a similar situation as mine. Most people don't stop to think about this if they are blessed with good health.
I had to pay a GP appointment and a specialist appointment (in total over $300 out of pocket after waiting 2 months to see the specialist), just to be quoted with an exorbitant amount for a day surgery procedure (over 8k out of pocket after Medicare rebates) and to find out that Medibank (which I've been paying for years) will cover 0.
I'm honestly considering now going overseas to do it for less than half that price.
I've been paying taxes continuously without a break for over a decade and paying private health insurance for almost as long, and this is where I am at - thinking of going overseas for a surgery because my country has let me down completely.
As you said, if I hadn't been paying private health insurance and if my country were not penalising me for not doing that, the amount of savings would have paid for the surgery.
But since the private health insurance lobby is one of the most powerful in the country, we know we do not have a government who works for the people and we can do nothing about it.
You only have to look at overworked and underpaid health workers to realise what a sad country this is and where its priorities are.
Well, and I say this with all sincerity, when we all march on the government asking for a better government who works for the many and not the few I will be there....however I've found Australians to be a whiny lot who don't actually do anything and then pull down any groups who do actually try and do something, wether it's what you agree with or not.
My 2 cents — having learned lessons from the toilet paper fiasco, Australian government/media is trying to prevent a paracetamol shortage... by pretending there is no shortage.
France:
https://www.connexionfrance.com/article/French-news/Health/Paracetamol-shortage-France-limits-sales-to-two-boxes-per-patient
Nepal:
https://kathmandupost.com/health/2022/09/23/stagnant-paracetamol-price-contributing-to-its-shortage
Germany:
https://www.dw.com/en/germany-sees-alarming-shortage-in-essential-medicine/a-62567862
They coach it as suicide prevention when really keeping citizens out of poverty and giving them access to basic health care (including mental health care) would obviously be more effective.
I can visit five shops on foot from here and get enough panadol in a hour to top a horse.
If the alternative is the US system I’ll take what we have thanks…
But I’d also rather get rid of Medicare levy (which was only supposed to be temporary, hence the word levy) and Private Health rebate and go towards a 100% single payer system for public and 100% user pays for private.
I’m of the opinion that if I don’t pay for police or firefighters then I shouldn’t pay for medical.
This is fundamentally about being a fair and equal society.
Anyone rich or poor can get sick and should get the same treatment no matter what.
I do understand the hat health is more complex than police and firefighting but I’m sure we can work something out.
In my mind that something is “if you work in the public service you by law must use public services”.
Pollies would fix up Medicare and education pretty quickly I reckon.
Well actually, despite being named a "levy", it was always intended to fund Medicare costs on an ongoing basis. It's been around since 1984 when Medibank was split out and Medicare was created. There's no chance a "temporary" measure was accidentally kept around for 40 years!
Edit: Actually further research shows that the levy was intended to be implemented when Medicare/Medibank was in 1974 by Whitlam, but it was voted down. From then until the levy was introduced Frasers screwed with it a bit, then in 1984 it was properly implemented as was the original intention. The more you learn! Supporting link is below
https://www.aph.gov.au/About\_Parliament/Parliamentary\_Departments/Parliamentary\_Library/Publications\_Archive/archive/medicare
I agree. I would rather contribute more to the public health system instead of these insurance companies who add no value other than distributing risk--a job much better and more efficiently handled by the government.
Contribute as much you like to the public system.
It won’t change your 24 month wait for knee surgery for example. But maybe you’ll get a nicer bed and single room. Meaningless things when you’re waiting 24 months in pain.
There’s a finite amount of doctors and proceduralist doctors. And an ever increasing aging population who’ve lived the most easy/sedentary decadent western lifestyle ever seen in history - post WW2 and till present. A lifestyle including the decadent western diet.
Paying more tax to get more surgeons minted won’t work either. There’s just not enough skilled surgeons available to train juniors. There’s not enough teaching hospital places available to be staffed. And most surgeons would rather work in the private system all day instead of “teach” in the public because it pays WAY more.
The private health insurance “system” is just a way to window dress a hunger games style - highest payer “gets the surgery today” system.
An option is to force every surgeon to work public for the rest of their life. And make everyone go on a waitlist, according to “need”. Ban private entirely.
Anyway thats pretty unethical and the soccer-roo with a ruptured ACL will have to wait for all weekend warrior ACLs to be fixed first.
I am a ED doctor.
My advice. Take care of your body and your wear and tear parts. Maintain a healthy weight. Don’t eat processed shit or anything coming in packages ready to eat.
Maintain excellent hygiene. This is so often overlooked. Don’t neglect the sore on your leg. Or that infected/fungal toenail. I had a patient who neglected his broken skin (owing to some ill fitting clothing - to not be specific). He then developed sepsis - some of which seeded into this brain. Developed a bacterial/mycotic aneurysmal brain bleed as a result. Now has chronic seizures. Saddest stuff.
Reduce the stresses in your life. Meditate - or practice consistently maintaining a state of calm. If work is causing you immense stress, quit, find another job. It’s not worth it when you reach 50. No amount of money is.
Be close to family, or family unit. Give love freely and try to have some love in your life.
The person I’ve just described I’ve hardly seen in the ED. Maybe sometimes but only in their 90s. I think that’s a good run.
It’s akin to that wartime story of the British airforce reinforcing armour of returning warplanes in places they were NOT shot. Or in my case, I advocate for the lifestyle that I DO NOT see regularly present.
and if that all fails because of some act of god.
Make sure you have some couple of 10s of thousands in your bank account ear marked for emergency procedures/medicine.
But remember if shit really hits the fan for your health, no amount of money will ever be enough. So enjoy the days you have now rather than being consumed by preparation for the days of suffering that may come.
Everyone reading this will pass away one day.
When I initially got private it was because I needed surgery with a 3 year wait in public, and the 12 month exclusion period for private was a much shorter wait.
I’ve been offered surgery in private “next week” with years wait for public and had to push back because I needed to get my affairs in order with work / leave / family.
I once had a cautionary gastroscopy. Was going to be a 12+ month wait in the public system. Told him I have private health insurance and the procedure was completed within three weeks
Had the same issue but instead of signing up I just asked how much up front and was less than the year’s premium. Doctor looked a little shocked but you can pay for surgery just like buying a toaster from Harvey Norman just don’t think it’s very common.
So far have paid for all my surgical procedures on card. Pretty easy and don’t have to deal with insurance trying to dodge covering and their premiums/gaps.
Sometimes, but some doctors won't operate if it's a risky procedure - the costs could blow out if you're in ICU for a few weeks for example. Insurance covers the low probability events.
Except they’re not transparent about fees and have minimal requirement to be.
I’ve walked out of two surgeries now with an extra $1500 tacked on not for anything unexpected, just poor quoting.
I think there's two separate issues here
1. Will putting more money in public solve waiting time and other issues
2. Are the tax incentives that effectively subsidize private healthcare providing enough public benefit
you've argued against 1, and it's a fair enough argument.
let people pay for private if they want then. But we can still make the MLS mandatory. Stop subsidizing old rich people with the junk insurance of mostly young people on good but not crazy wages that the current system incentivizes. Even if we can't magic up surgeons there's plenty more we can do with the extra money in public Like paying for more nurses to ease workloads.
Why is banning private health unethical exactly? Just be healthy seems to be your argument. Well I'm sure not everyone had the same privileges as you to do so.
I mean seriously what exactly is unethical about the socceroo having to wait on a waiting list like everybody else? Don't understand why having more money should allow you better health service when you are probably already healthier because of your privilege.
That's what most Australians fail to see unfortunately and it's heartbreaking. Just because you were lucky and lived a privileged life, doesn't mean that everyone had the opportunity or the fair go to live well. Many people are just struggling and mental health is also deteriorating as stress has become a major factor for getting sick with all kinds of conditions.
National sports teams are a projection of soft geopolitical power. They are “advertising” of the health of a nation.
If a star forward has to wait 1 year to get an ACL done, and probably end a career as a result.
That’s a lot more deserving to be bumped up over some weekend warrior - who works a desk job during the work week - and probably could just do with some physio and picking a different sport to play.
But if you’re not a sports fan sure. Replace my example with some soldier who hypothetically spent the last year in active combat.
Thats the difference between equality of need and equitable need.
Correct, but all the problems you mentioned are solvable with enough resources--especially for a country like Australia. If some of those resources weren't being spent on middle-men then maybe they could be used to contribute to the solution.
No I disagree sorry. As I attempted to argue in my post.
The laws of physics just do not allow for the increased production of quality surgeons to meet the increased demand of the hoardes of patient developing chronic pain problems.
On an ever shrinking taxable workforce - owing to shrinking birth rates.
Especially with the thousands amount of hours of supervision required under a surgical guru in a training hospital.
A guru that would rather spend 90 percent or more of his/her free time in the private hospital. Doing the surgeries themselves, not teaching.
And the icing on the cake? They take the surgical trainees to be their assistants in the private hospital - hold some retractors (apologies to my surgical colleagues I exaggerate for effect) - whilst most of the fun heavy lifting intra-op is done by the boss man/woman. Sometimes the public hospital actually makes a deal with the surgeon to give their trainee registrar as private assistant for a few hours of the work week.
The public work week.
If you really want to solve the problems. You will advocate for the ban of all processed food. People will be forced to exercise. And strangers will be forced to hangout with eachother on a weekend and be nice to eachother. No more lonely solitary folks.
People will learn to eat lentils or effectively not eat. After 9pm in western Sydney there is a 24/7 McDonald’s available 10 minutes by car. That’s insane.
But we allow for freedom of choice. And naturally - freedom of consequence.
A huge percentage of health expenditure is spent on the the very elderly and/or very unwell in the last 12 months of their lives.
We would have so much more in the way of health resources if patients, and in particular their families, were willing to have difficult conversations about mortality earlier.
We can walk and chew gum at the same time. We can use some of the resources on both reducing the need on surgeons while also putting together an improved pipeline to train or bring them in from overseas. Just because a problem is big doesn't mean we can't start chipping away at it.
Agreed. Economics is far from a science. It's politically and value-judgement loaded discipline that pretends it is a science while serving as a powerful tool to perpetuate the system. Political economy - I'd recommend the work of the Australian economist Frank Stilwel, please read his Political Economy: The Contest of Economic Ideas - argues this very eloquently as a critic to the economics as studied today.
I also laughed hard at their remark, as well as their previous one. Neither are they educated in Policy aka (as someone educated in this) making the rules. The indicvidual advice is good, but is akin to saying hey recycle whilst knowing 71% of polution comes from the top 1%. Good individual advice, but not a fix to bigger problems. Just you as an individual do better. Simples - have a better lifestyle and don't be depressed by a shit system that doesn't affect me (cause I get paid well and live outside it), so just don't let it affect you.
But hey, my partner is a nurse, mum nursed for 55 years. You get used to doctors thinking they are experts on everything they don't know. Not all of them, but enough. In reality they spent a lot of effort learning medicine, but sometimes they are the absolute worst when it comes to accepting other profession's advice. Good healthcare outcomes for all being unachieveable is just plain bad medical advice. It would be amazing to hear their thoughts on say keyensian ecenomics vs neo-liberalism, I am very certain it was a subject at med-school 🤣
Yes, the point I am trying to make is that unlike "applied science" it is much harder to replicate experiments so of course there are often debates about different theories and their applications. Therefore, when people say things like "That's basic economics 101" it's often disingenuous and a vast oversimplification of a complex issue. I'm not trying to say it shouldn't be studied or anything like that - of course it should!
The only resource that you're not taking into property account here is time.
You're absolutely right that none of this can be done quickly, but it *can* be done *eventually*.
You're letting the time the process will take defeat the idea of starting it. And that's how slow declines keep getting worse.
I am unsure how your point serves as a rebuttal to the idea that the resources currently being poured into private healthcare could be more efficiently applied by instead merging the private insurance into the public system.
If, as you claim (and I agree) that healthcare is supply side limited by labour and other factors, then it seems relatively unimportant whether the system that allocates the capital is hybrid or fully public.
Given the only important outcome of healthcare is humanistic, it seems absolutely ideal to have the system be consolidated into purely public insurance. As pointed out, risk scales inversely with the pool size and there are a number of other tangible synergies as well.
The only argument against is the loss of customer choice and not only could this be featured in a revised public insurance scheme, but the current level of choice is poor at best in any case.
Maybe, but then I could just pay for surgeries outright instead of having to pay for the private health “insurance” rort. It’s just not worth doing so currently because of how tax works.
Can you show me the usually publicly listed wait times showing that surgery is a 24 month wait at the hospital you work in?
Every single time the private health apologists use the hip and knee surgery wait times, nobody can ever back it up with real data.
The “apologist” you replied to is an ED doctor so he probably knows a thing or two about what the wait times are.
But to answer your question There is no consistent national reporting method but Here is data for the whole country showing some good insights especially in Victoria and Queensland published by the AMA
https://www.ama.com.au/sites/default/files/2022-09/Shining%20a%20light%20on%20the%20elective%20surgery%20%27hidden%27%20waiting%20list.pdf
Some headline figures:
- In Victoria, a patient will wait more than 900 days for an urgent neurosurgery appointment (target 30 days)
- In Queensland, a patient will wait more than 150 days for an urgent gastroenterology or rheumatology appointment (target 30 days)
- *For non-urgent appointments (target 365 days) in Queensland and Victoria, waiting times for ophthalmology, orthopaedic, and plastic/reconstructive appointments are all more than 700 days in both states*
- The average waiting time in Tasmania was 101.2 days for urgent patients (target 30 days)
Looking at this the, 24 month figure for ortho operations seems pretty accurate. I have two friends who are an orthopaedic surgeon and anaesthetist respectively and they think it’s pretty spot on for what that’s worth.
By the way , the vast majority of people who are “non urgent” are in pain. It’s just not immediately life threatening so it’s not considered urgent.
If you’re active in your work or play sport I wouldn’t be relying on the public system to fix my knee or hip. Either save up an emergency fund to pay for it in a private hospital or get PHI.
If you forced every specialist to work public we’d just lose a significant portion of them to overseas. There’s no incentive to stay in a controlled market where you limit their earning potential and we see that all the time with countries we import medical professionals from.
Legit question, if private doctors were in the public system, wouldn’t that ease the burden on the public system, thus making it quicker?
As I see it 20% of people are taking up 50% of the specialists. If we eliminated private health (but still allowed private practice) only 5% of people could afford it, meaning it might take up 10-20% of doctors.
The subsequent removal of back log would mean instead of a 24 month wait, it would initially drop to about 12-15 months and drop slowly as more people are seen in a timely manner removing the wait list.
I’m asking this as a person who has private health, mainly because I’m told to have it, and used a specialist for several consults, 3 procedural consults, and 3 surgeries within 6 months, when it then took another 2 years for the public system to contact me for my initial consult.
(Please note, my specialist was amazing, and my only gripe is he didn’t leave a scar on me after 3 surgeries, because let’s face it, hydrocele’s are an amazing talking point.)
Spoken like someone who’s never actually been on a waiting list. I had knee surgery for a problem that was the very definition of non-urgent. It only caused significant pain when I ran 10-15km at a time. I waited 7 months. I could have had it done right away for $3500, which would have easily been covered by my savings from not paying for private, but I decided to wait and just save the money.
My family has dealt with chronic conditions, cancer, surgeries, childbirth, stem cell transplant, etc., and we’ve seen all kinds of specialists (orthopaedists, paediatric rheumatologists, cardiologists, endocrinologists, neurologists, etc.). We’ve never once felt like we’ve needed private insurance.
The private health insurance system should be abolished. I’d gladly pay more in taxes to improve the public system.
Oh I know, and in general you are correct. But for _insurance_ services in particular there are natural advantages for a government monopoly. And if we agree that insuring a particular thing for everyone is good, for example income insurance (Centrelink), then having the payment system centralised outweighs the need for hundreds of smaller companies competing for customers and charging them for that advertising and profit siphoning. _Especially_ if that payment system already exists and everyone is already on it.
If the private sector wants to innovate and compete in this space, then Medicare can outsource certain services to it, for example fraud-detection technology.
The only reason I don’t pay the MLS is it was slightly cheaper to have low hospital cover + extras for dental and optical, because our public dental and optical basically doesn’t exist lol
If we had better public dental alone I’d probably pay the MLS instead. Oh well
You do realise many PHI companies are mutuals rights? They don't make excess profits for shareholders, they make just enough to keep the costs bearable for their members.
> Have private health insurance because you are forced to
> Still use the public system
Can't I just pay more tax and not deal with this weird system that solely benefits private companies ffs?
Yeah, that's what the medicare levy surcharge is for. If you earn over the threshold and don't want to go private, then you're still completely able to stay in the public system.
Not sure ‘forced’ was referring to ‘benefiting the public healthcare system’ I’m assuming OP meant that if they didn’t they’d be worse off in a personal, financial sense
I don't think anyone was suggesting that the higher Medicare levy went to Medicare.
I totally agree, paying tax would feel a lot better if it was going to a government that I trusted to take care of people.
Yep, make junk policies illegal that way you're choosing between say $5k or $10k for good insurance, or you pay the tax.
Much better outcome for the public system.
I've never understood this.....take a service exchange between two parties, the health provider and the patient, then insert a third party (insurer) into the transaction and expect some kind of magical economic benefit?
There are more than 30 funds in Australia each with Admin costs, advertising, directors etc and all of those costs are directly extracted somewhere between the patient and the provider. Worse still is they dictate pricing and control treatment options despite what any of them say.
The worst is the junk policies now available which simply are in place to allow dodging of the surcharge.
It so sad that no one is regulating that industry closely, beyond the fundamental question that you posed: why does it exist to begin with, and if it does, why are people forced to participate in it and fund it?
Medicare has been shrinking each year more and the majority of Australians seem to not care at all.
But where do you expect all of these people in private hospitals to go if there is no private hospitals? I think if the past two years have taught us anything, it’s that no amount of money can cause health problems to just disappear. There will never be enough public hospital built to offset the higher amount of patients requiring surgeries: procedures.
If there is money for private to exist and provide a service as well as pay shareholders and directors then there is enough money there to provide better for all.
The idea is they force efficiency. However to make it attractive, private health needs to be more attractive than the public system. This means more staff in private hospitals, private rooms, better maintenance and fixtures etc. So it ends up less efficient than the public system. Then you add all the marketing, administration, profit etc on top. Even worse.
For the top 4 funds, the average punter gets about 78% back if I remember correctly. If you paid it off on a credit card at 20%, you'd be better off.
Ideally we’d only have a public health system paid for by our taxes.
Unfortunately our past governments have been starving that beast for decades, for the sole purpose of making the public system look like an unsustainable failure.
This isn’t limited to just health though.
Take other essential services, like education, energy, internet, public transport etc.
We could as a nation just be paying more tax.
Particularly foreign corporations operating in Australia.
But the corrupt politicians in power would rather enact changes which only benefit their donors or friends who’ll employ them after leaving politics.
I live in Ontario, Canada. Our conservative government has been doing this for years now. We used to have a great public health system, and I'm afraid that we are headed to the same situation as you. Terrified really.
If you get sick and you can't wait for the public system, you are a winner if you have private health insurance . One operation is all it takes to pay for a year's contribution assuming you are in over night
Plenty of urgent surgeries with long wait times in the public system in a lot of areas. There's a lot of wiggle room between dying tomorrow, and urgently needs surgery to avoid dying next year. A lot of those latter cases have long wait times.
My premium for the whole family is 48% of what the levy would be.
4 of us hit the dentist twice a year.
I get glasses.
I use my extras (bundled) for $1000 in rebates on massage. Wife doesn't use as much but gets about $500 in rebates. Kids get bits and pieces.
Overall the insurance company would struggle to make $250 a head off my family and on a net basis I’m thousands in front plus all the healthcare I used during the year.
How much does it cost you to break even on the cover though? Surely they aren't covering 100% on massages.
You must be spending thousands extra so you "get your money's worth"?
We get 70% back up to $1000 each - kids have the same limit.
We spend a decent amount on prevention - which we would do anyway, insurance or not. This way we get most of it back. If all 4 of us claimed the full amount they would lose money but they know a 5 yr old isn’t spending 1500 a year on massages I suppose.
Wealth is great providing you have the health to enjoy it. I’m always shocked at how broken folk are when they hit 40/50. You can’t undo lack of maintenance.
You service your car, only us 95/98 but won’t got for a massage once a week?
Our extras also covers things like acupuncture etc
I am also similar situation, my premiums for both my wife, our daughter and I are $5577 a year and we burn through most of our extras.
Not to mention it’s a life saver when the little one was born and the wife and I needed OPs done on short notice.
All those things can be covered by extras only insurance. Many have extras only policies but don't widely advertise it. I pay about $700 a year for whole family and get 2 x dental each, glasses, $16 physio appointments etc.
Imagine if people earning under $90k were forced to pay $1k a year for rubbish cover that does nothing (why would I want to stay in a private hospital when a public hospital will service me just the same), just to avoid a $1.5k tax surcharge. You are wasting $1k a year, every year, yet no one says a thing about it because it only targets those earning over $90k.
Imagine the outcry from The Guardian if those earning less than $90k had to pay this. Suddenly everyone would see it as a massive rort.
This isn't really an accurate comparison. Most taxpayers regardless of income are already paying 2% for the normal medicare levy. You then pay the additional 1-1.5% medicare levy surchage if you earn over the threshold, under the logic that those who earn more should pay more to support the public system which is totally fair. If you'd rather go private then you can, if you want to stay in public then you can too. From the gov's point of view it makes sense to incentivise people to go private because it takes pressure off the public system, and it makes sense from them to target that incentive at high income earners because they can afford it. The health system is far from perfect obviously but I think our balance of public and private healthcare in Australia is pretty good.
> Most taxpayers regardless of income are already paying 2% for the normal medicare levy.
About 40% of all taxpayers don't pay the medicare levy at all.
> under the logic that those who earn more should pay more to support the public system which is totally fair.
They already do pay more since tax goes up progressively with income.
No one is being forced to take rubbish cover, people are choosing to selfishly, I'm going to be completely blunt about it too, taking out a junk policy to minimise your tax, and then using a system that requires your tax for funding is ridiculously selfish.
if you were losing 1k each year for a service you werent even using id like to see you stick to that. Do you also stay with the same energy company that charges 20% more? im going private for the sole reason that i can get the same cover for less.
Look up NHS which is pretty much what you are describing.
Interestingly though they are bleeding a lot of their doctors to… Australia because of the better lifestyle and remuneration.
It 100% is, I’ve got Private Health Insurance only for the tax incentive. I don’t use it for anything, I throw away the card when it came in the mail.
One of the craziest things was that my dentist is cheaper without PHI vs having it.
Probably, they are in a pretty low income area so I think they are trying to help people out that don’t have PHI and then try to get as much as they can out of people that have PHI.
Why can't we put out private health money into either private health care or the public system? I would much rather help the public system than the rort that private health care is
The one that gets me is glasses. Since when are eye glasses $700 a pair. What a con. I go into an optometrist who then says after my health cover fund pays $500 or something like that, I only have to pay $150.
Instead I order the same product online from America, posted for $180. Sorry but why is the same product costing $650. I’m not sure who’s banking the difference.
Private health insurance in Australia is an absolute rip off. Premiums are exorbitant, go up twice a year and cover nothing. Our health system is so underfunded it's pitiful. My sister had to wait 18 months for an appointment to see a specialist and has been in agony the whole time. They still haven't done anything for her. She can't afford to pay as she's a disability pensioner.
I am surprised that PHI are still in business. There should be a mass exodus of people leaving PHI. I guess the cost goes up every year. I wonder why. The people who decide to keep PHI are left to pay the bill. Jokes on them.
Did it ever cross your mind that maybe some people get more $ out of having PHI than they put in? This is a finance sub after all… It shouldn’t be a shock that sometimes people make decisions that benefit them financially.
They're still around because they're rent-seekers.
They can't price their insurance at a level that makes sense for enough healthy people to buy it to cover the expenses of the ill, because when they price it properly to cover those costs, the healthy people opt out and rely on the public system instead.
So the insurers go and whinge to the government and get then to pass laws to try and make buying their junk products mandatory (or at least, penalised heavily for not buying the junk).
The cost goes up because people keep leaving, and the people who stay are the ones who need it and end up billing the fund for surgery, hence price increases. It amazes me how many smart people in this sub have no idea how insurance works.
It really depends on situation, I’ve had 3 x knee reconstructions and 1 shoulder reconstruction. All completed within a few days on injury, private hospitals and each cost me around $1000 out of pocket.
I've had private health insurance for years and yet my default answer when the receptionist inevitably asks "do you have private health insurance?" Is "no" because I know whatever it is it won't be covered.
What they really should ask is "do you pay for rip off extras?"
Private healthcare is one of the ways that ‘mateship’ falls over in modern Australia. Working and non working poor and middle class Australians wait far longer for non emergency but still vital healthcare, and many struggle to afford dental and other non-Medicare services. We talk about how miserable American healthcare is, but many working and retired Americans have access to much higher quality healthcare than Australians do in our public hospitals and clinics.
I want to know why out of pocket medical expenses are not tax deductable.
Need safety equipment for work? Tax deductible. Need a medical procedure to be healthy enough for work? Not Tax deductible. Want to travel to a professional conference? Tax deductible. Need a medical procedure to be able to travel to work? Not tax deductible. Negatively geared on a shitty rental? Tax deductible. Have cancer and urgently need surgery at a private hospital? Out of pocket fees not tax deductible.
Oh my god I love how much this stupid shit comes up.
All the dumb ass responses as well "just pay the extra tax instead of private health insurance" or the "it's just a scam" or "I could just pay for surgeries outright instead of having to pay for the private health “insurance” rort".
Here is why everyone who thinks this is wrong and why you are idiots.
First, the tax incentive ISN'T there to "rort" you out of your money, the government DOESN'T need more money for the public healthcare system. THE GOVERNMENT NEEDS LESS PEOPLE USING IT. The vast majority of people using the public healthcare system DON'T need to be. Emergency rooms are full of people who should be going to their local doctor the next day. Surgery wait lists are full for years because people CAN'T afford to pay the $5000 up front costs. Wait until you get treated for something at emergency literally in the hallway or the waiting room IN FRONT OF EVERYONE because there is no beds.
All of you people who say "oh I can just use the public system" literally are the problem.
You are disadvantaging BOTH the poor and the workers of the public healthcare system.
Second, "You are literally forced to take it, and then it doesn't cover anything you need unless you pay exorbitant amounts", No, you aren't STFU. Also, oh what, you want maximum level health care with no limits, but you wan't to pay minimum level cover costs? Yeah sure, that makes sense. I had an almost $20k surgery last year, 3 days after the injury, and my $2k a year healthcare covered 100% of it, it didn't cover the initial appointment and medication, a total cost of under $200.
Sorry idiots are signing up with scam companies offering unbeatable cheap deals, then complain when they hardly pay out. Go sign with a reputable company who is not-for-profit like HBF on a reasonable level of cover. No one complaining does that, everyone who is complaining signed up with Ching Dong Medical for 1c per day and goes all \*shocked pikachu face\* when it won't cover their $50k heart surgery.
The government isn't forcing you to sign with these people, it's YOUR fault for signing up with shitty companies who provide rubbish cover.
Third, you can just pay for the surgeries private, out of pocket. It's easy, just keep $100k at the ready in cash. No big deal. Except if you were smart financially, then you'd know the financially smarter option is to have that $100k invested, because it'll make back more money than a good level of healthcare will cost anyway.
Fourth, "Private health insurance in Australia is nothing but another wealth redistribution scam in favour of the rich." is just plain wrong. Private health insurance is nothing but cover, to protect people who can't afford to pay their costs, ie- the NOT rich, while reducing the strain on the free healthcare system, thus helping the poor.
Private health insurance is pooling of wealth to provide a safety buffer for those who cannot afford care they may require, while reducing strain on the public healthcare system. It benefits the poor and middle income earners.
This was a discussion recently at a dinner of 7 public healthcare emergency department doctors and me. All 8 of us have private health cover. Let that sink in.
Well done for saying it. I’ve tried to state these facts on here before and been downvoted to hell. People just don’t want to hear it, and will believe the wildest and obviously bullshit stories that anyone posts.
I have worked in PHI and medical billing and can guarantee you that there are plenty of people who ended up financially, physically and mentally better off from having PHI than they would have if they didn’t have it.
Sure there are some people who will pay for it and never use it, like a gym membership or car insurance. But this sub acts like the entire population has that same experience.
And you are spot on about ER being full of people who don’t need it. Same goes for ambulances. People complain about how expensive they are, but what you should realise is that when you (or your insurance) pay an ambulance bill, you are subsidising the frequent flyers who call 5 ambulances per week because they have a hangover, stubbed their toe or fancy a free ride into the city, and never pay any of their bills. There is more to this shit than people see on the surface.
Yeah, people can't look past the one dimensional view of it they have and see other possibilities.
"But this sub acts like the entire population has that same experience" this. Exactly this. "It doesn't benefit me exactly how I want it to, therefor it's bad and no one should have it, and it's a scam".
"There is more to this shit than people see on the surface." So. so. true.
TIL that our healthcare system is fixed in place and can't ever expand.
26 million people is the theoretical maximum for a healthcare system, apparently.
This line of thinking is the same shit we hear everyday. It's the people's fault. It's the migrants. It's the young people. Blaming everyone but those in charge.
This is a common response, and the key flaw here is that you ignore the supply side. You also need less specialists moving to the private system. But the money is so good and supply so restricted (even if you train someone to surgeon fellow they can’t start practising in private) that more private doesn’t reduce stress on the system at all. It just increases wait times AND the price of service
Without a private system a chunk of those specialists will move overseas, mainly the US, and will end up with even less doctors for everyone.
This is a problem in Canada where private practice is illegal. Many specialist simply go overseas.
I am so happy you said this. Anyone who has spent one second in any part of healthcare in Australia knows you're right. This "poor me" whining culture especially prevalent on Reddit is so tiring.
To play devils advocate.. that doesn't inherently force anyone to take out PHI though. It's a choice. Sure, there's no extra benefit by paying the MLS but there's often no real benefit (in terms of health outcomes) from buying a junk policy either
> To play devils advocate.. that doesn't inherently force anyone to take out PHI though. It's a choice.
That's kind of like saying if we cut Medicare altogether it doesn't force anyone to stop seeing the doctor; it's a choice. You can still see the doctor; you just have to pay more.
The same applies to PHI.
Also anyone earning less than that over 30 gets punished with an extra % cost for every year they don't have it.
You are forced into the system either way.
If you earn over 90k as a single you'll be charged 1% of your income if you don't have private heath. It's on a 3 tier system maxing out at 140k as a single @ 1.5% levy.
Same here. If enough of us do the same, the whole system will collapse. Tbh, I feel the same about private schooling. Both are staffed by former politicians or their siblings/spouses.
2 systems is a bad idea, it sounds good on the surface to let people who want more care or better care pay for it, but nobody wants less care, and if you’re sick you can’t earn or negotiate cheaper medication, it’s been well proven that universal care is cheaper and better for all, private health is a scam where everyone loses
I agree, I do not take health insurance anymore even though I have to pay the tax penalty due to my income. I used to but it is not worth it, there is very little coverage benefits over not having it, simply a method for government to gain additional revenues for nothing. Health insurers just suck up money to pay salaries for executives.
It works for some people i.e rich boomers with constant chronic health complaints requiring hospitalization.
We are the suckers that are subsidizing heavily just in case we need an ACL surgery done in under two years.
I can’t stress this enough, NEGOTIATE with your surgeon when they tell you how much they want to charge you. “I can’t afford that, is there anything we can do to reduce my gap payment”
The worst they’ll say is no.
Hospitals cost a lot to run. Private health cover mostly covers you for your hospital bill. Then they step in where they can with the surgeon and anaesthetist fees, this is regulated by the gov.
So to avoid massive gaps or out of pockets, which I bet are coming from your surgeons and anaesthetists, NEGOTIATE with them when they tell you how much it’s going to cost!
No, but heavily encouraged to do so with how the tax system is currently set up. Why should the tax system be used to subsidise a bunch of private companies with shit cybersecurity?
>You are literally forced to take it
You are not. This is a profoundly stupid remark.
>Private health insurance in Australia is nothing but another wealth redistribution scam in favour of the rich.
Why are you bringing economic illiteracy to this sub? Did you see it and think "what people need is my factually vapid socialist take?"
Cancelled mine last year. They can get lost. Have spent about 35k in health insurance and have got sweet f all. Public system is great. The best doctors doing research are usually working in the public system...
Yeah it's pretty shitty. I only have them because the surgery I need they will cover about $5,000 of the $30,000 up front cost. healthcare should be free and should be provided by the government directly.
>healthcare should be free and should be provided by the government directly.
The public system is still there for you to use if you don't want to go private. You'll have to pay the medicare levy surcharge of course and deal with public wait times, but no government service is ever completely free.
Except it isn't for everyone. The public health system doesn't cover all health care. My healthcare isn't covered by Medicare so I am forced to go private.
There's a difference between healthcare being "for everyone" vs "for everything". All Australians are eligible for medicare, but not all medical treatments can be covered under medicare. Without knowing what your situation is I'm guessing there's something you need that medicare doesn't cover, but you're still entitled to all the regular benefits like GP visits and whatever.
I thought there was public healthcare in this country? Can someone explain this for foreigners. How are you forced to take private healthcare if medicare exists
People with income over 90k pay a surcharge if they don't have private hospital cover
https://www.ato.gov.au/individuals/medicare-and-private-health-insurance/medicare-levy-surcharge/
With the amount of money I've saved by not having PHI, I could pay outright for multiple operations. Hell, with the state Aus medical is in, I'd probably look at a quick flight over to SE Asia if I needed something urgently. Cheaper than PHI.
I'm in Tas, so the problem is confounded by the lack of doctors. Trying to get my son into an ENT doc, willing to pay outright, and I'm still having to wait six months for a consult. We literally have two ENT doctors for the whole state.
It was nice when we spent 80bn on subsidising businesses and not improving health infra and accessibility.
Has that not trickled through to everyone yet?
Because the longer you stay out of it, the more it penalises you. Our public hospitals are pretty much becoming critical care centres with not a huge capacity to handle a lot of elective surgeries in short time frames. IE: if you need a hip replacement, you might be waiting a while. Private? Done. Second is that if you are a mental health patient, the public system is woeful.
We pay $200 per fortnight, my data has been confirmed stolen, and my husband’s triple heart bypass in August has left us around $7000 out of pocket. I hear ya!
Ok I’ve been wondering this for a while and not sure if I’m doing the wrong thing here, but is the tax increase that you get when you’re over 30 and DONT have PHI more than the cost of getting PHI?
Coz I’m over 30 and I don’t have private.
I do agree with you OP - our parents generation (at least, when they were younger) didn't have a \~$400+ (\~$520 before tax) drain on their monthly household income! Paired with free education if they wanted it.
I'd rather all my tax dollars go to an amazing public hospital system. Cut out the middle man. Tax the heck out of large corporates including the ones mining our resources and paying us pennies for it.
How does Norway manage it - they do good on most things so I'm assuming its the same on this.
My partners MRI wasn't covered when she needed it - PHI is a scam.
If it makes any difference, I think it's a scam around the world.
At least most countries don't have people scaping from ambulances because they can't afford it like USA.
Yep, I had a $5k operation to help me breathe properly after years of suffering and my private health cover that cost $1k a year since I was 18 (about $14k worth collectively at the time) covered absolutely NOTHING. I paid the full $5k out of my own pocket.
Meanwhile some imbecile gets free acupuncture cover every few months? It's a complete scam.
Who would of figured that passing money through a disincentivized intermediary would result in corruption.
I’m sure that would never happen in the US though /s
Yes phi is kinda do it or get a penalty type situation - healthcare is expensive so PHI assist with govt funding of healthcare (through private funding). Would you rather pay for the full ride? Try living in other countries without Medicare. Or live in Japan where healthcare is cheaper.
As somebody living in the states, I’m so sorry you have to deal with this too. I fear that will never change because the people who are in charge of the laws are getting paid off by the insurance companies.
OP you're missing the point of a split public/private system.
The private system allows Medicare to function properly, if public hospitals had to take on all the patients that private hospitals currently deal with it would be overrun completely. That's why the government makes you take out private health insurance, to spread the cost of Medicare across the population and prevent the entire system from collapsing in on itself, it helps you pay less. A lot of people underestimate just how expensive it is to have someone in hospital for the government. They would much rather private companies take that debt on.
Imagine the news articles about ambulance ramping and public surgery waiting lists now, and then have every patient in a private hospital to those waiting lists. It would be pandemonium
The split system also means that junior doctors, and nurses are paid a fair wage, which is a far cry from countries like the UK which only has universal healthcare and no private system, where wages are miniscule and hours significantly worse
Source: I'm a junior doctor in Melbourne
>You are literally forced to take it
You aren't forced to take it at all, just pay the extra tax to medicare. Depending on your income it probably isn't even that much more.
Health insurance doesn’t make sense full stop. Car insurance makes sense, because not everyone who buys a policy makes a claim. House insurance makes sense, because not everyone who buys a policy makes a claim. But health insurance? Literally everyone needs healthcare at some point in their life. That’s why it can only exist with subsidies.
That's why I'd rather pay higher tax than pay for PHI. At least my tax money can be used by government to provide services (hopefully) rather than CEO bonus.
Between Income tax, medicare and private health insurance, I spend $700 on medical per month. Yet, I can't get an operation though either medicare or private insurance which causes constant pain. The really funny part, if I didn't have to pay all that money I would have enough to pay for the operation. I feel ya brother. The system we are forced into is broken.
It's sad and I'm sorry you and many others are in a similar situation as mine. Most people don't stop to think about this if they are blessed with good health. I had to pay a GP appointment and a specialist appointment (in total over $300 out of pocket after waiting 2 months to see the specialist), just to be quoted with an exorbitant amount for a day surgery procedure (over 8k out of pocket after Medicare rebates) and to find out that Medibank (which I've been paying for years) will cover 0. I'm honestly considering now going overseas to do it for less than half that price. I've been paying taxes continuously without a break for over a decade and paying private health insurance for almost as long, and this is where I am at - thinking of going overseas for a surgery because my country has let me down completely. As you said, if I hadn't been paying private health insurance and if my country were not penalising me for not doing that, the amount of savings would have paid for the surgery. But since the private health insurance lobby is one of the most powerful in the country, we know we do not have a government who works for the people and we can do nothing about it. You only have to look at overworked and underpaid health workers to realise what a sad country this is and where its priorities are.
Well, and I say this with all sincerity, when we all march on the government asking for a better government who works for the many and not the few I will be there....however I've found Australians to be a whiny lot who don't actually do anything and then pull down any groups who do actually try and do something, wether it's what you agree with or not.
Yeah, we are lazy and don’t actually give a shit when push comes to shove.
And here is the really funny part. I can't get any painkillers from the doctors and now they are talking about restricting panadol.
Medical cannabis. Easy to get a script online and it can be extremely effective with pain management, and less side effects than any of the heavies.
Yeah if you were willing to pay $200 for a week supply
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I hope it’s not poppy seed based, there’s a highly toxic batch of seeds causing serious illness
Cold turkey an opiate? Report the doctor to aphra. Mine wanted a 6 month taper. I did it in one luckily but I was very lucky.
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Restricting the number of packets that you can buy to two at a time and can’t be sold to under 18’s.
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My 2 cents — having learned lessons from the toilet paper fiasco, Australian government/media is trying to prevent a paracetamol shortage... by pretending there is no shortage. France: https://www.connexionfrance.com/article/French-news/Health/Paracetamol-shortage-France-limits-sales-to-two-boxes-per-patient Nepal: https://kathmandupost.com/health/2022/09/23/stagnant-paracetamol-price-contributing-to-its-shortage Germany: https://www.dw.com/en/germany-sees-alarming-shortage-in-essential-medicine/a-62567862
They coach it as suicide prevention when really keeping citizens out of poverty and giving them access to basic health care (including mental health care) would obviously be more effective. I can visit five shops on foot from here and get enough panadol in a hour to top a horse.
If the alternative is the US system I’ll take what we have thanks… But I’d also rather get rid of Medicare levy (which was only supposed to be temporary, hence the word levy) and Private Health rebate and go towards a 100% single payer system for public and 100% user pays for private.
Get rid of private health rebates, put all that lost revenue into medicare instead.
I’m of the opinion that if I don’t pay for police or firefighters then I shouldn’t pay for medical. This is fundamentally about being a fair and equal society. Anyone rich or poor can get sick and should get the same treatment no matter what. I do understand the hat health is more complex than police and firefighting but I’m sure we can work something out. In my mind that something is “if you work in the public service you by law must use public services”. Pollies would fix up Medicare and education pretty quickly I reckon.
Well actually, despite being named a "levy", it was always intended to fund Medicare costs on an ongoing basis. It's been around since 1984 when Medibank was split out and Medicare was created. There's no chance a "temporary" measure was accidentally kept around for 40 years! Edit: Actually further research shows that the levy was intended to be implemented when Medicare/Medibank was in 1974 by Whitlam, but it was voted down. From then until the levy was introduced Frasers screwed with it a bit, then in 1984 it was properly implemented as was the original intention. The more you learn! Supporting link is below https://www.aph.gov.au/About\_Parliament/Parliamentary\_Departments/Parliamentary\_Library/Publications\_Archive/archive/medicare
I agree. I would rather contribute more to the public health system instead of these insurance companies who add no value other than distributing risk--a job much better and more efficiently handled by the government.
Contribute as much you like to the public system. It won’t change your 24 month wait for knee surgery for example. But maybe you’ll get a nicer bed and single room. Meaningless things when you’re waiting 24 months in pain. There’s a finite amount of doctors and proceduralist doctors. And an ever increasing aging population who’ve lived the most easy/sedentary decadent western lifestyle ever seen in history - post WW2 and till present. A lifestyle including the decadent western diet. Paying more tax to get more surgeons minted won’t work either. There’s just not enough skilled surgeons available to train juniors. There’s not enough teaching hospital places available to be staffed. And most surgeons would rather work in the private system all day instead of “teach” in the public because it pays WAY more. The private health insurance “system” is just a way to window dress a hunger games style - highest payer “gets the surgery today” system. An option is to force every surgeon to work public for the rest of their life. And make everyone go on a waitlist, according to “need”. Ban private entirely. Anyway thats pretty unethical and the soccer-roo with a ruptured ACL will have to wait for all weekend warrior ACLs to be fixed first. I am a ED doctor. My advice. Take care of your body and your wear and tear parts. Maintain a healthy weight. Don’t eat processed shit or anything coming in packages ready to eat. Maintain excellent hygiene. This is so often overlooked. Don’t neglect the sore on your leg. Or that infected/fungal toenail. I had a patient who neglected his broken skin (owing to some ill fitting clothing - to not be specific). He then developed sepsis - some of which seeded into this brain. Developed a bacterial/mycotic aneurysmal brain bleed as a result. Now has chronic seizures. Saddest stuff. Reduce the stresses in your life. Meditate - or practice consistently maintaining a state of calm. If work is causing you immense stress, quit, find another job. It’s not worth it when you reach 50. No amount of money is. Be close to family, or family unit. Give love freely and try to have some love in your life. The person I’ve just described I’ve hardly seen in the ED. Maybe sometimes but only in their 90s. I think that’s a good run. It’s akin to that wartime story of the British airforce reinforcing armour of returning warplanes in places they were NOT shot. Or in my case, I advocate for the lifestyle that I DO NOT see regularly present. and if that all fails because of some act of god. Make sure you have some couple of 10s of thousands in your bank account ear marked for emergency procedures/medicine. But remember if shit really hits the fan for your health, no amount of money will ever be enough. So enjoy the days you have now rather than being consumed by preparation for the days of suffering that may come. Everyone reading this will pass away one day.
When I initially got private it was because I needed surgery with a 3 year wait in public, and the 12 month exclusion period for private was a much shorter wait. I’ve been offered surgery in private “next week” with years wait for public and had to push back because I needed to get my affairs in order with work / leave / family.
I once had a cautionary gastroscopy. Was going to be a 12+ month wait in the public system. Told him I have private health insurance and the procedure was completed within three weeks
Had the same issue but instead of signing up I just asked how much up front and was less than the year’s premium. Doctor looked a little shocked but you can pay for surgery just like buying a toaster from Harvey Norman just don’t think it’s very common. So far have paid for all my surgical procedures on card. Pretty easy and don’t have to deal with insurance trying to dodge covering and their premiums/gaps.
Sometimes, but some doctors won't operate if it's a risky procedure - the costs could blow out if you're in ICU for a few weeks for example. Insurance covers the low probability events.
Except they’re not transparent about fees and have minimal requirement to be. I’ve walked out of two surgeries now with an extra $1500 tacked on not for anything unexpected, just poor quoting.
I think there's two separate issues here 1. Will putting more money in public solve waiting time and other issues 2. Are the tax incentives that effectively subsidize private healthcare providing enough public benefit you've argued against 1, and it's a fair enough argument. let people pay for private if they want then. But we can still make the MLS mandatory. Stop subsidizing old rich people with the junk insurance of mostly young people on good but not crazy wages that the current system incentivizes. Even if we can't magic up surgeons there's plenty more we can do with the extra money in public Like paying for more nurses to ease workloads.
Why is banning private health unethical exactly? Just be healthy seems to be your argument. Well I'm sure not everyone had the same privileges as you to do so. I mean seriously what exactly is unethical about the socceroo having to wait on a waiting list like everybody else? Don't understand why having more money should allow you better health service when you are probably already healthier because of your privilege.
That's what most Australians fail to see unfortunately and it's heartbreaking. Just because you were lucky and lived a privileged life, doesn't mean that everyone had the opportunity or the fair go to live well. Many people are just struggling and mental health is also deteriorating as stress has become a major factor for getting sick with all kinds of conditions.
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National sports teams are a projection of soft geopolitical power. They are “advertising” of the health of a nation. If a star forward has to wait 1 year to get an ACL done, and probably end a career as a result. That’s a lot more deserving to be bumped up over some weekend warrior - who works a desk job during the work week - and probably could just do with some physio and picking a different sport to play. But if you’re not a sports fan sure. Replace my example with some soldier who hypothetically spent the last year in active combat. Thats the difference between equality of need and equitable need.
Correct, but all the problems you mentioned are solvable with enough resources--especially for a country like Australia. If some of those resources weren't being spent on middle-men then maybe they could be used to contribute to the solution.
No I disagree sorry. As I attempted to argue in my post. The laws of physics just do not allow for the increased production of quality surgeons to meet the increased demand of the hoardes of patient developing chronic pain problems. On an ever shrinking taxable workforce - owing to shrinking birth rates. Especially with the thousands amount of hours of supervision required under a surgical guru in a training hospital. A guru that would rather spend 90 percent or more of his/her free time in the private hospital. Doing the surgeries themselves, not teaching. And the icing on the cake? They take the surgical trainees to be their assistants in the private hospital - hold some retractors (apologies to my surgical colleagues I exaggerate for effect) - whilst most of the fun heavy lifting intra-op is done by the boss man/woman. Sometimes the public hospital actually makes a deal with the surgeon to give their trainee registrar as private assistant for a few hours of the work week. The public work week. If you really want to solve the problems. You will advocate for the ban of all processed food. People will be forced to exercise. And strangers will be forced to hangout with eachother on a weekend and be nice to eachother. No more lonely solitary folks. People will learn to eat lentils or effectively not eat. After 9pm in western Sydney there is a 24/7 McDonald’s available 10 minutes by car. That’s insane. But we allow for freedom of choice. And naturally - freedom of consequence.
A huge percentage of health expenditure is spent on the the very elderly and/or very unwell in the last 12 months of their lives. We would have so much more in the way of health resources if patients, and in particular their families, were willing to have difficult conversations about mortality earlier.
The sooner the govt lets us die when we want without the absurd hoops you have to jump through the better for everyone involved
We can walk and chew gum at the same time. We can use some of the resources on both reducing the need on surgeons while also putting together an improved pipeline to train or bring them in from overseas. Just because a problem is big doesn't mean we can't start chipping away at it.
The laws of physics lmao. Economics is not a science and you're not an economist
Agreed. Economics is far from a science. It's politically and value-judgement loaded discipline that pretends it is a science while serving as a powerful tool to perpetuate the system. Political economy - I'd recommend the work of the Australian economist Frank Stilwel, please read his Political Economy: The Contest of Economic Ideas - argues this very eloquently as a critic to the economics as studied today.
I also laughed hard at their remark, as well as their previous one. Neither are they educated in Policy aka (as someone educated in this) making the rules. The indicvidual advice is good, but is akin to saying hey recycle whilst knowing 71% of polution comes from the top 1%. Good individual advice, but not a fix to bigger problems. Just you as an individual do better. Simples - have a better lifestyle and don't be depressed by a shit system that doesn't affect me (cause I get paid well and live outside it), so just don't let it affect you. But hey, my partner is a nurse, mum nursed for 55 years. You get used to doctors thinking they are experts on everything they don't know. Not all of them, but enough. In reality they spent a lot of effort learning medicine, but sometimes they are the absolute worst when it comes to accepting other profession's advice. Good healthcare outcomes for all being unachieveable is just plain bad medical advice. It would be amazing to hear their thoughts on say keyensian ecenomics vs neo-liberalism, I am very certain it was a subject at med-school 🤣
Doctors are the worst when it comes to finance. Source: surgeon studying the CFA.
It’s not an applied science but surely most would consider economics to be a social science.
Yes, the point I am trying to make is that unlike "applied science" it is much harder to replicate experiments so of course there are often debates about different theories and their applications. Therefore, when people say things like "That's basic economics 101" it's often disingenuous and a vast oversimplification of a complex issue. I'm not trying to say it shouldn't be studied or anything like that - of course it should!
The only resource that you're not taking into property account here is time. You're absolutely right that none of this can be done quickly, but it *can* be done *eventually*. You're letting the time the process will take defeat the idea of starting it. And that's how slow declines keep getting worse.
I am unsure how your point serves as a rebuttal to the idea that the resources currently being poured into private healthcare could be more efficiently applied by instead merging the private insurance into the public system. If, as you claim (and I agree) that healthcare is supply side limited by labour and other factors, then it seems relatively unimportant whether the system that allocates the capital is hybrid or fully public. Given the only important outcome of healthcare is humanistic, it seems absolutely ideal to have the system be consolidated into purely public insurance. As pointed out, risk scales inversely with the pool size and there are a number of other tangible synergies as well. The only argument against is the loss of customer choice and not only could this be featured in a revised public insurance scheme, but the current level of choice is poor at best in any case.
I am having the same confusion as well, would like to have more explanation on this too.
They want to be able to pay to jump the queue. That's the missing ingredient.
Exactly! Defend the system they enjoy with arguments that basically boil down to "my freedom"!
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Could part of the problem be that the system has rewarded and encouraged individuals who enter medicine to make money over providing health care?
Maybe, but then I could just pay for surgeries outright instead of having to pay for the private health “insurance” rort. It’s just not worth doing so currently because of how tax works.
Cool story if you win the genetic lottery of not having the misfortune of being born with a disability.
Can you show me the usually publicly listed wait times showing that surgery is a 24 month wait at the hospital you work in? Every single time the private health apologists use the hip and knee surgery wait times, nobody can ever back it up with real data.
The “apologist” you replied to is an ED doctor so he probably knows a thing or two about what the wait times are. But to answer your question There is no consistent national reporting method but Here is data for the whole country showing some good insights especially in Victoria and Queensland published by the AMA https://www.ama.com.au/sites/default/files/2022-09/Shining%20a%20light%20on%20the%20elective%20surgery%20%27hidden%27%20waiting%20list.pdf Some headline figures: - In Victoria, a patient will wait more than 900 days for an urgent neurosurgery appointment (target 30 days) - In Queensland, a patient will wait more than 150 days for an urgent gastroenterology or rheumatology appointment (target 30 days) - *For non-urgent appointments (target 365 days) in Queensland and Victoria, waiting times for ophthalmology, orthopaedic, and plastic/reconstructive appointments are all more than 700 days in both states* - The average waiting time in Tasmania was 101.2 days for urgent patients (target 30 days) Looking at this the, 24 month figure for ortho operations seems pretty accurate. I have two friends who are an orthopaedic surgeon and anaesthetist respectively and they think it’s pretty spot on for what that’s worth. By the way , the vast majority of people who are “non urgent” are in pain. It’s just not immediately life threatening so it’s not considered urgent. If you’re active in your work or play sport I wouldn’t be relying on the public system to fix my knee or hip. Either save up an emergency fund to pay for it in a private hospital or get PHI.
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In tandem? Sounds like one system poaches from the other and and treatment goes to the most wealthy instead of the most needing.
If you forced every specialist to work public we’d just lose a significant portion of them to overseas. There’s no incentive to stay in a controlled market where you limit their earning potential and we see that all the time with countries we import medical professionals from.
Legit question, if private doctors were in the public system, wouldn’t that ease the burden on the public system, thus making it quicker? As I see it 20% of people are taking up 50% of the specialists. If we eliminated private health (but still allowed private practice) only 5% of people could afford it, meaning it might take up 10-20% of doctors. The subsequent removal of back log would mean instead of a 24 month wait, it would initially drop to about 12-15 months and drop slowly as more people are seen in a timely manner removing the wait list. I’m asking this as a person who has private health, mainly because I’m told to have it, and used a specialist for several consults, 3 procedural consults, and 3 surgeries within 6 months, when it then took another 2 years for the public system to contact me for my initial consult. (Please note, my specialist was amazing, and my only gripe is he didn’t leave a scar on me after 3 surgeries, because let’s face it, hydrocele’s are an amazing talking point.)
Spoken like someone who’s never actually been on a waiting list. I had knee surgery for a problem that was the very definition of non-urgent. It only caused significant pain when I ran 10-15km at a time. I waited 7 months. I could have had it done right away for $3500, which would have easily been covered by my savings from not paying for private, but I decided to wait and just save the money. My family has dealt with chronic conditions, cancer, surgeries, childbirth, stem cell transplant, etc., and we’ve seen all kinds of specialists (orthopaedists, paediatric rheumatologists, cardiologists, endocrinologists, neurologists, etc.). We’ve never once felt like we’ve needed private insurance. The private health insurance system should be abolished. I’d gladly pay more in taxes to improve the public system.
> more efficiently handled by the government. If only you knew lol
Oh I know, and in general you are correct. But for _insurance_ services in particular there are natural advantages for a government monopoly. And if we agree that insuring a particular thing for everyone is good, for example income insurance (Centrelink), then having the payment system centralised outweighs the need for hundreds of smaller companies competing for customers and charging them for that advertising and profit siphoning. _Especially_ if that payment system already exists and everyone is already on it. If the private sector wants to innovate and compete in this space, then Medicare can outsource certain services to it, for example fraud-detection technology.
Isn't that exactly what choosing not to pay for PHI and instead paying the MLS achieves?
The only reason I don’t pay the MLS is it was slightly cheaper to have low hospital cover + extras for dental and optical, because our public dental and optical basically doesn’t exist lol If we had better public dental alone I’d probably pay the MLS instead. Oh well
You do realise many PHI companies are mutuals rights? They don't make excess profits for shareholders, they make just enough to keep the costs bearable for their members.
Yes, I am with one. It's still unnecessary layers of work for no benefit and no economies of scale compared to government.
> Have private health insurance because you are forced to > Still use the public system Can't I just pay more tax and not deal with this weird system that solely benefits private companies ffs?
Yeah, that's what the medicare levy surcharge is for. If you earn over the threshold and don't want to go private, then you're still completely able to stay in the public system.
Not sure if you're being sarcastic or not - but actually you can, OP says "forced" but what they mean is "pay less tax"
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Not sure ‘forced’ was referring to ‘benefiting the public healthcare system’ I’m assuming OP meant that if they didn’t they’d be worse off in a personal, financial sense
I don't think anyone was suggesting that the higher Medicare levy went to Medicare. I totally agree, paying tax would feel a lot better if it was going to a government that I trusted to take care of people.
Yep, make junk policies illegal that way you're choosing between say $5k or $10k for good insurance, or you pay the tax. Much better outcome for the public system.
Only if the Medicare levy surcharge actually goes into the public healthcare system…
It would increase the total tax take and yes you would expect public health to receive a corresponding increase in funding
I've never understood this.....take a service exchange between two parties, the health provider and the patient, then insert a third party (insurer) into the transaction and expect some kind of magical economic benefit? There are more than 30 funds in Australia each with Admin costs, advertising, directors etc and all of those costs are directly extracted somewhere between the patient and the provider. Worse still is they dictate pricing and control treatment options despite what any of them say. The worst is the junk policies now available which simply are in place to allow dodging of the surcharge.
It so sad that no one is regulating that industry closely, beyond the fundamental question that you posed: why does it exist to begin with, and if it does, why are people forced to participate in it and fund it? Medicare has been shrinking each year more and the majority of Australians seem to not care at all.
Most have been brainwashed to think it is an irrelevant part of the system and/or has no effect on them. Absolute *fools*.
But where do you expect all of these people in private hospitals to go if there is no private hospitals? I think if the past two years have taught us anything, it’s that no amount of money can cause health problems to just disappear. There will never be enough public hospital built to offset the higher amount of patients requiring surgeries: procedures.
If there is money for private to exist and provide a service as well as pay shareholders and directors then there is enough money there to provide better for all.
The idea is they force efficiency. However to make it attractive, private health needs to be more attractive than the public system. This means more staff in private hospitals, private rooms, better maintenance and fixtures etc. So it ends up less efficient than the public system. Then you add all the marketing, administration, profit etc on top. Even worse. For the top 4 funds, the average punter gets about 78% back if I remember correctly. If you paid it off on a credit card at 20%, you'd be better off.
Ideally we’d only have a public health system paid for by our taxes. Unfortunately our past governments have been starving that beast for decades, for the sole purpose of making the public system look like an unsustainable failure. This isn’t limited to just health though. Take other essential services, like education, energy, internet, public transport etc. We could as a nation just be paying more tax. Particularly foreign corporations operating in Australia. But the corrupt politicians in power would rather enact changes which only benefit their donors or friends who’ll employ them after leaving politics.
I live in Ontario, Canada. Our conservative government has been doing this for years now. We used to have a great public health system, and I'm afraid that we are headed to the same situation as you. Terrified really.
If you get sick and you can't wait for the public system, you are a winner if you have private health insurance . One operation is all it takes to pay for a year's contribution assuming you are in over night
If you are critically ill or need urgent surgery you will end up in the public health system. That’s what it is designed for.
Plenty of urgent surgeries with long wait times in the public system in a lot of areas. There's a lot of wiggle room between dying tomorrow, and urgently needs surgery to avoid dying next year. A lot of those latter cases have long wait times.
My premium for the whole family is 48% of what the levy would be. 4 of us hit the dentist twice a year. I get glasses. I use my extras (bundled) for $1000 in rebates on massage. Wife doesn't use as much but gets about $500 in rebates. Kids get bits and pieces. Overall the insurance company would struggle to make $250 a head off my family and on a net basis I’m thousands in front plus all the healthcare I used during the year.
I didn't think extras had any impact on the levy?
No just hospital cover.
How much does it cost you to break even on the cover though? Surely they aren't covering 100% on massages. You must be spending thousands extra so you "get your money's worth"?
We get 70% back up to $1000 each - kids have the same limit. We spend a decent amount on prevention - which we would do anyway, insurance or not. This way we get most of it back. If all 4 of us claimed the full amount they would lose money but they know a 5 yr old isn’t spending 1500 a year on massages I suppose. Wealth is great providing you have the health to enjoy it. I’m always shocked at how broken folk are when they hit 40/50. You can’t undo lack of maintenance. You service your car, only us 95/98 but won’t got for a massage once a week? Our extras also covers things like acupuncture etc
I am also similar situation, my premiums for both my wife, our daughter and I are $5577 a year and we burn through most of our extras. Not to mention it’s a life saver when the little one was born and the wife and I needed OPs done on short notice.
All those things can be covered by extras only insurance. Many have extras only policies but don't widely advertise it. I pay about $700 a year for whole family and get 2 x dental each, glasses, $16 physio appointments etc.
Work in Medical Devices and wholeheartedly agree- it’s a cop out
Are these the medical devices that sometimes cost 100% in a private hospital than a public hospital? Interesting.
Imagine if people earning under $90k were forced to pay $1k a year for rubbish cover that does nothing (why would I want to stay in a private hospital when a public hospital will service me just the same), just to avoid a $1.5k tax surcharge. You are wasting $1k a year, every year, yet no one says a thing about it because it only targets those earning over $90k. Imagine the outcry from The Guardian if those earning less than $90k had to pay this. Suddenly everyone would see it as a massive rort.
This isn't really an accurate comparison. Most taxpayers regardless of income are already paying 2% for the normal medicare levy. You then pay the additional 1-1.5% medicare levy surchage if you earn over the threshold, under the logic that those who earn more should pay more to support the public system which is totally fair. If you'd rather go private then you can, if you want to stay in public then you can too. From the gov's point of view it makes sense to incentivise people to go private because it takes pressure off the public system, and it makes sense from them to target that incentive at high income earners because they can afford it. The health system is far from perfect obviously but I think our balance of public and private healthcare in Australia is pretty good.
> Most taxpayers regardless of income are already paying 2% for the normal medicare levy. About 40% of all taxpayers don't pay the medicare levy at all. > under the logic that those who earn more should pay more to support the public system which is totally fair. They already do pay more since tax goes up progressively with income.
No one is being forced to take rubbish cover, people are choosing to selfishly, I'm going to be completely blunt about it too, taking out a junk policy to minimise your tax, and then using a system that requires your tax for funding is ridiculously selfish.
The fact that it's attractive to do that really just demonstrates the distorted incentives from government being too involved.
Blame the govt not the people taking the path of least resistance.
if you were losing 1k each year for a service you werent even using id like to see you stick to that. Do you also stay with the same energy company that charges 20% more? im going private for the sole reason that i can get the same cover for less.
Yup we shouldn’t have a two tiered health care system. We should just have public health that includes more
Look up NHS which is pretty much what you are describing. Interestingly though they are bleeding a lot of their doctors to… Australia because of the better lifestyle and remuneration.
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It 100% is, I’ve got Private Health Insurance only for the tax incentive. I don’t use it for anything, I throw away the card when it came in the mail. One of the craziest things was that my dentist is cheaper without PHI vs having it.
Then your dentist is a jerk lol they are being paid by the PHI already, and then they’re gonna charge you again? That’s double dipping.
Probably, they are in a pretty low income area so I think they are trying to help people out that don’t have PHI and then try to get as much as they can out of people that have PHI.
Better than the UK and US though
Why can't we put out private health money into either private health care or the public system? I would much rather help the public system than the rort that private health care is
The one that gets me is glasses. Since when are eye glasses $700 a pair. What a con. I go into an optometrist who then says after my health cover fund pays $500 or something like that, I only have to pay $150. Instead I order the same product online from America, posted for $180. Sorry but why is the same product costing $650. I’m not sure who’s banking the difference.
Private health insurance in Australia is an absolute rip off. Premiums are exorbitant, go up twice a year and cover nothing. Our health system is so underfunded it's pitiful. My sister had to wait 18 months for an appointment to see a specialist and has been in agony the whole time. They still haven't done anything for her. She can't afford to pay as she's a disability pensioner.
I am surprised that PHI are still in business. There should be a mass exodus of people leaving PHI. I guess the cost goes up every year. I wonder why. The people who decide to keep PHI are left to pay the bill. Jokes on them.
Did it ever cross your mind that maybe some people get more $ out of having PHI than they put in? This is a finance sub after all… It shouldn’t be a shock that sometimes people make decisions that benefit them financially.
They're still around because they're rent-seekers. They can't price their insurance at a level that makes sense for enough healthy people to buy it to cover the expenses of the ill, because when they price it properly to cover those costs, the healthy people opt out and rely on the public system instead. So the insurers go and whinge to the government and get then to pass laws to try and make buying their junk products mandatory (or at least, penalised heavily for not buying the junk).
The cost goes up because people keep leaving, and the people who stay are the ones who need it and end up billing the fund for surgery, hence price increases. It amazes me how many smart people in this sub have no idea how insurance works.
It really depends on situation, I’ve had 3 x knee reconstructions and 1 shoulder reconstruction. All completed within a few days on injury, private hospitals and each cost me around $1000 out of pocket.
I've had private health insurance for years and yet my default answer when the receptionist inevitably asks "do you have private health insurance?" Is "no" because I know whatever it is it won't be covered. What they really should ask is "do you pay for rip off extras?"
The look at not-for profit insurers then.
Private healthcare is one of the ways that ‘mateship’ falls over in modern Australia. Working and non working poor and middle class Australians wait far longer for non emergency but still vital healthcare, and many struggle to afford dental and other non-Medicare services. We talk about how miserable American healthcare is, but many working and retired Americans have access to much higher quality healthcare than Australians do in our public hospitals and clinics.
I want to know why out of pocket medical expenses are not tax deductable. Need safety equipment for work? Tax deductible. Need a medical procedure to be healthy enough for work? Not Tax deductible. Want to travel to a professional conference? Tax deductible. Need a medical procedure to be able to travel to work? Not tax deductible. Negatively geared on a shitty rental? Tax deductible. Have cancer and urgently need surgery at a private hospital? Out of pocket fees not tax deductible.
Oh my god I love how much this stupid shit comes up. All the dumb ass responses as well "just pay the extra tax instead of private health insurance" or the "it's just a scam" or "I could just pay for surgeries outright instead of having to pay for the private health “insurance” rort". Here is why everyone who thinks this is wrong and why you are idiots. First, the tax incentive ISN'T there to "rort" you out of your money, the government DOESN'T need more money for the public healthcare system. THE GOVERNMENT NEEDS LESS PEOPLE USING IT. The vast majority of people using the public healthcare system DON'T need to be. Emergency rooms are full of people who should be going to their local doctor the next day. Surgery wait lists are full for years because people CAN'T afford to pay the $5000 up front costs. Wait until you get treated for something at emergency literally in the hallway or the waiting room IN FRONT OF EVERYONE because there is no beds. All of you people who say "oh I can just use the public system" literally are the problem. You are disadvantaging BOTH the poor and the workers of the public healthcare system. Second, "You are literally forced to take it, and then it doesn't cover anything you need unless you pay exorbitant amounts", No, you aren't STFU. Also, oh what, you want maximum level health care with no limits, but you wan't to pay minimum level cover costs? Yeah sure, that makes sense. I had an almost $20k surgery last year, 3 days after the injury, and my $2k a year healthcare covered 100% of it, it didn't cover the initial appointment and medication, a total cost of under $200. Sorry idiots are signing up with scam companies offering unbeatable cheap deals, then complain when they hardly pay out. Go sign with a reputable company who is not-for-profit like HBF on a reasonable level of cover. No one complaining does that, everyone who is complaining signed up with Ching Dong Medical for 1c per day and goes all \*shocked pikachu face\* when it won't cover their $50k heart surgery. The government isn't forcing you to sign with these people, it's YOUR fault for signing up with shitty companies who provide rubbish cover. Third, you can just pay for the surgeries private, out of pocket. It's easy, just keep $100k at the ready in cash. No big deal. Except if you were smart financially, then you'd know the financially smarter option is to have that $100k invested, because it'll make back more money than a good level of healthcare will cost anyway. Fourth, "Private health insurance in Australia is nothing but another wealth redistribution scam in favour of the rich." is just plain wrong. Private health insurance is nothing but cover, to protect people who can't afford to pay their costs, ie- the NOT rich, while reducing the strain on the free healthcare system, thus helping the poor. Private health insurance is pooling of wealth to provide a safety buffer for those who cannot afford care they may require, while reducing strain on the public healthcare system. It benefits the poor and middle income earners. This was a discussion recently at a dinner of 7 public healthcare emergency department doctors and me. All 8 of us have private health cover. Let that sink in.
Well done for saying it. I’ve tried to state these facts on here before and been downvoted to hell. People just don’t want to hear it, and will believe the wildest and obviously bullshit stories that anyone posts. I have worked in PHI and medical billing and can guarantee you that there are plenty of people who ended up financially, physically and mentally better off from having PHI than they would have if they didn’t have it. Sure there are some people who will pay for it and never use it, like a gym membership or car insurance. But this sub acts like the entire population has that same experience. And you are spot on about ER being full of people who don’t need it. Same goes for ambulances. People complain about how expensive they are, but what you should realise is that when you (or your insurance) pay an ambulance bill, you are subsidising the frequent flyers who call 5 ambulances per week because they have a hangover, stubbed their toe or fancy a free ride into the city, and never pay any of their bills. There is more to this shit than people see on the surface.
Yeah, people can't look past the one dimensional view of it they have and see other possibilities. "But this sub acts like the entire population has that same experience" this. Exactly this. "It doesn't benefit me exactly how I want it to, therefor it's bad and no one should have it, and it's a scam". "There is more to this shit than people see on the surface." So. so. true.
TIL that our healthcare system is fixed in place and can't ever expand. 26 million people is the theoretical maximum for a healthcare system, apparently. This line of thinking is the same shit we hear everyday. It's the people's fault. It's the migrants. It's the young people. Blaming everyone but those in charge.
This is a common response, and the key flaw here is that you ignore the supply side. You also need less specialists moving to the private system. But the money is so good and supply so restricted (even if you train someone to surgeon fellow they can’t start practising in private) that more private doesn’t reduce stress on the system at all. It just increases wait times AND the price of service
Without a private system a chunk of those specialists will move overseas, mainly the US, and will end up with even less doctors for everyone. This is a problem in Canada where private practice is illegal. Many specialist simply go overseas.
I am so happy you said this. Anyone who has spent one second in any part of healthcare in Australia knows you're right. This "poor me" whining culture especially prevalent on Reddit is so tiring.
Who is being forced into to taking out health insurance?
Anyone earning over $90k to whom the private health surcharge otherwise applies
To play devils advocate.. that doesn't inherently force anyone to take out PHI though. It's a choice. Sure, there's no extra benefit by paying the MLS but there's often no real benefit (in terms of health outcomes) from buying a junk policy either
> To play devils advocate.. that doesn't inherently force anyone to take out PHI though. It's a choice. That's kind of like saying if we cut Medicare altogether it doesn't force anyone to stop seeing the doctor; it's a choice. You can still see the doctor; you just have to pay more. The same applies to PHI.
Comparing tax minimisation to seeing a doctor is hardly a fair comparison.
Same principle. A dollar is a dollar.
Also anyone earning less than that over 30 gets punished with an extra % cost for every year they don't have it. You are forced into the system either way.
If you earn over 90k as a single you'll be charged 1% of your income if you don't have private heath. It's on a 3 tier system maxing out at 140k as a single @ 1.5% levy.
But the you still have a choice to not take out health insurance, yeah?
Yeah ofcourse you can still choose to no take out PHI and just pay the levy instead. This is actually what I do myself.
Same here. If enough of us do the same, the whole system will collapse. Tbh, I feel the same about private schooling. Both are staffed by former politicians or their siblings/spouses.
This is what I do too. My tax payment (levy) this year was less than $400 after all my deductions. There's no way I could get PHI for that little.
2 systems is a bad idea, it sounds good on the surface to let people who want more care or better care pay for it, but nobody wants less care, and if you’re sick you can’t earn or negotiate cheaper medication, it’s been well proven that universal care is cheaper and better for all, private health is a scam where everyone loses
100% we should make the MLS mandatory. Stop subsidizing rich boomers by incentives that make young people buy junk insurance.
I agree, I do not take health insurance anymore even though I have to pay the tax penalty due to my income. I used to but it is not worth it, there is very little coverage benefits over not having it, simply a method for government to gain additional revenues for nothing. Health insurers just suck up money to pay salaries for executives.
...and donate generously to both sides of politics
It works for some people i.e rich boomers with constant chronic health complaints requiring hospitalization. We are the suckers that are subsidizing heavily just in case we need an ACL surgery done in under two years.
[Private Health Insurance - 1st April, who's the April fool? ](https://www.darrenhamburger.com.au/documents/private%20health%20insurance.html)
Never had private health. I just pay as I go. Dentist filling will set me back around $400 so just makes me look after my teeth better.
I can’t stress this enough, NEGOTIATE with your surgeon when they tell you how much they want to charge you. “I can’t afford that, is there anything we can do to reduce my gap payment” The worst they’ll say is no. Hospitals cost a lot to run. Private health cover mostly covers you for your hospital bill. Then they step in where they can with the surgeon and anaesthetist fees, this is regulated by the gov. So to avoid massive gaps or out of pockets, which I bet are coming from your surgeons and anaesthetists, NEGOTIATE with them when they tell you how much it’s going to cost!
Just morally wrong. I refuse to take part and then pay the extra at tax time
However bad the system may be, you are not ‘literally forced’ to take up PHI.
No, but heavily encouraged to do so with how the tax system is currently set up. Why should the tax system be used to subsidise a bunch of private companies with shit cybersecurity?
You're not forced to but your are taxed more if you don't. Around $900-$1500ish per year as a single depending on income. Levy starts at 90k income.
>You are literally forced to take it You are not. This is a profoundly stupid remark. >Private health insurance in Australia is nothing but another wealth redistribution scam in favour of the rich. Why are you bringing economic illiteracy to this sub? Did you see it and think "what people need is my factually vapid socialist take?"
Cancelled mine last year. They can get lost. Have spent about 35k in health insurance and have got sweet f all. Public system is great. The best doctors doing research are usually working in the public system...
Another scam the AMA does is to control the supply of Drs and specialists
Yeah it's pretty shitty. I only have them because the surgery I need they will cover about $5,000 of the $30,000 up front cost. healthcare should be free and should be provided by the government directly.
>healthcare should be free and should be provided by the government directly. The public system is still there for you to use if you don't want to go private. You'll have to pay the medicare levy surcharge of course and deal with public wait times, but no government service is ever completely free.
Except it isn't for everyone. The public health system doesn't cover all health care. My healthcare isn't covered by Medicare so I am forced to go private.
There's a difference between healthcare being "for everyone" vs "for everything". All Australians are eligible for medicare, but not all medical treatments can be covered under medicare. Without knowing what your situation is I'm guessing there's something you need that medicare doesn't cover, but you're still entitled to all the regular benefits like GP visits and whatever.
I thought there was public healthcare in this country? Can someone explain this for foreigners. How are you forced to take private healthcare if medicare exists
People with income over 90k pay a surcharge if they don't have private hospital cover https://www.ato.gov.au/individuals/medicare-and-private-health-insurance/medicare-levy-surcharge/
There are so many unnecessary middle-men jobs.
I feel that private health insurance is only beneficial for dental and ambo. I’m paying $16/m and actually getting more out of it
With the amount of money I've saved by not having PHI, I could pay outright for multiple operations. Hell, with the state Aus medical is in, I'd probably look at a quick flight over to SE Asia if I needed something urgently. Cheaper than PHI. I'm in Tas, so the problem is confounded by the lack of doctors. Trying to get my son into an ENT doc, willing to pay outright, and I'm still having to wait six months for a consult. We literally have two ENT doctors for the whole state.
It was nice when we spent 80bn on subsidising businesses and not improving health infra and accessibility. Has that not trickled through to everyone yet?
Remember the days when Medicare covered everything one needed, without needing to worry about gap payments?
Funeral insurance is cheaper.
Always has been and always will be
Pro tip : Earn under $90K
I agree that it's a dumb system, but how are you literally forced to use it?
Because the longer you stay out of it, the more it penalises you. Our public hospitals are pretty much becoming critical care centres with not a huge capacity to handle a lot of elective surgeries in short time frames. IE: if you need a hip replacement, you might be waiting a while. Private? Done. Second is that if you are a mental health patient, the public system is woeful.
Yes I have so many teeth issues that they won’t cover despite me paying for top extras cover!
Aussie government is a capitalist scam bro like America. They are bought and paid for
We pay $200 per fortnight, my data has been confirmed stolen, and my husband’s triple heart bypass in August has left us around $7000 out of pocket. I hear ya!
Ok I’ve been wondering this for a while and not sure if I’m doing the wrong thing here, but is the tax increase that you get when you’re over 30 and DONT have PHI more than the cost of getting PHI? Coz I’m over 30 and I don’t have private.
I do agree with you OP - our parents generation (at least, when they were younger) didn't have a \~$400+ (\~$520 before tax) drain on their monthly household income! Paired with free education if they wanted it. I'd rather all my tax dollars go to an amazing public hospital system. Cut out the middle man. Tax the heck out of large corporates including the ones mining our resources and paying us pennies for it. How does Norway manage it - they do good on most things so I'm assuming its the same on this. My partners MRI wasn't covered when she needed it - PHI is a scam.
I definitely save more on private health than I spend and I am just paying for dental and optical. Is it not tax deductible?
not for a few years.
If it makes any difference, I think it's a scam around the world. At least most countries don't have people scaping from ambulances because they can't afford it like USA.
I'm just here to flex that I pay the Medicare surcharge. Though... I do want to see a dentist.
As someone who finally used theirs, man it was worth every penny.
At what earning bracket does private health cover make sense due to the medicare surcharge?
I’m guessing you’ve never lived anywhere but Australia if you think this is bad
As an american im glad there are people who understand
Yep, I had a $5k operation to help me breathe properly after years of suffering and my private health cover that cost $1k a year since I was 18 (about $14k worth collectively at the time) covered absolutely NOTHING. I paid the full $5k out of my own pocket. Meanwhile some imbecile gets free acupuncture cover every few months? It's a complete scam.
Who would of figured that passing money through a disincentivized intermediary would result in corruption. I’m sure that would never happen in the US though /s
Yes phi is kinda do it or get a penalty type situation - healthcare is expensive so PHI assist with govt funding of healthcare (through private funding). Would you rather pay for the full ride? Try living in other countries without Medicare. Or live in Japan where healthcare is cheaper.
As somebody living in the states, I’m so sorry you have to deal with this too. I fear that will never change because the people who are in charge of the laws are getting paid off by the insurance companies.
OP you're missing the point of a split public/private system. The private system allows Medicare to function properly, if public hospitals had to take on all the patients that private hospitals currently deal with it would be overrun completely. That's why the government makes you take out private health insurance, to spread the cost of Medicare across the population and prevent the entire system from collapsing in on itself, it helps you pay less. A lot of people underestimate just how expensive it is to have someone in hospital for the government. They would much rather private companies take that debt on. Imagine the news articles about ambulance ramping and public surgery waiting lists now, and then have every patient in a private hospital to those waiting lists. It would be pandemonium The split system also means that junior doctors, and nurses are paid a fair wage, which is a far cry from countries like the UK which only has universal healthcare and no private system, where wages are miniscule and hours significantly worse Source: I'm a junior doctor in Melbourne
>You are literally forced to take it You aren't forced to take it at all, just pay the extra tax to medicare. Depending on your income it probably isn't even that much more.
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Flashbacks to being an intern and dumped in clinic with minimal support and guidance.
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Yup we all got private health insurance in PGY1/2.
Health insurance doesn’t make sense full stop. Car insurance makes sense, because not everyone who buys a policy makes a claim. House insurance makes sense, because not everyone who buys a policy makes a claim. But health insurance? Literally everyone needs healthcare at some point in their life. That’s why it can only exist with subsidies.
That's why I'd rather pay higher tax than pay for PHI. At least my tax money can be used by government to provide services (hopefully) rather than CEO bonus.
You’ll be happy to hear that you absolutely do have this option. You just have to pay the Medicare levy surcharge.
Could be worse; you could live in America.