Rob Williams

Private v public health care? Public every time

How fabulous is our health system? 

On top of paying about $1800 a year for the Medicare levy, for just an extra $2309 I can get 25 per cent off cinema tickets and ten pin bowling, 15 per cent off theme park entry prices and Preggie Bellies exercise programs, 10 per cent off accommodation costs in one hotel chain, $30 off hot air balloon flights and discounts for lots of other stuff like magazine subscriptions and aromatherapy products.

A cornucopia of dazzling benefits.

There's just one thing I needed that I wasn't able to get from my private health insurer in the past 12 months - the health care I needed.

You see the year-long waiting period - that was applied when I learned I needed to upgrade to "top hospital cover" - has only just ended.


 Photo: Alistair Brightman / Fraser Coast Chronicle
Alistair Brightman

I guess I could have tried taking my mind off the severe pain in my left hip by going to a cheaper movie. Except sitting for periods was agonising. What about ten pin bowling or a trip to Dreamworld or Movie World? Sounds fun. Except the pain from walking was worse than sitting.

A nice nap after anointment with aromatherapy oils? Lovely... except it was almost impossible to sleep for the constant, powerful ache in my hip and leg. I was at the point where I was thinking I'd have to chuck in work. In short, I was in a hell of a bad way.

Or at least I was until I had the very necessary full hip replacement six months ago - done quickly and brilliantly in a public hospital, that picked up the slack created by a private scheme which, as I've written before, does not provide anything remotely like a good value for money auxiliary to our public system.

Luckily, when presented with the 12-month mandatory wait period, I had the sense to ask my GP to refer me to the public system.

Just as well as the hip's deterioration was as rapid as it was unexpected and my pleas to my insurer to waive or shorten the period if I had the procedure as an intermediate patient in a public hospital and/or paid the full year's premium, upfront, fell on deaf ears.

The operation, a brilliant success, was performed by a senior and excellent specialist - who has a private practice but also undertakes public work. The in-hospital care was faultless and the subsequent outpatient physiotherapy sessions were first rate, assisting my swift recovery.

I was out-of-pocket not one cent - over and above, of course, the Medicare levy.

Ironically, had I managed to last the 12 months the insurer imposed, I would have paid a $500 "gap" for the same specialist, a gap for the anaesthetist of several hundred dollars, the full cost of physiotherapy and probably a few other sundry gap payments. (Had I stuck with the private specialist I originally saw I'd have had a gap of $3500 just for the operation - we parted company when I realised what he charged.)

Now, this may seem all about me but it's not because variations of this scenario are played out every day all over Australia thanks to the, as I've also written before, "expensive, bastard, hybrid" health system we're lumbered with.


Emergency medical equipment in accident and emergency at Nambour General Hospital. Photo: Iain Curry / Sunshine Coast Daily
Iain Curry

It's a system that sees the private sector counterintuitively propped up by taxpayers to the tune of billions, including the $6 billion-a-year-and-climbing health insurance rebate and by more than a million of us paying punitive, 10-year penalties of up to 70 per cent on our premiums (for not taking out private insurance immediately we turned 30).

Profit-seeking private hospital companies are able to feed, like baleen whales gorging on a thick zooplankton soup, off this richly subsidised scheme.

Getting actual charges out of the sector is almost impossible with everyone shouting "commercial in confidence". But, if Ken's email to me last year advising his insurer had been billed $3954 for his wife's overnight stay in one Queensland private hospital is to be believed, there's gouging going on. Inflated bed costs will be reflected in higher premiums, as are the inflated costs private hospitals are allowed to charge for prostheses.

Annually, premium hikes are rubber stamped. There's another looming. Mine went up 8.6 per cent last year. Bill reported to me his rose 11 per cent and that, in the past eight years, his premium had gone up 94 per cent.

Meanwhile, the public system - which should be cherished not least for its training of our young doctors and all the fine, lifesaving research undertaken - and its funding are at the mercy of politics and the concomitant private v public ideological war.

So, despite the rising health bill, the Medicare levy hasn't been increased for 21 years and the Medical Benefits Schedule, which sets what Medicare will rebate for consultations and procedures, is hopelessly out of whack with realistic costs and is also subject to an indexation freeze to 2020.

The last APRA private health insurance quarterly report recorded a small drop in the number of people with private hospital cover, down to 46.8 per cent of the population. Is this the start of the revolt? If so, the pollies and private providers have only themselves to blame.