CHOICE membership

Health insurance - what would you like to know?

Hi, We are working on a new content plan for our health insurance category. Please let us know what questions you have and what topics you find interesting or confusing. Also let us know any tips and hacks you came across so that we can share them with other members.

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I would like an end to government subsidies of health insurance and would be happy to pay a higher levy to support a medicare service that makes appropriate healthcare available to all Australians.
As a teacher, I have seen children suffering significant pain because of long waiting lists. Just one example -a student who found it very difficult to cope as she was forced to choose between painkillers which made her too dopey to understand her lessons or pain which made her short-tempered, irritable and unable to concentrate.

We need to focus on improvements to medicare and an end to a system which benefits only the better off and the insurance companies.

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I absolutely agree. I am doing just that.

I agree with previous replies that Health insurance in principle undermines Medicare.

Even if Choice chooses to publish information on various options, it would be appropriate to point out that at the population level any private health insurance undermines Medicare. Arguments that private insurance take the burden off the public system are incoorect when the entire health and hospital system is considered as a whole.

It would be good to point out the option of using the private system even without insurance (which could be considered self-insurance if savings are held specifically for this purpose).

It would also be good to describe how we have been manipulated by government and the private insurance industry into considering health insurance is necessary. In fact Medicare is cheaper and for many services superior.

Thanks for the option to contribute.

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The most annoying thing about private health insurance and the system is the GAP.

You can take out the highest level of cover yet I have been staggered to be left $100s out of pocket for a very simple procedure because the specialist and others involved want more than the Govt and the insurance co. are willing to pay them. It really made me question the value of my private health insurance and just what I am really paying for as it seems like a con job! When I attempted to get to the bottom of who is responsible it ended up a three way blame exercise between those parties with guess who in the middle.

I also came to the tentative conclusion that the amount that you are charged by the medicos is strongly influenced by the amount that they think you can afford to pay (based on your occupation and postcode?) and this was confirmed by an article in the SMH this week relating the variable costs of prostate surgery. Sorry can’t locate the link.

Following on from my previous post, as far as a tip, I forgot to say that maybe it’s worth telling your specialist that you are unemployed.

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Perhaps health insurance companies could offer ‘No Claim Bonuses’? At 61 I pay over $2,000 a year to my health insurance company and only claim my twice yearly visit to the dental hygienist (and am still out of pocket $31 each time). Yes, I am blessed with good health - so far. but some sort of no claim bonus would be helpful. Also, when looking at health insurance comparisons it would be helpful if more attention was given to single folk like myself.

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It beggars belief that a hip replacement (as an example) in Canada is one third the price in Canada than is is in Australia.

Similarly it is one third the price in Australia in the public system than in the private health system, some K11.000 compared to in excess of K33,000. How is this possible and who is to blame. The level of care is the same in both. In fact many of the surgeons who operate at public hospitals also operate in private hospitals.

Why is it that beds are empty in private hospitals whilst those on the public list struggle to obtain surgery for debilitating conditions. It seems that those who can afford to pay are somehow better citizens.

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We are pensioners who struggle to pay private hospital insurance and the specialists know this but that doesn’t stop them charging well above the recommended fee. I must add that our hard working GP always considers our
Low income status.
Agree with the first post, I would gladly pay the private fee amount for a public scheme that benefited all.
To keep to the subject though, I would suggest a more flexible private system that perhaps addressed the fact that couples over a certain age do not require maternity cover, etc.

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Private health care is a rip off with the money being paid into companies that only care about profit and not our health. We are in danger of becoming like America. I would be more than happy to pay a higher Medicare levy to ensure everyone got a high degree of health services. Although I don’t see our government managing the system very well and there is no guarantee that they won;t go dipping into Medicare coffers and use the money elsewhere.

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My wife and I are ~50 (and our children are in their 20’s). We like to take care of things ourselves and have never been particularly interested in insurance as a form of safety net. We have relied on the provision of public health, funded through Medicare, for our health care; and we have cheerfully paid its additional levies and surcharges all our working lives. We appreciate the provision of hospitals and surgeons for things like broken limbs, Achilles tendon tears and burst appendices etc.

However, we have also had children who were high achieving in sport, and in line with our self provision, we have always paid 100% of our needs in the areas of physio, chiro, dental, orthodontal, remedial massage, supplements, gymnasium memberships, correct footware, optometry and not to mention paying for scans and MRI’s (like when there were 3 month public waits and we needed to know now if the knee was broken) and of course medications. It has cost us a fortune to handle things ourselves in this way, but it is how we see things, we don’t look for the handouts.

Recently, the levies and surcharges have appeared to become quite sizable. We have no dependents and last tax return we paid $5600- in medicare levy & surcharge (as a couple - that doesn’t include what our children paid) without a single visit to a medical professional of any kind.

This massive contribution to public health prompted me to look into a Health Fund. But we’ve been ‘penalised for life’ for looking after things for ourselves all these years. Our health is good. We anticipate that to continue for a decade or two yet, with no plans for replacement hips (or anything else) anytime soon.

I don’t really have a specific question, I just think it seems inequitable to be trying to force everyone to carry private health cover, when those companies are responsible to their shareholders to report profits - how can that be good for the people of our nation?

And being forced we are. Where does the money obtained from the surcharge and the levy go? Why do tax payers contribute government funds to assist people to have private health cover? If it goes into the increasing cost of healthcare, is it justified? The escalating personal cost to contribute to the government’s semi-provision of healthcare seems ridiculous. We, personally, are not Rockerfeller. I guess we are somewhere less than 30% above the average wage (as it was reported by the ABS from back in 2013)

I have also raised (and paid to educate) two nurses, and one teacher. I’ve spent years fostering children needing a caring family home; and have paid for their education and medical needs too, as they were not provided for adequately by the government (at least to our standard).
Are my contributions to the government coffers being wisely spent on healthcare?
Somehow I don’t think they are.

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Hi Robert,

Thanks for commenting. That is an interesting question. The money paid for the Medicare levy is used to fund the public health system. However, I am not sure if the same is the case with the Medicare Levy Surcharge. And the original idea of private health insurance was that those people who could afford it would pay for it and thereby relieve the public system, Whether or not private health insurance is an efficient and cost effective way to do this is debatable.

I don’t have to tell you that you are likely to pay less for hospital insurance than the surcharge you are currently paying even after the Lifetime Health Cover surcharge of more than 40% of the premium you would both be paying. That is especially the case if you were to take a basic cover or even ‘junk insurance’ which you could consider since you are not planning on using it.

A number of people have talked in the past about ‘self-insurance’ so opening a saving’s account fund and instead of paying for health insurance, pay money into your savings account to fund your health care needs. That obviously would not work if you actually end up paying more in tax than you would have paid for insurance.

Thank you everyone for your comments, please keep them coming they are very interesting and enlightening.

Actually I need to correct myself - I have just checked on this with an expert and both the Medicare levy and the Medicare levy surcharge are handled as general Government revenue so while the Government funds Medicare and public hospitals, the levies are not directly used for this purpose, so paying the Medicare levy surcharge is probably not the best way to support public hospitals and Medicare.

We would not be without our private health insurance, and we are very happy with our insurer, who we have been with since 1989. We have family cover plus extras, and, whilst expensive, we definitely use it! We have had a number of surgeries over the years, and although often have to pay a gap for surgeon’s fees, we still prefer to go private, choose your surgeon and not have lengthy waits for surgery.

One thing no-one ever seems to look at when comparing companies, is the excess payment on hospital cover. We chose to have an excess of $300, as this reduces our premiums. However, when I phoned other health insurance companies a few years ago to check how ours stacked up cost-wise, I found that our company seemed to be the only one (that I could find) where they do not charge the excess if it is day surgery. This makes a huge difference, as many surgeries now are day surgery. Definitely worth asking about if you are shopping around for health insurance.

We also get good value out of our extras cover. We use optical, dental, physio, osteopath, podiatrist and more. I did the sums a few years back, and it is definitely cheaper for us to have the insurance.

That to me is totally dishonest and unethical. I thought all that money went into the health system .

That is really poor but I don’t know if I should be really disappointing that it doesn’t surprise me in the least.

From my point of view, my family has used both the private and public system depending on our requirements. I pay for hospital cover because we have a family history of just about anything you can think of, and I pay for extras cover for the ongoing little things that we have.

It would be good to have some way of knowing exactly what any provider charges for a service and what the health funds return (i.e. an easy way to identify item numbers before appointments and look up whether they are covered by medicare or a health insurance or both before showing up for the appointment).

One lesson I have learnt is to split my extras from my hospital cover because I have found that funds who have an all encompassing hospital cover generally have poor extras returns and vice versa. Since i have separated them out I now pay less and get more back.

The first thing about PHI is that it isn’t ‘private’ at all. It is a government regulated scheme to prop up incomes for private hospitals and specialists. It doesn’t help to ease the burden on public health care and hospitals IE both arms of Medicare.

Tell them all about community rating and what happens to their money, please do.

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When I was married, I had a couple health insurance cover. When we had our baby, we upgraded to a family cover which was no extra cost - kids are free.
However now that I’m a single parent, the kid isn’t free on my coverage.
I want to know why a couple can get coverage for their child with no additional cost, but a single parent can’t.

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