The health insurance myth 15



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Australia has a public medical system that is the envy of the western world; why then do people find it necessary to take out health insurance? It is a mystery, particularly when it comes to pensioners. 

Marketing of health insurance has successfully convinced consumers that insurance is required to receive first class treatment and is a necessary evil. This is disingenuous, but then again is not all insurance?

Medical insurance is a revenue maker for the companies that offer it. Payments for visits to a general practitioner, often the first and last point of treatment for many ailments, are excluded other than the small payment of a gap whereas with bulk billing doctors this is not a problem and many first class doctors offer this service. 

When a serious medical condition requiring hospitalisation occurs, the public system reacts at it’s best. Whether or not you have medical insurance is not a concern for the attending medical staff and will make no difference to the quality of care received. 

Having the ability to choose the ‘right doctor’ is nothing less than a fraud. It is not a question that bears any relevance when rushed to a hospital, particularly for those who are travelling and far away from major cities. 

There are no private hospitals in the bush therefore health insurance is unnecessary. Medical assistance at regional and country hospitals is a better experience than major hospitals in major cities if for no other reason than size. The staff at such establishments are nothing less than fantastic, doctors are dedicated experienced and knowledgeable making a stay in a country hospital a far more palatable and caring experience. 

Should urgent surgical intervention be required then again Insurance is not an issue. Surgery will take place in the same theatre, with the same equipment and staff in attendance and often with the same surgeon.

Should emergency treatment be required then speedy transfer to a major public hospital is arranged. Major public hospitals have the equipment to cater for most if not all emergencies whereas private hospitals do not and often need to transfer a patient to a public hospital for the required treatment.

It is extremely difficult to find an argument why any person of pensionable age should require health insurance. In general the Public Health system caters extremely well for pensioners the only area of concern being waiting time for non life threatening surgery which only a major injection of funds in to the public system will solve. 

If instead of paying vast amounts of scare money to uncaring insurance companies does it not make sense to eliminate the insurance companies and have a system whereby all money paid to insurance companies is channelled into the public system creating a viable system for all Australians. If all the money paid to insurance companies was paid into the public system how good would the system be?

Do you pay health insurance, if so, why? Do you believe better treatment is received as a result of health insurance? If you are a pensioner why are you paying health insurance? Have you calculated the actual cost against usage?

Share your thoughts below.

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Paul Goldfinch

Married with two children retired to the Valley Of Peace, Kongwak, Victoria. Formerly a Detective Sergeant, The Flying Squad, New Scotland Yard, before coming to Australia almost 40 years ago carving a career in small business and within the Corporate arena as a senior manager, including the establishment of WorkCare Victoria. Retired as Licenced owner/operator of an independent Real Estate Agency and Business Brokers in Queensland. Now dividing time between family and travelling Australia by caravan with a passion for the plight and lack of support for aged pensioners.

  1. I haven’t had private health insurance since I quit work and was given a carers payment. Have had brilliant service from the public health service.

  2. I have had private health cover since turning 16 ,and was brought up to take responsibility for myself, and one being my health.when the labour government promised free health for all, many opted out forcing the insurance up in costs. I didn’t opt out, have had excellent service, for 48 years, and still pay on a disability pension. I have had many friends who don’t have private cover waiting for a very long and painful time to have “elective ” surgery, ie: cataracts, in her 80’s, had to wait 18 months, eyes weren’t bad enough, couldn’t even drive! back , pay $15, 000 , and can have it done, but not on free list! and now a friend has to wait on a waiting list of at least 8 months for shoulder surgery. How horrid is that. She was told by the specialist that she could have it done NOW for thousands , and thousands of dollars. Is that elective! I think not. So don’t rabbit on about not needing private cover, it’s just as bad as saying not to have house insurance because the possibility of a house fire is need it just in case.if everyone payed into private health insurance , the costs would be lowered for the 1970 ‘s. Our country’s health system will be like the U. S.A. Soon , being turned away from hospital if you’re not covered enough.

  3. My grandaughter has been on the waiting list for an appointment to see a doctor so she can go on the waiting list to have her tonsils removed for the last 12 months. Her large tonsills interfere with her breathing at night as well as frequent infections. Decided to just pay to have it done in the private system.

  4. I had to have a spinal operation 2 years ago without insurance I would have had to wait months if not longer instead I saw the surgeon 2 weeks later I had the operation and was painfree immediately, if you can afford the insurance it is silly not to have it

  5. Four years ago my husband needed a hip replacement. He was told the wait on the public system was two years. The pain was nearly killing him and we could see him getting worse every day. We had private insurance but when he retired we dropped it from top cover to middle cover only to find out that it didn’t cover hips, knees or heart ops.
    We immediately raised it up to top cover but had to wait 12 months to use the cover., so we ended up paying $25.000.00
    ourselves to get it done straight away. Now I need a knee replacement and thank god we have the private cover to
    get it done straight away.

  6. My philosophy is like many popular natural health blog writers – prevention is cheaper than cure of disease/sickness. I have not had private health cover since 2012 – the period when I returned to university to study health sciences – wellness, nutrition and genetics. My blood work, fitness and health profile has improved ever since. Prior to 2012 I was pre-diabetic and had metabolic syndrome and had quite bad arthritis. A DNA test indicated that I was predisposed to high homocysteine, cardiovascular disease and more. I then started regular fasting, regular exercise and healthy nutrition. I no longer have any serious arthritis either. My goal is that my health will continue to improve. Next year I plan to cycle around Australia – when I will be 66.

  7. It’s ok not to have it but as I have witnessed over the last few years you DO get treated a little different in all hospitals if you have private cover.given first class drugs and instant treatment too, as always some off us retire without any health care or centre link cover,and most families today just can’t afford the extra cost so it’s to each his own, the cost how ever should be done on what the people require who at an older age give a hoot about some of the stuff listed in packages ie:plastic surgery!but we are forced to pay for things,health insurers should give you the op to choose!

  8. Imagine my surprise after being with the biggest Health cover provider for 16 years when I needed a knee replacement and was told NOT COVERED. 8 years ago we ALTERED our policy and removed a few things such as Obstetrics. At the time I knew eventually my knee would need help…its done a lot of miles and all I heard from our face to face conversation was knees etc would be covered. Good any reconstructions will be OK. So sure enough a few years later my knee was getting very painful and so into hospital I go and have the reconstruction operation. Now more than 6 years on its painful again. So off to the Doctor, Xrays, Specialist, organise the Hospital checkin, pay the Gap payments and then the Hospital rings and says NOT COVERED for replacement. Really whats the difference between reco and replacement ? so after a meeting with this company I was told be in pain for 12 months pay about $20 a week more and then get it REPLACED. Its been 3 weeks since that meeting and their “special resolutions” department will consider the case and get back to me in 4-5 days…still waiting. And this along with their recent REPORTED record PROFIT.

  9. I do not have private hospital cover. Even if I had wanted it, the age loading makes it unaffordable.

    I *do* have private extras cover. Every single year, I get more money back in refunds than I spend on the policy… by a significant margin.

  10. My husband has suffered with Parkinson’s disease fit 27 years. 14 years ago he had Deep Brain Stimulators input. At that time it was only performed by private surgeons. Even now it is a mystery to public hospitals in Quuensland. He needs a new battery input every 3 to 4 years so we must keep our private hospital fund even though we have opted out of extras.

  11. Thank goodness stayed in health insurance when I retired…..knee replacement last October…all paid, would’ve been$ 24,000…….another knee replacement this week, would’ve been lost without it, couldn’t have stood the pain

  12. On a disabled pension now but have had health insurance since 17 am now 69. Having been a nurse in the past, one can see the difference when a patient is public and can’t access a private Dr or a specialist.
    Six joint replacements later at no cost except the doctors and anaesthetists small gap fee and was in hospital within 3 weeks each time with the Specialist of my choice . Many Professors work in the private hospitals and are brilliant as well as many Surgeons with an excellent records. I was amazed that the writer of this article could write on something they obviously have no idea about. If a person can afford health insurance it is a great thing to have. It is sad to see patients wait months for surgery in pain whereas a private patient is admitted in 2-3 weeks with their choice of surgeon. How lovely is it to have a private room to oneself with no interruption from another patient who could be difficult, being attended to frequentlty through the night etc., or forever on the phone or complaining. Often there is an extra menu or food that can be ordered that is not on the list for public patients. I would rather go without something else than give up my health insurance and extras. It is so hard for the younger families to even pay insurance for their health. The fees are too high.

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