renth

I've been here 9 years and find the health system hard to understand.

I think it's important to have the right level of hospital cover so you can get treated quicker if you have something like cancer or need a heart bypass.

My wife's cancer op was done on the public system. I decided that was best after spending a lot of time reading through the Aussie breast cancer forum. With hindsight it wasn't the right thing to do. We should have had it done privately. Time will tell if that was a REALLY bad decision or not.

There is no private radiotherapy in WA but my wife is still having to drop about $2000 a week for her treatment but we are getting most (but not all) back from Medicare.

It also doesn't help that our insurer Medibank sounds a lot like Medicare so my wife (and I) often take a bill into one of the offices when it should be the other. Sometimes you need to go to both (don't ask me why).

The whole system is f**ed! it's a huge "make work" scheme for the thousands of people employed to take the money off you, then to give (most of) it back.

Oh, and DON"T EVER tell the hospital you have private health if you are an emergency patient.

Penny45

It's not your taxes though surely? You get some of your own tax back. If salary is over $168k then there's a LOT of tax deducted, why shouldn't people get some back?

jad n rich

But you accept the 47.5 cents in the dollar tax those people pay to cover your medical expenses??

People who earn that amount work for it. 60+ hours a week is not uncommon. That amount sounds slightly less 'rich" once you take off the tax.

If that person pays $10,000 for a private surgery, sure they deserve some tax relief. They are already paying huge income Tax, medicare levy, private health cover and gap payments. They also free up places in the medicare system for you!

Imagine if the 48% of people who do pay private all give it up and join the line up for medicare.

fish.01

It's a complicated policy area. The carrot and stick policies introduced by the conservatives drastically increased the number of people taking out private insurance.

The problem was a lot of these people don't use their private cover because of the gap payments so our tax dollars are paying private companies (through the tax rebate) for a service they are not always providing and draining the public system of funds. Many feel these measures went too far and far too many healthy people are paying private company premiums reluctantly and unnecessarily. The membership of private health funds drastically increased from roughly 25% to 48% off the top of my head and profits have been healthy.

The measures by labor to wind back some of these carrots and sticks is an attempt to pull some of these people out of private health who don't really want to be there and release some of that funding to be pumped back into the public sector that is often providing the service to them anyway. Of course the subsidy these healthy people were paying the private health funds will decrease and their profits will decrease and premiums rise and those over the limits will pay more.

I guess only the experts have a real idea where the correct balance might be.

Wol

Socialists never understand the laws of unintended consequences.

jad n rich

The Labour Government does not want anyone to pull out of private health cover, To make sure of that, they have introduced yet another increase in the additional medicare levy for those without private insurance.

Its just another hit on people who earn over $80,000 a year who the government have decided are rich because they need to hit them over and over again to pay for the mess this country is in since the Labour government took over.

fish.01

Both Abbott and Gillard and the funds disagree...they all claim the legislative package will overall cause a drop in numbers holding private insurance and increase policy downgrading. Funding to public health is being increased with the money saved.

To give the full picture the limits are $83,000 for a single and $166,000 for a couple/family. The rebate just starts to reduce at these levels...it doesn't cut out until $129,000 for a single and $258,000 for a family.

Impartial independent overseas economists have routinely praised the govt's handling of the GFC and despite some failures the subsequent legislative programme has been very impressive for a minority govt in very difficult position.

Certainly the alternative legislation offered so far by the coalition seems very poor in the main. Lets hope they improve or find a more effective leader.

Surprisingly for these times a lot of the govt's legislation has a long term view (apart from the understandably rushed GFC stimulus programmes) so will have to reserve my judgement on some of it but respect earned for thinking big in trying circumstances.

abi31

I don't know enough about this - I too thought that PMI covered for everything. This thread has made me look it up and for almost $5k pa (family cover) - all they do is cover 25% of a figure that's lower than what the medics charge anyway!?

"The Medical Gap is the difference between the
Medicare Benefit Schedule (MBS) set by the
Federal Government and the amount medical
practitioners charge...
Medicare covers 75% of the MBS fee for private
in-hospital medical services for Australian
residents. HBF pays the remaining 25%. ...
However, many medical practitioners do
charge more than the MBS fee. "

It barely seems worth it but then the medicare fee goes through the roof if you don't have it.

Ho humm

Gibbo

As I have said before, if the Labor government of the past had left the Australian health system alone we would all be better off today. Everyone had affordable Health Insurance which covered absolutely everything. Those on pensions or out of work got FREE health cover from the government.

fish.01

Labor started reforming the medical system because the previous one had left "nearly 17 per cent - or one in five Australians - uncovered by insurance, and unentitled to publicly assisted health care"

Source: http://www.aams.org.au/contents.php?...lename=index#2

Gibbo

They made a dreadful job of it! It costs people much more, the waiting lists are ridiculous for public hospitals and the quality of care is not that great.
I lived with the old system and never heard anyone complain. The complaints started when, Mr Whitlam, I believe it was, started to change everything to give us the "benefits" of a national health system. Another Labor fiasco.

fish.01

I fear the 17% might have complained. According to reports the systems around the world run off private insurance now cost far more as they add an extra layer of profit taking expense. eg USA.

As the source above quotes, the Nimmo report commissioned by the Coalition government at the time found:

"Over time, Menzies'-style health welfarism through the Page Plan proved inadequate. It resulted in a multiplicity of separately targeted groups and a complexity of measures. Bureaucracy expanded. Total health expenditure in Australia rose from $683 million in 1961 to $1.7 billion in 1971 - a rate of increase well above that of the GDP. But it still left nearly 17 per cent - or one in five Australians - uncovered by insurance, and unentitled to publicly assisted health care.

By 1968 problems and public discontent had grown to a level that prompted the Coalition government to appoint a Committee of Inquiry into Health Insurance. The Nimmo Committee was asked to consider the problems of health insurance, but it was instructed to do so only in the context of a voluntary scheme and the existing arrangements with State governments.

The Nimmo Report found the existing scheme to be too complex, the benefits received too low, and the contributions beyond the capacity of too many. It found bureaucratic red tape was causing serious and widespread hardship; that too much of contributors' money was being absorbed by the operating expenses of the insurance funds, and that many health services were not covered by the scheme, including nursing, dentistry, and optometry. "


No system is perfect but I don't feel you can have a bad public health system and still be rated the sixth highest country in the world for life expectancy. Every system in the world has plenty to whinge about but we are doing better than most.

abi31

Some time ago (so no reference) I read that 2/3rds of Aussies don't bother with PMI.

Can someone explain how medicare rises if you don't have PMI? (someone above has said something but that just made me even more confused!) - I know (or think I do) that it rises for every year you are over 31? But how much does it rise by? And does it ever stop rising?

And does medicare also have a gap that you have to pay for yourself? Or if you go through medicare do they have to have a limit how much they'll charge?

And can you get restricted PMI - for eg to cover you if you needed cancer care or something? And can you get dental cover by itself?

Thanks!

Petals

2% a year for every year over 31.

However even with top cover you have to pay extra just paid three thousand dollars for my knee operation and adding the premiums on it cost six thousand dollars.

So private health is not for people who are short of cash.

fish.01

The over 31 thing is a rise in private medical insurance premiums rather than medicare for every year you are over 31 when you first join private medical. It has a max rise. It is a stick to try and scare people into private insurance.

Medicare comes out of your general tax in your pay packet (added in by your payroll dept). Also, at the end of the tax year, if you earn over $83,000 for a single or $166,000 if in a couple you pay an extra 1.5% tax. They waive this extra tax if you have private hospital insurance. Another carrot and stick.

Medicare has no gap for public services but it can do if you use a private service.

Ie

All GP's are private so some charge a gap to everyone, a lot charge a gap to working adults only, some are free, specially in lower income outer suburbs.

Private specialists charge a gap...note private hospital insurance does not cover things outside hospital like private specialists.

Public specialists are free.

Public hospitals are free.

No restricted pmi afaik. Many get first rate treatment for cancer in public hospitals from the same specialists who practice in the private hospitals.