I need a gastroscopy, it's going to take well over a year on the public system. Privately it will cost about $500 (my excess) although I think I might be able to get it for less as a "self insured" patient i.e. just pay the bill myself.

You would wait the same length of time for bypass surgery if y had it done at the Mount. They're the same surgeons as RPH czrdiothoracics team.

For something like heart bypass do you really want to be in a smaller private hospital or a large tertiary hospital fully staffed 24/7 by consultants with the newest technology?
That's exactly right. If you present to Royal Perth with chest pain and tests show that you need an angiogram or bypass you will be admitted and have it done within a couple of days. Inpatient procedures are not waitlisted, so they don't show up on the NEST. (national Elective surgical target) tables.

I'm the person who books the elective coronary angiograms at RPH. I work just down the hall from the woman who books the elective cardiothoracic surgery. We regularly attend waitlist meetings for our division and have to meet the NESt targets for bookings as set out by our consultants. If something is put on our electronic booking system as a category 1 (urgent) it has to be booked within 30 days. Usually if it's a cat 1 we can fit them in within a week by juggling lists. Anything that waits more than 30 days is considered not urgent by the consultant cardiologist or surgeons .

It varies very much from area to area. We have recently moved from Bribie Island Queensland to Taree, NSW. Mrs had a cararact operation privately on one eye, cost around 4K so for the other eye she went onto the waiting list which would involve a 3 year wait and an hours drive to Redcliffe hospital.
Here in Taree the private guy she is seeing for Lucentis injections as an outpatient is actually the same surgeon who pops up the road to the Base Hospital a few days a week and does the cataract surgery. He was able to tell her on the spot "11 months". Bonus is that it's a ten minute drive.

I noticed as well that in Redcliffe, a Lucentis injection into the eye for macular degeneration costs around $650 whereas with our new guy it's $160. They were horrified - what were you paying for? Oh, surgery booking fee, anaesthetist fee, blah blah.

What? they must be joking. Ok come on in, you can sit in on this. Masks and gloves on, anaesthetic drops into the eye. Prick. Done. $160 please. Ten minutes.

If this is typical then I'd suspect that many practices that depend on their patients coming to them as insured private patients are milking the system for all they can get out of it.

I recall I was quoted just over $330 quite a few years ago, but that was after the medicare rebate, but no insurance.

Going private, but with Insurance, seems to be a higher charge from what I see now.

My local quoted $325 if I was paying myself

Seems in line with what I googled
E.g
http://www.giprivate.com.au/faq-links/

So I don't really understand tat HCF table, as a lot of the costs are picked up by Medicare anyway even as a private patient.

Interesting figures there, especially with the discount for aged pensioners:
Costs:
$500 Excess (or whatever excess you have) if Insured.
$300 Self Funded (if without insurance).
$140 Aged Pensioners.

It does seem that Insurance is not always a good thing...
And that was exactly what I found in 1987 when I was advised NOT to use my insurance, as I would end up paying more......

Again I'm a bit confused as to what private insurance actually brings in many cases, and I also have to comment that I think the medical system in Australia sucks (not the staff and their quality of care)

I need to see a gastroenterologist, went to a bulk-billed GP. He said if referred to public hospital I'd be waiting months and have no choice. I said ok, I'll pay my own and go private. Had to make another appointment (money-spinner for the GP) just to go back with the gastroenterologists name so that he could write a referral letter.

The Gastro place won't make appointments without a letter, he likes to triage them first, and doesn't have appointments until late August/September.

All up it will cost around $420 for an initial consultation and I think around $250 of that I get back from Medicare.

Then I will need to wait for any subsequent treatment.

But really, what a poor service the whole thing is both public and private.

Last month I went to a private hospital in Singapore, saw the primary physician in the morning and got a same day appointment for a gastroenterologist (with his UK Royal Fellow certified certificates on the wall) and a gastroscopy - all up approx. $600 AUD. Significantly nicer environment than any hospital I've been in in the UK or Australia.

So despite being fully prepared to pay everything in Australia, I still have to wait 1-2 months.

It's probably best not to think of it as "medical insurance" but as a financial product that helps with some of the costs of private medical treatment (and lowers your tax burden in you earn more than average), if you see what I mean. I don't believe they should be allowed to call it insurance.

If you shopped around I think you'd probably find a gastroenterologist much quicker than 1 or 2 months.

Bu I have to agree, the bloated and inefficient system sucks camel dicks.

Yes, I just did that - bizarrely got the same doctor next week at another clinic (in a lower socioeconomic area) and the entire fee is claimable at Medicare - so no cost to me - but technically I'm a private patient and bypassing public waitlists solely because I am paying up front and claiming it back. How is that efficient?

Yeah, Not efficient at all unless you work as a bureaucrat in Medicare or a Private Health company shuffling rebates from one account to the other in which case it's highly efficient at keeping you in employment.