Oh, the discomfort and the peril of trying to juggle while straddling a barbed wire fence.
That, at least, is the image that comes to Croakey’s mind when listening to Health Minister Roxon on the hustings recently, arguing that it is only fair and fiscally responsible that there be means testing of Government subsidies for private health insurance cover. There she was, on the radio, in the newspapers and everywhere else, arguing that it is so unfair to expect lower income earners to be subsidising the cover of millionaires.
And then we hear that the $1.9 billion saved from the proposed means testing (the relevant legislation is expected to be up again for debate when the Senate resumes on September 7) could help fund long overdue e-health reforms.
It’s a finely balanced juggling performance given that this Government specifically excluded any consideration of the inequities of the current private health insurance rebate subsidies from the brief of the National Health and Hospitals Reform Commission. The Sydney Morning Herald reported last month that: “When he announced the health reform commission last year, the Prime Minister, Kevin Rudd, specifically instructed the commission to keep clear of the rebate issue. This was in deference to the health insurance industry, to which Mr Rudd had given an undertaking before the election to retain the rebate.”
Meanwhile, a Croakey contributor, Jen Li, who has been watching the debate closely from the perspective of an experienced patient, has a question. She is wondering, who benefits from private health insurance?
Jen Li writes:
“Mark Metherell wrote in the Sydney Morning Herald recently that private health insurance numbers continue to rise because of anxiety about the public health system and waiting lists. I’m wondering whether the people who hold private health insurance because of lack of faith in the public system are doing it for the right reasons.
The public health system is undoubtedly under pressure and it seems that it is in need of a makeover at least in its management. But public hospitals are where new doctors, nurses and therapists get their training, where the most care is available for patients, and where you would go in the case of an emergency.
Often, doctors work in both private and public hospitals and clinics, and their performance does not change depending on whether you have some nice paintings in your room or whether you have the option of receiving wine with your dinner. Private hospitals are beautiful (or as beautiful as a hospital can be), with slightly softer beds, toilets that look like something in a fancy hotel, and carpeting in the hallways. I really don’t think that these are sufficient reasons for going into a private hospital.
There are many reasons why private health insurance can benefit an individual, such as if they need a hip or knee replacement, or if they are using it to cover dental or optical costs, or are using it for tax purposes.
To have it because you have no faith in the public system, however, seems misguided. Having private health insurance does not in any way guarantee your costs will be lower, nor does it guarantee you better care.
I am 24, and I recently spent 6 weeks in hospital. Nine days were in a private hospital, because the surgery I needed was “semi-urgent” and it was coming up to Christmas. Five days after the surgery, I had a stroke, still in the private hospital. I was transferred to the public system and spent a further five weeks there.
This whole experience of the surgery, private hospital stay, ICU in the private hospital, blood tests after the stroke, surgeon and anaesthetist costs came to around $24,600. Of that, about $5,800 was claimed back from Medicare. A further $2,000 was claimed back from my private health fund. I had a cover that the health fund recommended for someone who was young, single and without any pre-existing conditions. And yet this experience still left me with out-of-pocket costs of around $22,800 (I know the numbers don’t add up, but the receipts are very complicated. If someone can make sense of it and tell me how it all adds up, please get in touch!).
I am in no way regretting the experience, and I completely understand that there is no monetary value that can be put on the fact that I am still alive. I’m grateful for doctors and nurses in both hospitals I was in for keeping me alive, but at the same time, when it is claimed that people are taking out private health insurance because they do not trust the public system and would rather be in the private one, I wonder if these people are given all the facts and details. Health insurance companies love telling you what you get when you join, and they make it all seem such a great deal, but my own experience tells me otherwise.
Furthermore, I have also heard the argument that by taking out health insurance, we are alleviating the stress on the public system. This only seems to happen if you elect to go into a public hospital as a private patient, but it doesn’t seem as though many people choose this. And why would they? They receive the exact same care as if they were a public patient, and they are likely to incur costs.
I have a sneaking suspicion that those who benefit the most from private health insurance are not the patients or the public system, but instead the private health insurance companies, private doctors and private hospitals.”
• Jen Li is a geographer who was diagnosed with Cushing’s Disease last October, and had a stroke five days after surgery to remove a pituitary tumour. She has spent more time than she wanted to in the health system as a patient, and now has a goal to do a PhD on the relationship between the public and private health systems in Australia.
If you’ve read this far, you may also be interested in this Crikey article by economist Ian McAuley, arguing that the Government is actually increasing the incentives for high income earners to hold private insurance.