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Why you don't need private health insurance

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How to make the most of your health cover

SMH's Harriet Alexander's hot tips to save you money and optimise your private health insurance in 2016.

PT1M22S 620 349

Every year people rail against the private health insurance companies for hiking up premiums, usually way above the inflation rate.

Not me. Couldn't care less.

Private insurance doesn't cover the full cost of "extras", including dental work.

Private insurance doesn't cover the full cost of "extras", including dental work.

I don't have private health insurance. Never have. Can't see the point.

Not only do I think I'm better off financially, I'm also putting my money where my mouth is - in support of a universal public health service.

Ian McCauley, a research fellow at the Centre for Policy Development, has done some modelling on whether you're better off insuring or not. 

Think you're covered? Choice is urging consumers to check again.

Think you're covered? Choice is urging consumers to check again. Photo: Supplied

He told me that if a reasonably healthy person at 25 wisely invested the equivalent of their insurance premium every month to cover medical expenses, they'd have about $80,000 left over at death in their 80s to pay for a very decent wake.

I, too, reckon I'm better off without forking out thousands for a policy I don't really need. And my family has had some health emergencies in our time.

Last year my partner was diagnosed with cancer. She is now recovering after having had the most dedicated support from nurses, doctors and other professionals in the public health system. We have been out of pocket for some things, sure, but many of those expenses aren't covered by most health insurance, anyway. The bulk of our expense was covered by Medicare. 

We found there is no difference in the quality of care she received. We know this first hand - my partner shared a public ward with private patients.

For other incidents - broken bones, childhood illnesses - and ongoing visits to the GP, Medicare covers us via payments we make through the taxation system. (We only go to bulk-billing doctors.)

We have never felt like we were a low priority - whether on the cancer ward or when my son broke his leg. We have nothing but appreciation and praise for the dedicated healthcare workers in our public hospitals. They truly are heroes.

One of my sons has braces at the moment. We've paid for that out of our pocket, but the payments are spread out over a couple of years and are manageable at $280 a month.

Private insurance doesn't cover the full cost of what they call these "extras", anyway.

A quick look at Medibank's insurance for "Top Extras" (up to $45.51 a week for a family with hospital cover from April 1) shows they only pay $1000 a year for orthodontics, with a lifetime limit of $3000 per person. So that's $2366.52 a year in premiums for ancillary health cover with only a $1000 for braces.

I think I'll pass. Have they actually checked how much braces cost? It's closer to $10,000.

Given all the caps, limits and thresholds, it really shouldn't be called insurance. 

The whole idea of insurance is that you cap your expenses by paying a premium and the insurance company carries the burden of open-ended risk. Don't feel sorry for them, they employ batteries of actuaries to make sure they make a tidy profit.

If you have top-shelf comprehensive car insurance and through no fault of your own your vehicle gets totalled, you'd expect your policy to cover the cost of a new car.

But health insurance? It's the insurance companies that cap their exposure while you still carry the open-ended risk.

Some people take out health 'insurance' just to avoid paying a tax levy. And the insurance companies know this. NIB's website asks "What can we help you with?" and one of the options is "Cover to avoid tax".

Seriously? Why would anyone prefer their money sitting with an insurance company rather than going into the collective pot to pay for roads, schools and hospitals?

While many of us focus on whether or not to continue paying a premium for a pretty poor product, we actually need to look at the policy implications.

What is our health system for? The argument that public patients are a "burden" on the health system is just muddle-headed. It seems our policy pundits and political parties are all in favour of our public health system - until somebody has the temerity to use it.

This is a false moral appeal, says McAuley. "It is an attempt to redefine our public health system as one for the also-rans, the poor and indigent in our society."

The whole public health system should actually be seen as a universal public good, not part of a welfare system.

Sure, if you can afford to pay more you should - but that's what we have a taxation system for. Making that more equitable should be the real focus of tax reform.

279 comments so far

  • Couldn't agree more if I tried. Universal Healthcare and Universal Education at no additional cost to anyone should be the bedrock of our society.

    Commenter
    Megadodo
    Date and time
    March 31, 2016, 1:15PM
    • True in theory but the reality is that public patients can wait 2 years to see an ENT or Orthopaedic surgeon to then go on another waiting list for 2 yrs to have hip surgery etc. I'll bet if the author ever experiences those delays he may change his mind about health insurance being useless. Universal Medicare funded healthcare is a nice idea but the reality is the public hospital system is already severely overloaded and can't keep up with rising public needs.

      Commenter
      C
      Date and time
      March 31, 2016, 2:32PM
    • The public health system provides excellent care for emergencies, cancer care and other serious and life threatening illnesses, but cannot cope with the non-urgent but significantly life improving procedures such as joint replacements (6-12 months waiting), cataracts (similar waits), hernia repairs, gall bladders and the like. Forget about not having it if you are young and enjoy active sports - needing a cruciate ligament repair or similar will have you sidelined for a couple of seasons at least.
      Here is a big fail in the argument: "a reasonably healthy person at 25 wisely invested the equivalent of their insurance premium every month to cover medical expenses, they'd have about $80,000 left over at death in their 80s" No-one actually does this! It gets spent on daily living and/or extra luxuries.
      There is a solid argument for taking the risk yourself, but there is a reason it's called insurance.

      Commenter
      beenthere
      Location
      Sydney
      Date and time
      March 31, 2016, 2:37PM
    • you obviously don't pay surcharge

      Commenter
      Gaz
      Location
      Yarrawonga
      Date and time
      March 31, 2016, 2:38PM
    • the greatest problem with funding the health system is the succession of governments who are too piss weak to take on medical practitioners over their take from the system. The greed of the doctors knows no bounds. I would love to see how much would be left in the system if all medical practitioners were prepared to reduce their income by 10%. Yet try something as minimal as having doctors by FBT like the rest of Australians - watch the outcry.

      It wouldn't put them on the breadline.

      Commenter
      Gaz
      Location
      Yarrawonga
      Date and time
      March 31, 2016, 2:42PM
    • what it should be is not relevant here, the question relates to the reality of what it is.
      the public health system is outstanding in Australia compared to most countries, and no, we're not the best at everything, no one is.
      BUT, you got to put the medicare levy surcharge into the mix when considering getting private health insurance or not.
      personally i have high cover insurance, but i accept that it may not be the correct decision for everyone.

      Commenter
      Victorious Painter
      Date and time
      March 31, 2016, 3:25PM
    • G'day Megadodo.
      Marcus - thank you.
      I'm in favour of having a choice.
      Why portray it in terms of 'good' or 'bad' - 'better' of 'worse'; we'll have a variety of reasons for our personal preferences.
      So
      Ask the politicians - about their views on these matters (do they have):
      Private health cover;
      Private schools for their kids.
      That'll give you an idea - about the funding direction in the future

      Commenter
      Howe Synnott
      Location
      Sydney
      Date and time
      March 31, 2016, 3:29PM
    • Some specialists will only see a percentage of public patients.
      So if there is a shortage of certain type of specialist those public patients will be waiting a very long time to be diagnosed.
      This may or may not be life threatening.
      You will not be told this.
      You essentially jump the queue if you have private health insurance.
      I too believe in universal and equal access healthcare but we don't have it in Australia.

      Commenter
      Fred
      Date and time
      March 31, 2016, 4:04PM
    • Without private health insurance the public system would crumble under the added strain.

      Commenter
      The Cutter
      Date and time
      March 31, 2016, 5:11PM
    • Gaz - I can see why you think Doctors earn lots of money, they do. But they also sacrifice there younger years for study and career.

      They might end up earning generous salaries in the longer term, but I'd prefer to tax Bankers/Financials Advisers/Wealthy Businessmen more then cut salaries of Doctors and Surgeons. Nurses deserve to be paid more too.

      Commenter
      nodormat
      Location
      CBD/Coogee
      Date and time
      March 31, 2016, 5:15PM

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