Help Needed Please - Tonsils Private Surgery Cost Is Very High and Public Wait Time Is Nearly 12 Months

My child needs removal of tonsils, adenoid and middle ear fluid.

We don't have private health insurance and cost of getting it done private is $5600 after medicare rebate. The cost is as follow:

1) ENT Specialist $1400 after rebate. I would have to borrow personal loan of $5600 because cannot afford it.
2) Hospital $3700
3) Anaesthetic $500

ENT specialist operates in Nepean and Westmead hospital where he advised the waiting time on public list could be more than 12 months. He said he could push for 1 month out of 12 months so effectively 11 months wait. Is this how it works?

Is there anyway to get it done cheaper or get it done via hospital with less waiting time(don't know how to find waiting times)?

Many thanks in advance.

Comments

    • +22

      Yes but now we've introduced a private system which makes a lot of rich people and organisations even richer.
      It provides an incentive to squander and waste taxpayers money, because people find it acceptable to have a crap public healthcare system as the expectation is that everyone will be happy paying for an expensive out of control private system, as proven by most of the replies on here.

      Let's take something used to be great, that people already pay for with their taxes. Make it crap, then they'll be happy to pay more for a decent service and soon it becomes the norm.

      • Maybe @hbr93 was talking about 20 years ago when there were less people. Don't think it's the introduction of a private system that caused this. Private system just saw an opportunity, caused by a ill working public system. Health systems a very expensive.

        • +6

          The introduction of a private system has leeched money off the public system and into private health fund companies.

          Not only that, people paying for private health are funneling money away from supporting the public system via Medicare and into private companies. That again reduces the money that the public system can use to fund services.

          You're kidding yourself if you say it doesn't affect the public system.

          Even with private health care, they'll do what they can to avoid covering for you (unless it's a non profit one).

        • +1

          @twig: If I look at Switzerland, where there is no "Public" health cover, and it is mandatory to have a health cover, there are no wait for 11 month to have a surgery done. Of course the whole system is very expensive, and for a family it's quite common to pay almost 8K in health insurance.
          Interesting enough, Health insurance are paying back almost 90% of the fees received. Which makes them quite efficient.

        • Agree 100%. Lets eliminate the public/private schism and instead have quality, government run universal healthcare.

          I read recently that Chinese have been purchasing lots of private hospitals in Australia. Foreigners don't care about the well being of Australians, just maximum profit extraction for the odious capitalists that own them.

        • +1

          @Thaal Sinestro: That is another problem. I seriously wonder how Australia government would Chinese investors make a profit out of Australian Health. Ohh wait, they let them make profit with housing already, and mining and farming. Probably road tolls to. Well, when Australia has finished selling out everything to Chinese investors, it might be time to move overseas.

          "Australia’s fifth-largest developer had saved some revenue – about 2 per cent – by selling directly overseas and cutting out the sales agents."

      • +2

        You would have to pay for it one way or another. Either via private health cover premiums or increased taxes. Doctors/equipment/hospitals are not free.

        • There's plenty of money floating around, but most of it is inaccessible.

          There are only three options for taxation: tax companies, tax the rich, and/or tax the masses. We definitely know the approach this Government is taking…

          For a US perspective: think back to the days of the New Deal. In the depths of the Great Depression, Roosevelt introduced a social security system, and created thousands of Government jobs. Where did he get the money from? Corporations and the rich. Why were they so cooperative? They weren't, but they were afraid that if they didn't cooperate, the unions, socialists, and anti-capitalists would start a revolution and dismantle the status quo.

          The truth about 'class war' in America - Richard Wolff

          at the end of the second world war, for every dollar Washington raised in taxes on individuals, it raised $1.50 in taxes on business profits. Today, that ratio is very different: for every dollar Washington gets in taxes on individuals, it takes 25 cents in taxes on business. In short, the last half century has seen a massive shift of the burden of federal taxation off business and onto individuals.

        • @Procyon: The situation is more complex than that.

          Firstly, a lot of the company profits end up in the hands of individuals who then pay tax on that income. So what is registered as tax on an individual is effectively a tax on a company's profits at the individual's marginal tax rate.

          Secondly, raising company tax has unintended consequences that ultimately leads to less tax dollars for our government and a poorer Australia. Quick example, an Australian company that makes phones. Suppose it only sells one type of phone. The phones are manufactured in China for a cost of $200 (landed cost) and retails in Aust for $800. In the normal intuitive way of doing business, the Chinese arm would sell the phone to it's Australian arm for $200 and the Australian arm would sell the phone for $800 to a consumer, booking $600 in profits. Aust government takes 30% of this as company tax which is $180 per phone sold (ignore overheads). Great. However, our high tax rate actually incentivises businesses to book profits offshore rather than in Aust.

          Singapore has a company tax rate of 17% which is much lower than ours. The business creates a Singaporean arm, an international distributor. The Chinese arm sells the phones to the Singaporean arm at $200, the Singaporean arm then sells the phone to the Australian arm for $800 (for simplicity, in reality they would leave a small amount of profit on the table). The Australian arm then retails the phone for $800 making no profit and not paying any Australian Tax. The Singaporean arm makes the $600 profit and the Singaporean government 17% of this ($102). So Australia earns nothing even though the profit is generated from an Australian consumer and Singapore earns 17% for doing almost nothing. In reality it doesn't work exactly like this but I've just put it simply. This is why you hear of multinationals earning billions in Aust but paying hardly any tax… legally.

          Instead if Australia charged a company tax rate of 17%, it would have earned 17% rather than zero. Maybe people would even set up distribution companies in Australia rather than Singapore. We operate in a global economy and these are the realities we face. We have to be competitive.

        • @Xastros: Indeed, much more complicated. Being "competitive" in a "global economy" is a race to the bottom of the exploitation wormhole, and it means becoming economically dependent on other countries.

          Sure, some of those profits end up in the hands of individuals: the 1% investors and CEOs, who command their armies of accountants to find all the 'legal' tax loopholes (and indeed help the Government write new ones). Very little ends up with those who need it most, and need it to survive.

          Most of it, as you say, stays with companies, and they 100% legally keep it in off-shore tax havens. But those are billions of dollars that we as a country need to maintain our society: to keep offering the social services we enjoy today, to help students with their loans, to maintain our infrastructure, to develop our schools and medical facilities, and so on. We don't have that money, because we permit corporations to escape their taxes. Of course it's in the interest of companies to tell us we should give them a tax break to bring that money back into the country, because look at all of those wonderful benefits we will have when they do! The implication being that this money will then be used by companies to hire people, expand production and generally improve the country.

          In other words, suddenly for the good of the country, having not paid taxes for years, they should be rewarded by being able to bring that money back without paying any of the taxes that they should have paid all along. Instead of spending that money to hire people and expand production, companies have always wanted to use that money to pay higher salaries to their executives, and pay out dividends to the investors who own their shares. And they've found a way to do it: companies such as Apple are using the piles of cash in their off-shore accounts to borrow (up to ~70% of that) off-shore money from local banks. Why would they do that, that's crazy?! Well, it's cheaper to pay very low interest rates, because they're saving all the taxes they would otherwise have to pay!

          So if they now are allowed to bring the money back without paying taxes (or minimal taxes), do you know what they will have to do with it? They're going to have to pay off their loans to the banks. There won't be any money to hire thousands of people or expand production.

          It's all a fraud. Companies use the way finance works to borrow in Australia (and in all the western economies) the money they need to take care of 'who they take care of' (the executives and shareholders). When that money finally comes back, it will just be used to pay off those debts. So we know what they're going to do with the money, because they already did that.

          This is a fundamental demonstration that to take seriously the arguments for corporate tax cuts, is to be gullible, and to be at the play of the people who are running this system for their own immediate benefit. End of story.

        • @Procyon: Hang on now, yes they have to pay existing debts off if they bring money from offshore havens into the Aust but if our tax rates are competitive there would be no need to park money in these havens in the first place and future profits could be earned and taxed in Aust.

          Also to say that the profits of companies end up in the 1% investors and CEOs is not correct. It is too hard to find out the exact concentration of ownership because of managed funds/trusts etc but a significant portion of our listed companies are owned by Super funds of ordinary Australians. A much bigger portion than that owned by CEOs. Yes, the richer you are, the more likely you are to hold a larger portion of these companies through super or external investments but it benefits almost everyone, not just the 1% investors.

          "he money they need to take care of 'who they take care of' (the executives and shareholders)" <— I'm sorry but it is a company's job to make as much money as possible for their shareholders. Paying the least amount of tax legally possible is part of that responsibility. If we create an environment where our corporate doesn't punish them for booking profits here rather than overseas then they will be able to look after their shareholders and still pay tax here locally.

          Executive salary is a whole different topic. I agree, it doesn't make sense that a company should slash jobs when one guy at the top earns the same as 100 full time salaries within that company. Difficult decisions need to be made during hard times? Well maybe cut your salary in half first and save 50 jobs.

        • @Xastros: The point is that we are letting companies get away with tax evasion. If they want to do business in Australia (and there's always going to be companies that will) then they should pay taxes at the rate we as a democratic society require of them. Does our government go after them for manipulating so the profits show up overseas? No. Does the government go after them for using this as a tax evasion mechanism? No. Has the government made consistent efforts to change the law so it can get the taxes from these large companies? No. Instead, you are suggesting we should reward companies for avoiding taxes by giving them an even lower rate.

          And you're exactly right: the sole purpose and desire of companies is to use the money they have to make more money. Indeed they would be stupid if they didn't do that, as that's what our economic system requires of them to be successful. Anything else, including the betterment of society and anything to do with human lives, is a side-effect at best. That's precisely the problem: the economy must serve our society, and not the other way round.

        • +1

          @Procyon: It's not tax evasion if it's legal. Yes the government is doing something about these multinationals. Last year the libs were introducing a bill to crack down on transfer pricing between countries within multinational companies. Not sure whether it has gone ahead or not but it was being introduced ahead of a consensus being reached by the OECD nations. So it does signal that they want to do something about it and sooner rather than later. It is a very complex thing and hard to enforce. The legislation needs to be drafted carefully so there are no loopholes or glitches that unfairly punishes some countries over others. This is why it is taking a long time and the international community is consulting on it. If there are any loopholes, companies will find them and use them.

          As for companies that are actually evading tax, the ATO does go after them. Earlier this year Chevron was hit with a $300m tax and penalties bill when the ATO successfully sued them.

          They also conducted audits of all the big boys like Google, Apple, Microsoft etc. Apple's audit took 5 years and they found that no tax evasion was going on. We are trying to get our hands on that tax money and not just sitting back letting these guys do whatever they want. They have complied with current regulations but soon new legislation will be put in place to greatly reduce these companies' abilities to avoid tax.

          The way you are writing about it is that the government is deliberately wanting to let companies avoid tax. I don't believe that is the case.

  • +4

    Sadly these conditions in children are not considered life threatening so you have to wait your turn. It is up to the Specialist to decide the urgency of the condition. Lots of kids waiting for surgery and have to wait their turn. You could contact NSW Health to check what the actual waiting times are supposed to be. Sometimes moving to a different area in NSW can affect/reduce waiting times . Sorry your child has to suffer in the meantime!
    http://www1.health.nsw.gov.au/pds/ActivePDSDocuments/PD2012_…

    • -1

      My current ENT only offers private surgery in Nepean and Westmead hospital so could it be case that he is pushing for private so he could get his take?

      If I go publicaly, he can't operate. How can I push him to put my son's referral for public at least category 2?

      • +2

        To be honest with you, most specialists are booked out months in advance. Whether one additional person visits them or not won't really make a large difference it'll just add to their wait list. Its unlikely knowing your situation he's purposefully trying to direct you to his private practice.

        • -1

          To be honest with you, most specialists are booked out months in advance.

          Why such shortage of specialists? Cannot we produce more specialists?

      • +1

        If he is only asking for $1,400 he is nice and honest. So, no.

        You cannot push him, categorising a patient is up to the doctor and they have a duty to be fair to other patients too.

        I suggest you let your specialist know about the latest symptoms, and if he still thinks your child can wait 11 months without harm, to trust him.

  • Can someone please guide me how public referral system works?

    If I am in Penrith, can I only get on waiting list of local catchment hospital e.g. Nepean and westmead or do I have a choice to go anywhere?

    Royal Prince Alfred Hospital has significantly lower average waiting time for tonsils as compared to peers so I will prefer putting him on their list.

    • My friend, living in western sydney, got his daughter's tonsil surgey done in Gosford hospital. Probably the wait time is not long there. He knows a doctor there, not sure if that helped him.

    • +1

      You can ask your family doctor to refer you to a ENT that works at rpah.

  • I can't unserstand why going private costs more without private health insurance when medicare pays 75% of the cost anyway, the health insurance only pays 25%.

    Medicare will cover 75% of the Medicare Benefits Schedule (MBS) fee for associated medical costs. Provided you have the appropriate private health insurance policy, your health fund will cover the remaining 25% of the MBS fee.

    • You can also get a 75% rebate of the Medicare Schedule fee for services and procedures you have as a private patient. This can be in a public or private hospital. This doesn’t include hospital accommodation and items such as theatre fees and medicines.

      In my case, accomodation and theatre fee forms is the highest expense.

    • $3,700 of the cost is the hospital. PHI covers this less the excess, plus the 25% of the MBS.

  • +2

    You could try a smaller peripheral emergency department.

    It's a long shot but hospitals like Bankstown with an on call ENT registrar who can occasionally not have much to do may just bring your little guy in from ED and pull the bits out straight away.
    It does depend on how busy it is at the time but some non emergency surgeries happen just because you happen to present at a time when the surgeon has nothing else on their list for that shift and they feel like some cutting.

    Key is not to present to ED and say you've been seeing a private ENT, because they'll just defer to them as the senior / treating professional.
    Sometimes it's about luck…

    Also worth mentioning that the public list is highly variable. If your surgeon operates at multiple hospitals you have a better chance of getting a call saying a spot has opened up, come in for surgery this week, and your wait time goes from 300 days to 30.

    • Thanks for the information. Can you guide me on following questions:

      1) Is assigning surgery triage catergory dependent upon ENT? If yes, how can I push him to assign at least semi urgent category if he only operates in private hospital? He will naturally push me to go private as he won't he won't get any fees if we go public.

      2)Can I go to hospital which is outside catchment area?

      • +1

        1) your private ent will have his own list and you will be triaged based on where he puts you on the list, with the potential to be called in early if any cancellations

        2) if you present to an ED in nsw that has an ent service, you can be treated there regardless of if it's in catchment or not. For all they know you're visiting family and the emergency occurred…

      • You may need to check with your GP to see if its okay to hospital hop in NSW.

        In QLD, there's a system that prevent people getting referred to multiple hospitals to try their luck to get seen/surgery done earlier.

        You can certainly ask to be pushed to an earlier appt/surgery.

  • +1

    OP You can also shop around with private ENT surgeons and find the best price.
    Best get into the public system now and get in the wait list, don't take the surgeons word that it is a 12 month minimum.
    Also when going private be mindful the cost that your surgeon has quoted is for a overnight stay, if something goes wrong and your done needs more attention cost could go up quite quickly!

  • +2

    I would talk to your GP about going to a different ENT specialist, preferably one with ties to a public hospital. My other half had to have an angiogram and the original heart specialist would only test in a private hospital. The GP found us another specialist. The initial waiting time we were quoted came in quite a bit by the time he was tested so what you are being quoted may not be accurate. If you can find a sympathetic specialist it can make a difference. Best of luck.

  • I'm currently on the waiting list for tonsils at Nepean Hospital.. i'd just keep going back to your doctor and get them to contact the ENT to push the date forward if its that serious. I originally was told a 6 month wait just to get into the ENT specialist, but my doctor got me an appointment within a week! If its that bad over a long period of time they would push it forward.

    • Hi Jaded

      I am currently in the same situation. Could you please advise on which doctor you have use back then?
      I am on the waiting list through the public hospital and been told it would take 12 months to see a specialist and then another 12 months to even get the surgery done,
      My Son is 6 yrs old and has enlarged tonsils and adenoids that needs removal
      Have contacted two specialist to go see them privately and then probably get a referral through the public hospital or even get it done privately,
      I am booked to see a specialist in 6 months which is too long

      Cheers

  • I can't help the OP with advice. But would.love a PM with the ENT's name. The out of pocket for my daughter's tonsils and adenoids was about $2400 (+ consult fees) for specialist/anaesthetist 4 years ago and her adenoids have grown back…Whilst your quoted price is a huge chunk of cash I'd dare to say it's still at the bottom end if Sydney prices. I know operations in Qld are way cheaper from past research; would an ENT at a non-Sydney hospital be cheaper?

  • Some surgeons are happy to do tonsillectomy as a day procedure which would save you some money.

    • +1

      its the adenoids that they have the stay for

  • +3

    we went through the exact same thing with my 5-year-old earlier this year. was told 12 month waiting period and it ended up being done 6 months. our doctor does both private patients in his clinic and public patients at Royal North Shore.

    As other people mentioned before, you need to get your specialist and doctor to call the hospital and push the date forward. Our son was breathing at night like somebody was drowning in a pool. We took our son for a second diagnosis and pleaded with the specialist to help push the date forward. Within 2 weeks we got a call telling us we have a spot for my son. If I had pushed earlier then he might have gone in even earlier. There was probably 1 month in total time when we started to push the doctors and hospital to find our son a spot. Our doctor was the best. He sympathised with our situation and really helped us with moving the date forward. I think that is key.

  • +8

    Firstly, put yourself on the waiting list. Get that started now.

    Secondly, do your research. Are you 100% sure that your child needs this procedure? There are loads of money-spinning procedures with little to no evidence supporting their effectiveness indeed you're often worse off in the long term. Get a second & third opinion. Go back and talk to your referring GP.

    Third. ENTs make money, they make more money if you go through the private system. Vastly more money. My experience with specialists has been very hard sell to go private. The waitlist may not be as bad as the "up to" figure quoted.

    So once you've been satisfied that you need to have the procedure done AND it's worth the risks AND you want it done now. Then shop around for an ENT who will do it for a reasonable price.

    my experiences:

    • I've had a useless procedure for nasal polyp removal/deviated sceptum which was pressure sold to me from an ENT. Miserable recovery. Absolutely no change to my symptoms. Wallet $3,000 lighter. After doing my research I found that the operation was very ineffective for my symptoms. I even found one guy I worked with who had done the procedure 7 times!
    • Hard the hard sell from a neurosurgeon for sciatica. I was in so much pain, I would have done anything to fix it. But fortunately, I have a really good GP who advised me to wait 2 weeks. I didn't want to, but took his advice and I was lucky I did because my back pain vanished with gentle exercise and walking. No risky spinal procedure and saved >$5000. Again, did a lot of research and found out that while the procedure can fix it quickly, it's about as effective as walking. Getting the procedure done has risks and is worse in long term. The neurosurgeon didn't tell me any of this!
    • For my newborn, paediatrician mentioned tongue tie and wrote me a referral. I'd already done my research into this and I quizzed her on it, she said that there wasn't any actual evidence that it was effective but it may help with breastfeeding. After a few days and a visit to a lactation nurse the baby is breastfeeding fine… Very glad I avoided an unnecessary operation on my kid.

    worth watching http://www.abc.net.au/4corners/wasted-promo/6804372

    • +1

      I'm sorry to hear that you still suffered, but I had nasal polyp removal and I would have kissed my specialist if I wasn't so busy breathing for joy.

      It does pay to get a second opinion for any procedure, just for your own peace of mind, but you have to remember that people may react differently to the same procedure.

      • +1

        That's good to hear. I was hopeful that mine would be a success too.

        Look, I want to stress, I'm not saying every procedure is useless. But there is mounting evidence of specialists out there who push unnecessary surgery. The word of the first specialist you see is not gospel, educate yourself and seek 2nd & 3rd opinions.

    • Your last point doesn't sit well with me.

      Tongue ties are a few second procedure during infancy. Most tongue ties self corrects. Some do not and can be of concern later on.

      The operation, whilst possibly unnecessary, is also minimally invasive. In the unlikely (but not uncommon) scenario where the tongue tie is significant and untreated, the child can suffer from speech problems and a forked tongue. Completely unnecessary if someone took a box cutter and made a snip much earlier on.

      • For a moderate tongue tie the procedure is a waste of time. I'm not talking about a VERY RARE significant tongue tie.

        There is ZERO evidence I can find to support intervention in moderate cases. The effectiveness of an intervention in significant cases has been used to justify using it in moderate cases.

        Even a minimally invasive procedure still carries risks, even if it's 1 in 1,000 or 1 in 10,000. That's still a risk that does not need to be there. It's also an unnecessary cost.

        • I don't know if there's even a cost attached to the procedure, however, the risk is really negligible. There's a risk with everything, even staying in a hospital nursery has its risks.

          I speak out of experience of doing these procedures. Whilst it is lucrative, I find it disatisfying doing something that could have been entirely avoided.

          It's a stretch but I compare it to treating someone for a disease that can be vaccinated against.

          And a significant tongue tie is not that rare. It's also not rare for one that appears moderate at a young age to still have a significant impact at a later stage.

          It's a small issue and I acknowledge your opinion to be valid. Just offering a different perspective.

        • @tshow: Well none of what you are saying is borne out in the research, indeed what you've described has been attributed to the placebo effect. If you did a sham procedure the outcomes would be the same for moderate cases.

          Sorry, it's nothing like a vaccination.

          I don't know if there's even a cost attached to the procedure

          ? Not sure what you're talking about but there is a cost for the procedure and, where conducted unnecessarily, it is a waste of health care money which could be spent on important things.

        • @ChickenTalon:
          Placebo effect of tongue tie release? The patients have been referred from speech pathologist or present due to their own concern regarding their speech and/or appearance. As the procedure is done with a diode laser (at least in modern practice) and without anaesthesia, the patient experiences increased tongue mobility and perceivable difference in speech immediately after the procedure.

          I'm not relating tongue tie release to vaccination. In the context above, I'm talking about the disatisfying nature of the procedure and outcome, NOT the origin or the classification of disease.

          As to cost incurred, a tongue tie release on an infant is literally snipping the fibrous frenum under the tongue. At that age, the fibrosity is minimal, scarring is minimal, bleeding is minimal. It is still a procedure but if a parent requested for it to be done, I'll do it and not charge a private fee (may have to charge Medicare if in public care so hospital gets funding).

          I'm perplexed by your strong accusations that it is a sham procedure and for placebo effect. It clearly has an intended physical and psychological impact.

          And of course what I am saying not borne out in research. I literally pre text that I am speaking out of my experience. As for clinical proof that a lingual frenectomy has as an impact, just google lingual frenectomy.

          Whatever your agenda is, I will leave you to it. I literally have nothing to gain by promoting the procedure. I've clearly outlined that I would do it pro bono if in post-natal care, and I get no joy from doing the procedure on an adult.

          Edit - noticed you reference ABC.com.au. I should not have entertained a discussion in the first place.

        • I'm clearly not saying that it is a useless procedure. I said that the evidence for the procedure's efficacy in serious cases is being used to justify it being done more and more.

          I referenced the ABC 4 corners report because it summarises many of the wasteful procedures that are sold to people, and it's easy for most to understand. It also covers off the important things to ask when someone is selling you an operation, such as "What is the evidence for performing this procedure". The evidence is showing that there are many procedures and tests being sold by doctors which are completely unnecessary, some have worse outcomes than doing nothing. So it's very important for people to understand the evidence, know the risks and have information on the alternatives.

          If you want a non-ABC summary of the frenectomy procedure as it applies to newborns and infants, which was clearly what I was referencing "FOR MY NEWBORN", then the most recent comprehensive review of the literature is provided by PubMed here

          In short, there is self-reported feeling better from mothers immediately following the procedure. But the evidence even for that is pretty weak. There is no evidence supporting any difference in long-term outcomes between intervention / no intervention.

          All of this is compounded by the fact that the procedure is being used more and more. So the criteria for performing the procedure is not at all standard. Even you say you do it "when a parent asks for it", great diagnostics!

          And of course what I am saying not borne out in research.

          If you know that then why are you doing it? The placebo effect works on doctors too I guess. Or are you saying the procedure should be done on infants, just in case, because it is very uncomfortable to perform when required for older kids? If so, WHOA!

          You are right, it is low risk, compared to other procedures, but still not completely risk-free.

          My agenda. As I said, I was burned by an ENT selling me a very uncomfortable operation that didn't work and then pressure sold an unneeded diskectomy from a neurosurgeon, but thanks to my GP's warning I didn't take that option. It opened my eyes to the greed of some doctors in putting profits over patients.

  • +8

    You're going to find that your only 2 options as a parent is get your child on the public wait list and wait it out, or pay for it and get it done.

    When I was in my late teens to very early 20's, I was getting tonsillitis 3-4 times a year. That still wasn't an emergency.
    A week before I turned 21, I had an abscess on one tonsil. That still wasn't considered an emergency.

    In the end, my mother being a nurse and knew how much trouble it was causing me, just paid to have it done.

    At the end of the day, whilst tonsils cause discomfort, they aren't an emergency. You need to help your child understand that when they are sick, not to run and play and make the situation worse, and to help them manage it, until they are removed.

    • Now, third option go overseas and spend significantly less.

      You need to over come your hangups and preconceived notions, but that take work and research.

      It's probably easier to get a personal loan

      • Huh?

        I have no hangups and preconceived notions. My tonsils are gone. I have nothing to worry about.

        And I'm pretty sure your "third option" falls under my "pay for it and get it done".

        • Mate sorry this was for the OP not for you..
          was typing on mobile I think I hit the wrong reply button.

        • @dealman:

          Ah no worries :)

  • As the hospital is the major cost, ask your specialist if they operate from a public hospital (as a private patient)?

    Or find a specialist who works in both and go as a private patient in a public hospital, shorter wait and no hospital costs.

  • +1

    I'm in the same boat with my daughters' tonsils. 12 months wait, even though the specialist has been pushing the hospital to bring it forward. She had such a compromised throat that she has been to ED three times since getting on the waiting list, but it means nothing to the priority.

    • -7

      Jeez your daughter is suffering so much that she needs to go to ED numerous times and you can’t spare a few thousand dollars in saving. Personally if I were you I’d get a loan and I wouldn’t have anymore kids in the future.

      • +1

        wow, thanks for the judgemental comment, considering you know nothing about me or my daughter or my family.

        For the record, I'm already feeling guilty enough for the medical problems she has I sure as hell don't need some inconsiderate comments from a person that has no right to judge and no idea what she is talking about.

        One thing we both agree on - you not having anymore kids in the future.

        • -7

          You were the one who mentioned that your daughter is “suffering so much that she needs to go to ED numerous times.” Quite frankly I would love my daughter enough to realise that is all I need to know to make the decision to just pay for the surgery.

        • +1

          @LadyCocoa1234: You're rude, judgmental, inconsiderate and right. ( not on the having more kids )
          I seriously hope OP does not still have is morning barista coffe, lunch out, takeaway and pizza on weekends.
          Child is suffering, OP not having Insurance, take responsibility, get loan, get it done. Have happy kid. Stop blaming the system, the system is broken, has been a while and probably never will get fixed.

        • -1

          @cameldownunder: Stop blaming the system, the system is broken

          Well done on failing to follow your own advice before you'd even finished the sentence.

        • -1

          @banana365: let me rephrase
          The system is broken, no use complaining about it.

        • Some people just can't help but worship the neoliberal trope and blame victims of a broken system.

      • +1

        Not everyone has savings and not everyone can get a loan.

        • then don't have precious children, that require money.

      • Back off judgey mcjudge, you have no idea what their financial circumstances are.

  • -1

    Get private health insurance

    • +2

      Or don't. Private health insurance in australia is little more than a scam

      • +2

        it is what it is… insurance.
        and if you value your health and can afford it, can provide timely treatment for medical issues the public system would make you wait years for.

      • +6

        It's not a scam. It's insurance. You're not meant to get your money's worth from it. The way insurance works, most people pay and hardly ever use it but if you are one of those unlucky people who need ongoing treatment for non-emergency health issues, insurance is worth it's weight in gold.

        • Kinda missing my point. Its a scam within the context of our system. Plenty of articles about it

          http://www.smh.com.au/federal-politics/political-news/danger…

          http://www.abc.net.au/news/2017-09-11/is-private-health-insu…

          and on and on

        • @Pacify: You didn't say anything in your first post so it is kind of hard for people to get your point. Even with those linked articles, I fail to see how it is a scam within the context of our system. If people don't read what their policy covers then it is their own fault. No I don't work for an insurance company nor do I own any shares in any of them.

          Various levels of policy are necessary to reduce premium costs. Otherwise everyone would have to buy cover for every possible procedure. That would be more of a scam than the current system. If you want cover for a hip replacement as a 20 year old the nyou can still have it but you just have to pay the cost of the premium for that policy.

        • +5

          @Xastros:

          The private insurance system in australia was designed to reduce the load and waiting times within the public system. At the moment its not doing that at all, its just taking money from the public system with no real positive aspects.

        • +1

          @Pacify: Oh I see, yes I agree it doesn't appear to be reducing waiting times.

          It does however allow people the option of a shorter waiting time if they are willing to pay private health insurance costs (and GAPs).

      • Scam?

        Mines paid for itself 4 times over with the surgery costs I would have endured. Not to mention the ability to get the surgery done when you want as opposed to waiting lists. Agree with you if you don't play sport.

  • +2

    5600? I believe it would be cheaper to do it abroad with no or very less waiting period.e.g. A return trip to India, VISA charges & medical charges will roughly save $1000-$1500.

    • Too risky - post op care not as good, infection rates higher and antibiotic resistance a huge issue in India especially.

      • Antibiotic resistance scares the hell out of me.

        • XDR-TB gives me nightmares :|

  • Different specialist. We did my daughters in Brisbane, surgery was private but done in a public hospital (Mater). Was less that 2K for the whole lot (admittedly over 10 years ago). The specialist was a female, an ENT and apparantly operated on all the rugby league players (she was famous for that). So I'm sure there are other surgeons you can go to.

    Couldn't have gotten it done publicly, you need to prove sleep apnoea for that.

  • Hard call, but seems a different specialist with links to public hospital is the way to go.

    Making you go private makes a bigger profit for the surgeon, he has a commerical interest in exaggerating public wait times and not pushing for a quicker surgery date.

    Make sure your GP knows the full extent of child's issues.

    On the other hand, symptoms might not be so extreme to warrant emergency. If the child can eat… That's mild tonsilitis.

  • Not sure if this still works but it is the way I have always done it. See the specialist privately, costs is very little just the gap, possibly $50. Then the specialist can book you in semi private or put you up the list publicly, the cost is way less, I only paid for the anesthetist from memory. Shopping around can make a huge difference too. When my daughter had grommets done, I found a specialist that operated in his rooms, same again, all costs covered and only had to pay for the anesthetist.

    Shop around and see what options are available.

  • +3

    Hi OP,

    I had a similar situation a few months back where the ENT specialist offered us the choice between a PVT and public system with similar kind of time frames.

    the difference was I think for our child it was not that urgent but anyway I opted for the Public system knowing it could be over a year as per the information given by the doctor.

    when filling up the form for the Public system I selected an option that said I would be happy to do the surgery earlier if anything came up like someone cancelled etc. don't remember what the exact option was but I am paraphrasing here.

    after the forms were submitted to the hospital I got a call in less than a week and the hospital admin asked me if I wanted to do it at a short notice and it was short as she wanted me at the hospital next morning. I agreed it was done in the public system by the same doctor under 2 weeks from when I first saw the specialist.

    This was in Hornsby.

    Just letting you know as similar thing happened with my friend who also lives in Hornsby too with the same hospital with less than a month of wait time. I know the situation will be different in different public hospitals. Just sharing what happened. All the best with the surgery.

  • -7

    Best health care system in the world…. Lets kids suffer for a year before having a routine operation. Impacts parents, jobs, schooling, kids life ….. But still the best.

    • Wait times yes, $50k out of pocket, no.

  • +2

    Look at having it done in another state, prices of surgery vary wildly beyween states and nsw is known to generally be the most expensive.

    South Australia is my suggestion.

  • This is a bit cheeky but get yourself on that public list for Nepean/Westmead, and then see if your GP will give you a referral to someone out of that area who operates at multiple sites and get on their public list too. The hospital surgical departments don't talk to each other and don't share information. Nepean/Westmead are amongst the busiest services in NSW so I'm not surprised by that waiting time. That said, it's also entirely possible you get bumped up the list really quickly too. Also if obstruction is getting worse, ring the ENT's rooms and they may be able to justify escalating your category to the bean counters at the hospital.

  • Just had both my kids in hospital last week to get their tonsils and adenoids removed. Costs were as follows (per child):

    Surgeon: $1,400
    Anaethetist: $814
    Hospital: $2,000 approx

    This was at The San in Wahroonga. With private health insurance I saved about $300 on the surgeon, all of the hospital fees and am waiting to see what I get back for the anaethetist. So out of pocket will be somewhere around $1,800 per child.

    We were out of hospital the same day.

    • +13

      so even with private health cover you still had to fork out $1800 per child! So what the point of private health cover if a gap as big as this still exists. No wonder Health fund membership has been falling by around 10,000 people a month due to the increase in premiums.

      • +5

        Depending on the surgery, private health insurance isn't much cheaper but it lets you skip the queue.

    • Your kids both had tonsillitis severe enough to warrant a tonsillectomy? That sucks.

      • +1

        I had a tonsillectomy when I was 20. Now, if I ever get a sore throat (if ever), I can at least comfortably eat and drink. It was so bad when I was a kid I would skip meals. Money well spent.

        • +2

          I was forty ! As a kid I suffered sore throats and tonsillitis 3-4 times a year every winter. I hated it, knew it was coming and suffered in silence. My parents never realised how bad it was. Then later in life I told my GP who wasn't a big fan of surgery, more of "let nature take it's course" thinking. So again I suffered for years. Then at 40 I went back to the GP again but he was away so I saw the locum. He asked what do you want to do ? I said rip them out - so he wrote a referral and I went into private day surgery shortly after and only paid the excess (top cover). 2 weeks recovery on painkillers. Best thing I've done for my health other than breathing.

          My advice to the OP would be to accept that you've saved a fortune on Private Health Cover, and now is time to pay back for the sake of your child.
          Take out a loan and think of it as if paying Private Health Cover for the past 12 months - eliminating the waiting period (private or public)

          Hey, and why is everyone recommending India, isn't Malaysia or Thailand just as reputable but closer ?

      • Recurrent tonsillitis causes irreversible swelling of the adenoids and tonsils which then obstruct the airway at night and cause sleep apnoea and a subsequent raft of health problems including long term hearing loss if middle ears involved.

  • +3

    My 18 year old just had major jaw surgery at a public hospital. Excellent care, excellent follow up by her specialist.

    In our specialist's view pubic hospital was the best place to have her surgery done.

    We had all our children in the public system. No complaints.

    Carried health insurance for 20 years, always offer it to the public hospital too. (saves penalty tax)

    As for your immediate needs, get your GP to refer you to a specialist who maintains a public hospital list.

    Alternatively just turn up at your local children's hospital emergency room. You'll get excellent care from super young doctors who are keen to learn and to help. If the triage system in the emergency room leaves you waiting for ages, that's good….take that as a message that your child isn't too bad.

    The Public System is publicly funded for everyone, subject to need and priority. The Private insurance industry and private hospitals are there for the financial betterment of the people within that system, not necessarily YOUR betterment.

    • +2

      Well said. Our public health system is amazing, especially when compared to many other countries. We are very fortunate.

  • +1

    As a parent who went through this, results of this surgery is gold (for the whole family)! We were the same as you, and now our family enjoys less disturbed sleep!!

    My opinions are;
    1> Give it a go with public. One of my child's friend who was on waiting list (1 year) suddenly got a call after a cancelled surgery (in 4 months). If you are lucky, you could get it. If Royal Prince Alfred Hospital has lower waiting time, I would choose it against other public hospitals.
    2> Has your child got any allergies that is triggering the rhinitis? If so worth consulting an allergy specialist. In our case, his medication helped to reduce our child's symptoms of allergy (Claratyne and Nasonex).
    3> If it is bothering you child's and family's health too much, worth considering a personal loan. Trust me, you wont regret it. Assess the situation and make a call.

    Hope all go well with your child and you! Wish your child a speedy recovery!!

  • Did you see the ENT specialist privately or at the Nepean clinic?

    I'm less sure about NSW but in Victoria the way this usually works is your GP can refer you to the hospitals ENT clinic - I see Nepean Hospital has a Paediatric ENT clinic that GP's can refer to. You then wait to be given an appointment (which admittedly can take a month or two). Your child is then seen in the clinic, usually first by a registrar then one of the specialists. They will assess your child and determine the urgency. Some of the symptoms you're describing sound pretty bad but as someone else has mention, the evidence for tonsillectomies is fairly poor. If they deem surgery is necessary, they will give you a category and you will be put into the queue. You'll then receive a letter telling you the date your surgery is scheduled for.

    This is the fastest way to get something done in the public system (short of turning up to ED with something life threatening) and will all be covered under medicare.

  • +12

    Update and good news: My ENT has advised he could operate privately in public hospital so total cost is now reduced to $2300 which is significant as compared to $5600. There is still average 3 months waiting time but still way better than previous options. Not sure why he didn't offer this solution previsouly.

    I had already booked another appointment with ENT, before this info came through, who works in RPAH and this hospital has lowest waiting times for e.g 39 days against 129 days for Westmead. There could be case where he gets operated in RPAH completely on public list before his number comes with existing ENT but not sure whether it is worth forking out $220 as new ENT fee to try this option.

    • +3

      Nice one! Good luck with locking that in. Hope your kid will stay as comfortable in the meantime.

      • +2

        Thanks!

    • +1

      Do you know how elective procedures work? There are 3 categories, 30 days, 90 days and 365 days. Your child is on the 365 day list - indicating this is non-urgent. If your child's condition deteriorated, this can be pushed up further with your doctor's recommendation. This comparison and cherry-picking of hospital wait-times is ridiculous as it is all on a needs and case-by-case basis.

      Judging by your comments, you are just shopping around for the cheapest option. I can assure you RPA's waiting list is no quicker than any other tertiary public health facility in NSW.

      • +1

        If it were my daughter I'd be doing the same regardless of what category they'd been allocated to. Having your child stop breathing at night is a terror like no other.

        • +2

          I understand that is the case, especially as a parent. But op has a few real options:

          Option 1 - Pay for treatment at a private facility
          Option 2 - Condition deteriorates, visit the ED
          Option 3 - Sit on the waitlist

          Op can afford $2300 for treatment of his child, but will not pay $5600 given the current condition he states his child is in?

          Purely on numbers, there are countless numbers of children on hospital wait-lists requiring surgery. Op's child is another number on the list. Due to the nature of the public system we cannot treat everyone immediately and we have to prioritise based on acuity of patients. You can all keep fighting what category you have been assigned but you will all end up in the same place because you are not special and there are other people just like you who require treatment as well. This is why private facilities exist - as an alternate pathway to support the public system.

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