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

Sshanaz on 15/10/2017 - 08:01
Last edited 15/10/2017 - 11:39 by 1 other user

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.

Health & Beauty

Comments

        • MessyG on 16/10/2017 - 20:45

          @glasklart: I know. And I agree with you. But I'd still be trying to find a way to get it done faster and cheaper if I was in that situation and money was so tight I couldn't get a personal loan. It's not rational.

    • CLoSeR on 17/10/2017 - 09:16
      +1

      That's good news, now get your family some hospital cover!

    • Dont Care on 17/10/2017 - 20:41

      you don't have private insurance. that option is for private insurance holders. even if you took up PHI now you would have to serve waiting times and it is not available to pre-existing conditions.

  • darkchoc on 16/10/2017 - 18:00
    -7

    By no means is my post suggested as a cure. But…

    We traditionally make a paste from honey (raw) and tumeric powder. Clean your hands thoroughly, then use your finger to run the paste onto the back of the throat generously. Careful not to trigger the gag reflex too much. Then just eat the paste.

    Salt water gargling too.

    3 times a day.

    Helps with sore throat, tonsils.

    Consider this as a low cost, adjuvant therapy that may help a little

    • JuryWheel on 17/10/2017 - 11:54

      i would have no idea how id go about rubbing something on my throat!

      • darkchoc on 17/10/2017 - 13:02

        Or just eat the paste.

  • HHH-888 on 16/10/2017 - 19:20
    +6

    Mate, what are the MBS item numbers for the surgery you have opted? I work in a private hospital, I might be able to assist with the hospital portion of the cost.

    Cheers,
    HT

    • Sshanaz on 16/10/2017 - 20:14
      +1

      1 x 41789 (removal of tonsils and adenoid)
      2 x 41632 ( middle ear drainage for both years)
      1 x 41764 (Nasendoscopy or sinoscopy or fibreoptic examination of nasopharynx and larynx, one or more of these procedures, unilateral or bilateral examination)
      1 x 30278 (tongue tie cut)

  • [Deactivated] on 16/10/2017 - 19:36

    Been a few years since I've done any ENT work but we did kids with snoring/sleep apnoea issues as a priority tonsilectomy because of the associated learning difficulties that came with it. Maybe the evidence has changed in the last few years but it's surprising to see your kid waiting so long given the symptoms described. Granted someone with a massive head and neck cancer obviously takes priority for that Cat1 appointment.
    This is in QLD though.

    • DrC on 16/10/2017 - 20:46
      +1

      Yeap - this sounds like a pretty clear case of sleep apnoea and developmental delay as a consequence. I'd put yourself down publically as I imagine you will wait nothing close to a year. We don't delay that long in public in Vic.

    • MessyG on 18/10/2017 - 09:02

      OP is just unlucky to be in Westmead/Nepean catchment. A lot of kids and adults out that way with illnesses and complications you don't see in other areas. Westmead adults is a thousand beds and 11km of corridor (wish I was joking) and they're still packed to the brim and overflowing.

  • Yamun121 on 16/10/2017 - 22:19

    Good to hear of a potentially earlier date!
    If you have written support of a pediatrician regarding the developmental impact of surgical delays, this may also help - otherwise it just comes across as another parents hustling staff, thinking their child is special
    Good luck

  • JUSTINO on 16/10/2017 - 22:29
    +1

    I’m so sorry hearing that I wish I could help

  • Yttrium on 16/10/2017 - 23:05
    +2

    I would have to borrow personal loan of $5600 because

    So, it will end up costing $7,000

  • weeeen on 17/10/2017 - 08:12

    Try a regional area. We got surgery done in 3 weeks from a surgeon who works at country hospital one day a week - the lists are not so long, still public. We travelled to Rochester Hospital from Bendigo to get the surgery done. Very nice hospital and the same surgeon as if you paid top dollar in the private hospital. This was not ENT surgery, so won't help to give details, but you could try ringing some ENT surgeons in regional areas close to you. Hope this helps!

    • kiitos on 18/10/2017 - 12:38

      Clever idea.

  • goms on 17/10/2017 - 08:22
    +1

    Just adding an alternative to borrow money for free…

    How much can you save $5600? If you can save that in a year and already have a credit card, apply for another credit card for a balance transfer with 0% interest. There are some that offers 12, 18 or even 24 months interest free balance transfer. Make sure that you will be able to pay it back before its due otherwise you will be paying a high interest on it.

    Good luck! Hope your kid gets better soon.

  • SupeNintendoChalmers on 17/10/2017 - 09:18
    -1

    Option 1- Get a small loan or equity from home (if applicable)
    Option 2- Have a holiday to SE Asia get it done there.

    • [Deactivated] on 18/10/2017 - 22:53

      Assuming return airfare for two - $2,000.
      Accommodation for three nights two days - $600.
      Assuming cost of surgery is 1/4 - $1,500.

      These is the best case scenario and it saves the OP about $1,000.

      Assuming honest complication and child is kept in a ward overnight $1,000.

      Or maybe an opportunistic scenario which may escalate the price ten to a hundredfold. This is very common and even happens to locals.

      Or head back to Australia with a complication which will then not be covered under Medicare.

      One would have to have seriously questionable decision making capabilities to take Option 2 into consideration.

  • Mobsie on 17/10/2017 - 10:13

    If your child is struggling a trip to emergency in my experience helped us when we were on a wait list for urologist. My thoughts are with you happy to chat anytime!!!

  • Cleremy on 17/10/2017 - 13:21
    -8

    Thanks Gough Whitlam for introducing this gravy train for the Medical industry and making healthcare inaccessible for future generations of Australians! Job well done in your capacity of traitorous PM (same to all your successors to the present day).

    • altomic on 18/10/2017 - 00:28

      yes, make everyone pay up front for healthcare.

      because everyone can afford private healthcare.

      and putting $$ before peoples health can only be a good thing.

      we should also avoid Japans example where they only allow Dr's to own and run medical clinics.

      let's allow capitalists and businesses to run our health care.

      because capitalists and businesses only look out for the customers.

  • PVA on 17/10/2017 - 18:12
    +2

    go on the wait list.
    We have never had any problems with public hospitals (only needed a ew time I guess), in fact last time needed (wife needed Thyroid operation) she was in public hospital before we could even see a private specialist. (called specialist, two weeks wait for initial consult, called public- they phoned our doctor because they hadn't received her report yet and called us back that afternoon (Friday) to say come in Monday.

    Super impressed with the public system, really professional and helpful seeing we didnt know what was going on a freaking out about Thyroid, poorly disappointed with private.

  • Sammyboy on 17/10/2017 - 20:16

    Wow that's a lot that need to be done. Have you had 2nd and 3rd opinions from other paed specialists? You could have come across a surgeon that we term cowboys. They do much more than necessary, either because they like to cut things a little too much, or have a new renovation or holiday to pay for. I would definitely seek multiple opinions to see if so many procedures are necessary. I was due to get my tonsils removed, and got treatment from a Chinese Acupunture/Herbalist Dr. Fixed me up and never had a problem with tonsils since. Of course this was only one problem, not multiple.

  • aleminium on 17/10/2017 - 22:19

    Private was hell expensive even with my private cover, so I decided to wait it out and go public. Was advised 12 month wait time.. 2 months later got a letter to attend and it all got done pretty quick with no out of pocket.. best
    Not long after had to get wisdom teeth out using private health. It covered bugger all, and didn't cover anesthetist at all (another $500).
    Anyways my point is maybe go public and hope they smash through the wait list like with me.

    • altomic on 18/10/2017 - 00:22

      similar with my hernia. Went public - 12 months wait, 3 weeks later -"we've had a cancellation, can you come in next week?"

    • myfuturej on 18/10/2017 - 10:16

      Similar with lump found near my partner's lymph node. It didn't look suspicious enough after 2 ultrasound and examination, but still warranted a surgery. Said we would have to wait a year, minimum.
      We got the surgery 7 weeks later, no out-of-pocket-cost. Turned out to be benign. We would have gone private if there were more suspicion from the doctor's part.

  • Dsquall on 17/10/2017 - 23:01
    +4

    As a medico, private is better it just is, there is no way around it. You'll have the surgeon of your choice operating and they will be doing the operation themselves and not one of their registrars. The facilities are nicer and other support staff are just friendlier in general.

    Also please be aware that your child needs grommets if they have chronic middle ear effusions "glue ear", so the quotes and different avenues of therapy offered by other people for tonsillectomy alone is not accurate. This is definitely an ENT specialist only thing, I really don't think coming to ozbargain to get specialist advice is not a great idea. The decades of training required to become an ENT surgeon are required for a reason.

    Also, bear in mind that glue ear may be associated with developmental delay and possibly permanent repercussions as to learning and intellect.

    Talk to your specialist and be candid about your difficulties, we're here to help first and foremost not to bleed you of money. While the public wait time for ENT surgeons in NSW is 12 months regardless of hospital, as another user mentioned, I do believe RPA has a specific program for people in situations that you find yourself in that may expedite things.

    • MessyG on 18/10/2017 - 09:04
      +2

      Dsquall I don't really agree that private is better - it's definitely faster and more convenient but often lacks the tertiary level oversight and peer review you get in the public. As for the reg vs consultant operating - I'd be really interested to see the numbers of complications for each, including post-op infection rates, not that I'm sure that's even recorded.

    • stalker878 on 18/10/2017 - 13:40

      i don't see why Dsquall should be neg for expressing his opinion about the system given that he is in the field.

      his points are still valid but not universal.

      everyone's have different views about cares they want to receive.
      and just to note, private hospitals can also have registrars

    • Xastros on 18/10/2017 - 13:46

      Not sure why you got so many negs. Have an upvote.

      Personally I would rather have a consultant with 15 years training than a relatively new registrar. Experience builds skill, there is no way around this.

    • Symbiotic on 18/10/2017 - 21:06

      I really don't think coming to ozbargain to get specialist advice is not a great idea

      That’s a long winded way of saying it is a good idea.

  • myfuturej on 17/10/2017 - 23:47

    Is it possible to jump the queue if you just pay privately? I'm really curious because we also do not have private insurance but regularly save money for emergency situations.

    • Gronk on 18/10/2017 - 09:37

      You don't so much jump the queue - you just don't go in it in the first place because you pay for everything up front.

      This is generally how I prefer to do things…

    • Xiaomi on 19/10/2017 - 13:34
      +1

      You can get it done privately. An example for colonoscopy, through the healthcare system 2-3 month wait, privately was out of pocket $550 (rest was covered by medicare) with a 3 week wait.

      • myfuturej on 19/10/2017 - 22:56

        Wow! That's not even a lot of money. A decent PHI cover for our entire family is around $500, this means covering higher amount of general and major dental, physio and psych. This is around $6000 a year.

        • Xiaomi on 19/10/2017 - 23:30

          Dr. Choudhary - Western Sydney if anyone is interested.

  • Dpkmax on 17/10/2017 - 23:57
    +1

    Is it possible to provide your bank details or PayPal details so whoever wants to help have this option to chip in. Frankly my heart cries when I think about the child. God Bless.

  • konazz on 18/10/2017 - 00:16

    I hate the two tier system. It really puts pressure on the public system and on people like OP. We went to our ENT on Wednesday night and our 11 month old had grommets put in Friday morning in private. Booked in for feb adenoids and tonsils. It’s costing us the gap, but at least we can get straight in.

    If you want a gap, my parents had a $50k gap for one of my younger brother’s brain surgeries 11 years ago - had to remortgage the house. No paediatric neurosurgeon in the public system would touch him so he ended up with Charlie Theo. At least the other 13 surgeries were public.

    • MessyG on 18/10/2017 - 13:49
      +3

      Charlie Teo is a very very extreme exception. I don't think there's very many examples of $50k gaps in Australia. Except him.

      • Zondor on 19/10/2017 - 15:34

        Dude even has a Wikipedia page wow.

        Edit: I think I remember seeing a documentary on him.

  • altomic on 18/10/2017 - 00:21
    +1

    I'll do it for a slab of beer.

  • MorriJ on 18/10/2017 - 07:54
    +3

    Go to the RPA emergency department, get your child through triage and referred to the ENT department there - no need to mention private ENT.

    If they consider high enough priority, will be done straight away, otherwise their ENT wait times are the lowest in the state pretty much.

    https://www.myhospitals.gov.au/hospital/1153B2180/royal-nort… - Royal North Shore - '15–'16 75 operations 301 days
    https://www.myhospitals.gov.au/hospital/1152D2100/nepean-hos… - Nepean - '15–'16 81 operations 342 days wait time
    https://www.myhospitals.gov.au/hospital/1150A2080/royal-prin… '15–'16 93 operations 39 days

    A little over a month median wait time in '15-'16 for the main operation needed at RPA vs 1 year other hospitals.

  • OzzyOzbourne on 18/10/2017 - 08:31
    +2

    Interesting how private health insurance was meant to take the load off public hospitals and reduce waiting times, yet so many private medical procedures are done in public hospitals.

  • [Deactivated] on 18/10/2017 - 08:35
    -4

    Are you working two or three jobs? If you're not, then you should be, you could do that instead of surfing ozbargain.

    • [Deactivated] on 18/10/2017 - 18:22
      +2

      Can't believe people care more about saving the cash than the kid. Shame on the downvoters.

  • stalker878 on 18/10/2017 - 13:35

    the symptoms you describe are concerning as they are affecting development esp speech and learning.
    did you see a public ENT surgeon or private?
    if only private, I would suggest that you see a public ENT surgeon at the public hospitals. get triage in the public system.
    explain that it affects his sleep, time at school, sports etc.

    if its particularly bad during a virus infection, consider presenting to ED for an assessment to get the oncall to review your child.
    if it is unchanged but you really want to see someone via ED, then i would suggest you pick a non-peak hour time (early morning to early afternoon on a weekday) to see the ED as your wait time would be slightly shorter (but no guarantees) and that the ENT team will not be on a skeleton crew (esp over weekends).

  • KLoNe on 18/10/2017 - 20:56
    +4

    You don't have $5k saved up to get your kid into a private hospital? Put it on your credit card, stop buying 3x $10 starbucks coffees a day and get your damn finances sorted out.

    • [Deactivated] on 18/10/2017 - 23:57
      -1

      That's exactly what I was thinking. Seems like it's more important to spend on fancy beers. There are no excuses when living in Sydney or Melbourne. There are plenty of jobs and it used to be standard to work two jobs and plenty of overtime in the 70s and 80s. Now people just want to keep up with the Jones' and not get their priorities in check. Coffees, fancy beers and smashed avocado brunches. Give me a break.

      • Zenyatta on 26/10/2017 - 19:21
        -1

        You really don't know about OP's personal circumstances. That is a completely unfair judgement.

        Edit: just saw the post about the 75" TV and the extra contents insurance. Hmmm…..

        • [Deactivated] on 28/10/2017 - 20:21

          I'm sorry. Although there are personal circumstances, there are very little reason to not have worked beforehand to save for others. What you are specifying is 1% of the cases, we don't live in a third world country. What you are doing is letting the other 95% be irresponsible just to not offend 5% of people who unfortunately have run into bad circumstances.

        • Zenyatta on 29/10/2017 - 19:35

          @jared444: Of course. At the end of the day it comes down to personal responsibility, but despite that, circumstances like disability, family illness, personal illness, death of a loved one etc can very quickly turn your life and finances around and you can find yourself unable to get by, even if you were doing okay beforehand.

        • [Deactivated] on 30/10/2017 - 18:12

          @Zenyatta: That's why I said 5%.

  • ffhound on 18/10/2017 - 22:05
    +1

    Here in Victoria I have found that waiting times for surgery such as a gastroscopy have come down. Mind you your child's surgery is a little different.

    I do recall though that it was sometimes possible to get a particular surgery done if you were prepared to travel a bit, say to a regional centre or across town. Have a word to your GP, explain the situation and ask whether your doctor could ring around and find a public hospital somewhere in your state that could attend to your child earlier. Being flexible about where you have the surgery done may open up extra options.

    cheers Peter

  • Eggsperential on 18/10/2017 - 23:27
    +1

    Come to canberra. 3hr drive. I got tonsils and adenoids done in the public system and only waited a few mths.

  • Cluster on 19/10/2017 - 16:04
    +1

    People wonder why medical treatment costs so much here while in places like India and Thailand it's so much cheaper.

    Having worked around the medical industry for many years, I have observed the following:

    1. Insurance. It's very expensive as patients with negative outcomes like to sue, often for millions. It's a problem that hasn't developed in India (yet).

    2. Shows and conferences. The industry loves these, often scattered around the world with a nice golf course nearby. These things aren't cheap, and it's the patients who pay.

    3. Salespeople. There are lots of them. Each supplier has a wad of them trying to convince you to buy the latest gadget or treatment.

    4. Hospital staff costs are much lower in certain countries. We live in a wealthy nation. That's just the way it goes.

    5. Variable medicine costs. Some countries don't recognize certain patents, leading to massive cost reductions for patients. Other times the government simply declares the costs to be outrageous for their poor population therefore the pharma companies are forced to discount to make any sales at all. A good example: Hepatits C treatment.

    http://www.abc.net.au/news/2015-08-20/hepatitis-c-sufferer-i…

    $100k in Australia, $900 in India. I believe the situation has improved recently with the drug being listed on the PBS, but the drug was available for years in India with a 99% discount. Before the listing you could have a luxury multi month holiday in India while undergoing treatment, and paying whatever 'fees' were required to qualify for treatment reserved for Indian citizens.

    • [Deactivated] on 20/10/2017 - 08:11

      Many pharmaceutical companies do not represent doctors, surgeons, or anyone in the medical profession. The pricing decisions, supply and availability are dictated by stakeholders who are often businessmen whose interest is the returns on there investment.

      In the scenario above, the same with HIV anti vitals, they are practicing predetory pricing. These companies essentially hold many lives ransom. These lives means votes for governments. This essentially means that the pharmaceutical companies have emotional leverage over political campaigns.

      When a government refuses to pay the ransom, the people cry that the doctors, the elites and the government do not care about the diseases more prevelant through the poor.

  • agam2104 on 20/10/2017 - 00:21

    Go to India .

  • benbarren on 20/10/2017 - 08:21

    it will be quicker than 12 months on public if urgent which just means finding a good local doctor in public system and presenting well when going to hospital doctors for their consult. but it still may take months. how actually urgent is it ?

  • CLoSeR on 20/10/2017 - 12:01
    +3

    Seriously, if your child is that sick then put it on the creditcard or get a personal loan. Whatever you need to do to get it done. You only have yourself to blame for no insurance.

    Or alternatively sell some stuff like your 75" 4K TV.

    https://www.ozbargain.com.au/node/299129

    • [Deactivated] on 24/10/2017 - 09:14

      That's appalling. Goes to show the people out there, I'm sure he didn't wait as long about deciding to get that tv

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