Should We Have The Right to Opt out Medicare and Full in with Private Health Insurance or Vice Versa?

plastererJazz on 17/05/2022 - 15:03
Last edited 17/05/2022 - 23:18

We all pay the medicare levy as we are covered by the public health system. some pay surcharge and loading even.

Could or should an individual have the right to opt-out from medicare completely and go full-on with private insurance at their own risk?

I believe a lot of people go for the basic tax-effective cover to avoid surcharge and loading and these covers probably only cover items covered by medicare already.

Some company websites even brand as tax saving plans.

Scenario 1 - public only, he/she will pay for levy and surcharge but no MLS.
Scenario 2 - private only, he/she will pay a higher tier of private health insurance but no MLS

So private cover holders only go to private hospitals and medicare holders go to public hospitals?

For example, A pays a $2000 levy and $1000 private insurance to get public health treatment and low to no private health treatment.

Would it A better of paying $3000 or $3500 more for private insurance only to get better private health treatment and free up public resources for others.

Almost forgot that their opposite is to not enrol any private insurance and happily pay for the levy.

Whether buying private insurance or not shouldn't be a tax-related action and the surcharge and MLS should be gone.

Happy discussion

Poll Options

  • 25
    Yes, levy, surcharge and loading are a pain in the ass
  • 761
    No, it will break the public system as fewer pay the levy, private insurance will be more expensive
  • 8
    Others
Health & Beauty Health Insurance Insurance

Comments

      • Motek Benzona on 17/05/2022 - 18:00
        -1

        Art subsidies
        Womans groups
        Anything to do with funding for MINORITY groups such as LGBTQ
        thats a start

        thats a start

        • try2bhelpful on 17/05/2022 - 18:24
          +2

          That is your list, it isn’t for others.

          • Motek Benzona on 17/05/2022 - 18:29

            @try2bhelpful: Really? I did not know that, thanks for the enlightenment

            Of course as a leftist I expect every single person to agree with me and want the same though

            • try2bhelpful on 18/05/2022 - 09:43
              +1

              @Motek Benzona: So you don’t like me pointing out that others might disagree. Right wing free speech, huh?

              • Motek Benzona on 18/05/2022 - 11:47
                -1

                @try2bhelpful: Oh, sorry… let me clarify.. I dont care what you say or how you say it, i do not see one single word I wrote that said you cannot say what you like. Feel free to use the right of free speech to say what you like!!!

                People have different opinions and views and i welcome them all. I am surprised that a leftist can actually admit that though ;-)

                • try2bhelpful on 18/05/2022 - 11:53
                  +1

                  @Motek Benzona: You are the one who went abusive because I pointed out that others don’t share your opinion. I didn’t say you couldn’t express your opinion. You are the one doing the projecting here. You wonder why we “lefties” have an issue with the right. Apparently even pointing out that others might think differently will get you abused.

                  • Motek Benzona on 18/05/2022 - 14:33
                    -3

                    @try2bhelpful: "Abuse" awwwwwww cherub, go hide in your safe room, have me cancelled, start a petition…. THERE WAS NO ABUSE! Just my opinion
                    Again, your last comment indicitive of the new leftists perception on life. FFS, what is wrong with you people?

                    • try2bhelpful on 18/05/2022 - 14:38
                      +3

                      @Motek Benzona: Yup, and the abuse continues. What I said wasn’t leftist it just pointed out others had a different opinion. Now you are continuing to escalate. I do wonder why you have trouble allowing others to even suggest there might be a differing opinion, but yours, out there. Just waiting to see what the next escalation will be.

                      • Motek Benzona on 18/05/2022 - 14:53
                        -2

                        @try2bhelpful: Now you are getting BORING… learn to read.

                        • try2bhelpful on 18/05/2022 - 15:00
                          +2

                          @Motek Benzona: You can’t countenance a difference of opinion, so you go the “leftist” insult, and you want me to “learn how to read”? I’m not the one who escalated. I’m sorry if the truth is boring you.

        • MessyG on 18/05/2022 - 17:47
          +1

          So, not okay small amounts of funding going to minorities, but totes okay with billions being funnelled into the corporations like mining companies and Aspen medical for no clear benefit. Got it.

          • Motek Benzona on 18/05/2022 - 18:10

            @MessyG: Oh..I disagree with that even more but did not want to write an essay.

            In fact I disagree with all spending unless it's being spent on me 😉

        • DrScavenger on 19/05/2022 - 08:23

          Strange to hear this here where majority are labor leftists

      • brendanm on 17/05/2022 - 18:33
        +6

        Billions in funding for universities to study things that have no value to the taxpayer.

        First home buyers grants, baby bonus etc.

        Ridiculous perks for politicians.

        Subsidies/payments to profitable businesses.

        Plenty of other things.

        • Jolakot on 19/05/2022 - 11:54
          +1

          Billions for studying useless things? It'd barely be in the tens of millions.

          The real rort here is how expensive universities have become, for a 3 year compsci degree at a second tier university I had 30k in HECs debt, on top of whatever the government paid as a subsidy

          That same university just bought 5 more properties adjacent to it to extend their faculty, meanwhile the professors and PhD tutors are being paid peanuts and leaving by the year, not sure why they should be allowed to profit like that

          • brendanm on 19/05/2022 - 13:41

            @Jolakot:

            Billions for studying useless things? It'd barely be in the tens of millions.

            It's all there to see for yourself, it's public information how much is spent, and on what. 3 billion last year, 2 billion this year.

            The real rort here is how expensive universities have become, for a 3 year compsci degree at a second tier university I had 30k in HECs debt, on top of whatever the government paid as a subsidy

            No one is forcing you to go to university, however all taxpayers are being forced to fund this "research".

            • Jolakot on 19/05/2022 - 20:58
              +1

              @brendanm:

              It's all there to see for yourself, it's public information how much is spent, and on what. 3 billion last year, 2 billion this year.

              Are you talking about $2.2 billion University Research Commercialisation Package? Because almost all of that is industry lead, considering $1.6 billion of that is already ear-marked for the Economic Accelerator, so not sure how that could be considered "useless"

              No one is forcing you to go to university, however all taxpayers are being forced to fund this "research".

              Do you know how much my parents paid for their degrees? $0. I don't understand how an entire generation that received free university paid for by taxes can complain about current generations wanting them to pull the ladder back down

              • brendanm on 19/05/2022 - 21:28

                @Jolakot:

                Are you talking about $2.2 billion University Research Commercialisation Package?

                No. There are various ways research seems to be funded, arc, rtp, rsp, probably a tonne of others.

                Do you know how much my parents paid for their degrees? $0.

                Amazing. In your parents day, they probably only had worthwhile degrees, and they could probably get jobs with them.

                Surely your university degree has made you more than $30k? That you can pay off bit by bit, with the amount only indexed to CPI?

                Again, you also have the option of bot going to university if it upsets you too much.

                • Jolakot on 20/05/2022 - 05:57

                  @brendanm:

                  No. There are various ways research seems to be funded, arc, rtp, rsp, probably a tonne of others.

                  Ok great, what percentage of government funded research is in 'useless' areas then?

                  Amazing. In your parents day, they probably only had worthwhile degrees, and they could probably get jobs with them.

                  They had the same useless degrees that we have today, with plenty of people studying recreationally on the government's dime, my aunt for example got a free Journalism degree before deciding she hated Journalism and went to work as a bank teller

                  Surely your university degree has made you more than $30k? That you can pay off bit by bit, with the amount only indexed to CPI?

                  Sure has, I majored in Software Engineering and minored in Cyber Security, got a job as a graduate software engineer straight out of uni

                  For all your whining about useless degrees, I did one in the most in-demand areas possible, and it still cost me 30k. Why shouldn't sought-after degrees be free like they were for everyone a generation ago?

                  I don't understand why it's acceptable to pull the ladder up behind you, reeks of generational selfishness

                  Again, you also have the option of bot going to university if it upsets you too much.

                  Whatever job I could have done without a degree would have cost the government more money in lost tax revenue than my degree cost, so that's just a dumb argument to begin with

                  • brendanm on 20/05/2022 - 06:23

                    @Jolakot:

                    Ok great, what percentage of government funded research is in 'useless' areas then?

                    Plenty of it, most likely.

                    Journalism degree

                    Journalism is not useless at all. It's a pity we don't teach actual journalism these days, rather than the tripe that passes for it.

                    Also, did you stop to think that, perhaps, it is people like your aunt who ruined it for everyone?

                    Sure has, I majored in Software Engineering and minored in Cyber Security, got a job as a graduate software engineer straight out of uni

                    So you have a job you like, are successful, and making good money? What's the issue with paying $30k for what I assume would be at least a six figure job?

                    Why shouldn't sought-after degrees be free like they were for everyone a generation ago?

                    I actually have no problem with them making degrees that are actually worthwhile, that have a shortfall of qualified people, lower cost, or free.

                    While they do that, the garbage degrees, and ones that are already completely saturated with graduates who can't get jobs, should have subsidies removed or decreased.

                    Whatever job I could have done without a degree would have cost the government more money in lost tax revenue than my degree cost, so that's just a dumb argument to begin with

                    You are only applying this to yourself, who made a good choice, on a degree with a real world application, that isn't already oversaturated with graduates looking for jobs. That doesn't apply to all of them.

                    The taxpayer shouldn't have to pay for people doing a degree, simply because they like to do it, or don't know what else to do. That is a terrible return on investment.

  • freefall101 on 17/05/2022 - 19:07
    +10

    Private health in this country should be taken out the back and shot. It's less efficient, it's more expensive and the only reason it exists was to lower government spending on healthcare when it could have been done purely through higher taxation (which, while it sounds bad, would have meant lower actual costs for people).

    The entire industry is defined by the government. They control the prices, the services delivered, the standards of care, etc, plus it's still subsidised by the government. The only benefit is they have to pay less than if they were running it fully themselves with the rest of the cost worn by us. But we have dual networks as a result. And thanks to medicare being cheaper even if you do have insurance and the "you get to pick your own doctor/jump the queues" being the selling point of private it's never going to be an efficient way to deliver healthcare.

    If some billionaire wants to build their own hospital or hire their own doctors then fine, that's a true private system. But the very premise of this post is wrong - even if you go full private health as the system stands the government will be paying for it anyway just for that system to be there and that is very expensive.

    • plastererJazz on 17/05/2022 - 23:09

      Yeah it supposed to be options in the post but I couldn’t see it for some reason

    • MessyG on 18/05/2022 - 17:47

      It's also used to prop up public surgical waiting lists too.

  • Clear on 17/05/2022 - 19:46

    FWIW when you're unwell like me you save heaps by going private and skip the public waiting lists that can be for years.

  • barge-in hunter on 17/05/2022 - 20:58
    +6

    Why on earth would you prefer to receive medical care from a system who's purpose is to make money off your medical care?

    The private system in Australia is a joke.

    • plastererJazz on 17/05/2022 - 23:08

      No the point is to have the option not that I will do it just now these two are tied together.

      I guess most people prefer buying stuff when they need not when the government pushes them to

      Basically people at age 30 will have to spend over $1000 or more either on surcharge or private health cover otherwise the MLS will be like a penalty for 10 years

      For some reason part of my post wasn’t there which could be why you are misunderstood my question

      • barge-in hunter on 18/05/2022 - 07:47
        +1

        The private system doesn't have emergency departments - generally speaking, they're not a "full service" health system, providing only medical care with the highest profit margins… Back to my point.

        In order for your idea to work, private hospitals would have to be built all around the country (particularly regional areas). It's a very expensive and unrealistic proposal simply to provide people "choice".

        • brendanm on 18/05/2022 - 22:58
          +1

          The private system doesn't have emergency departments

          Some private hospitals do have emergency departments.

          • BakaHaze on 20/05/2022 - 13:29

            @brendanm: Yup, and they're not full service

          • dp1 on 21/05/2022 - 09:11

            @brendanm: Private ED is very different to public. They cannot possibly offer what the public system does. Their ideal customers are the simple stitches or sniffly children but don't go there with road trauma or a mental health crisis

            • brendanm on 21/05/2022 - 09:20

              @dp1: It still exists, contrary to what I replied to.

  • pangwen on 18/05/2022 - 07:48
    +4

    Private health cover (talking hospital here - extras is a whole other kettle of fish which isn't relevant to your question anyway) only tops up things that Medicare covers. That’s why all private health hospital cover will exclude “treatment where Medicare does not pay a benefit” (the exact wording will vary by provider but the effect is the same). While you say “these (basic) covers probably only cover items covered by medicare already”, that is technically true, but all covers are like that. The basic ones won’t cover a bunch of things that Medicare would.

    For covered procedures, Medicare covers 75% of the MBS fee. Your private health will cover at least 25% of the MBS fee. Where your doctor charges more than the MBS fee (leading to a gap), your private health may cover some of that gap too. The cheapest providers (looking at you NIB) are often known to have lower gap cover.

    So if you “opted out” of Medicare, your private health provider would have to cover the 75% MBS fee that they currently don’t. This would significantly increase the cost of PHI. If you allowed people to opt out of Medicare and they only had procedures covered by a “basic” phi policy, there would be a significant number of procedures that would be not covered at all. This type of thing would only work for those who were paying for a gold+ policy where everything Medicare covers is covered, and even then the price would probably be double (just a guess) what you’d pay for such a policy today.

  • TrumpisKing on 18/05/2022 - 08:12
    +1

    Wait until China takes over. You'll be lucky if you can even get Panadol 🤣🤣

    • GG57 on 18/05/2022 - 10:05
      +3

      It would be cheaper than Panadol is.

    • kaos on 18/05/2022 - 14:13

      well, in North Korea they get meth instead of hospital care.
      but they feel better, for a while…

  • Joey2scoops on 18/05/2022 - 08:33
    +8

    Lived and worked in the US for over 10 years. Many health insurance policies there have monthly premiums that would be equivalent to Medicare levies for an entire year and then you have to pay $6,000 out of your own pocket before you can claim.

    So, decouple public and private in Australia. But has to be a clean, cold turkey split. No government funding, no public ambulance. 100% funded by private patients.

    You and/or family will use the public system at some point. You never want to be in a position where you have to deny grandma's hip surgery because you can't afford it.

  • hogehoge51 on 18/05/2022 - 08:56
    +1

    We have a strange form of welfare in Australia where those who can pay twice, and those who can’t get it free. Those who are in between suck it up and pay too much or freeload.

    There should be a single system that incorporates public and private providers and public and private insurers. Pricing and accessibility should be common between both, outcome should be indistinguishable for those insured publicly or privately. Premiums should be means tested, based on income. Free below a certain threshold, and tax deductible at all levels. Moving public hospital funding to come via public insurance premiums should reduce tax rates.

    Private players are needed for demand driven capital allocation and innovation and general fairness in choice for consumers and practitioners.
    Public players are needed for access to large amounts of long term capital, stable employment of expertise and general fairness in accessibility for everyone in society.
    Unlike now, the strengths of each system should be used in a complimentary way.

    Nothing revolutionary about that plan, it is based on overseas experience.

  • saltypete on 18/05/2022 - 09:41
    +3

    No. Pre-medicare things were quite Shiite if you didn't have private. That's why they brought it in.

    The system got a bit screwed up by the grate Howard and could use a bit of a fix. A simple unravel of his dickering isn't enough unfortunately.

    Also needs some way of keeping the worried well out of Emergency. Apparently a nurse administered slap over the head is now considered 'assault'…..🙄

    I look at 'merica and so glad that is not our system.

    Bad idea…..

    • try2bhelpful on 18/05/2022 - 11:48
      -2

      There is a point about Emergency; which is why GP clinics attached to hospitals would be a good idea. My GP is business hours Monday to Friday. If something happens in a weekend we, tend, to go to emergency because it is close by. Also, sometimes it is difficult to get a “same day” appointment with a GP.

      The problem is you don’t know what is important until you get triaged. A couple of times my other half has been admitted when he decided to “just get things checked out” by visiting emergency. With a clinic they could hive off the “don’t need to be in emergency” people after the triage. Sitting in emergency is, certainly, an eye opener. You understand a lot of people aren’t very bright; including yourself.

  • kanad on 18/05/2022 - 11:52
    +7

    I worked in PHI industry many years back. One thing you may not realise is that unlike US here in Australia Private Health Insurance cannot discriminate you due to age or pre-existing condition or being a smoker or diabetic etc. Everyone pays the same premium for the same product. Also all insurers share a risk pool where all insurers contribute, so if say Medibank has much higher claim they can draw from the pool, in effect all insurers are linked in a way. It is highly regulated. In your model eventually PHI will become market based, they will start denying insurance to many, charge more premiums for the sick and in general premium will increase hugely.

    I would rather Government eliminate the PHI rebate and put that money to bring Dental into Medicare.

  • Vote for Pedro on 18/05/2022 - 12:15
    -1

    You do have an option. It’s called the USA. I see it works well for them.

  • Dack Smith on 18/05/2022 - 12:19
    -1

    Just like super is mandatory and kept from our usage in most instances by the ruling regime, the Medicare levy needs to be compulsory forever and subject to a percentage rise in line with CPI inflation.

    Unlike the privileged elite few on OzBargain, many have trouble paying bills and are struggling. They can’t afford 55K for a new car, nor can they afford a few thousand bucks to buy a GPU just for gaming or mining.

    The Medicare levy needs a drastic increase, and a new 4% hospital levy instituted to increase public hospital funding and deal with the current ramping and medical staffing crisis

    Society can’t afford to be selfish and greedy when everybody uses the public system for medical care but then refuses to pay to keep it running.

    That would be childish and dumb, Medicare and universal health doesn’t fund itself without money, costs rise, just like people in good jobs asking for pay rises.

  • RefusdClassification on 18/05/2022 - 12:20
    +4

    The UK (NHS) and Canada have the best health systems. No out of pocket costs to see doctors or specialist or for hospital visits. In Australia we have a bad public health system a good private system that all the powerful and affluent people use. The existence of of the private system is really holding the public system back and draining it of talent.

    Fully socialize medicine; no more 2 tier system. If politicians and CEOs had to use public hospitals, their quality would massively improve. Add dental care to socialized medicine (Medicare). In Qld the wait time for a checkup via the public system (free for health card holders) is 2 years for instance.

    • mdavant on 18/05/2022 - 13:11

      Except in our system the well off pay for their own system (private) and the system for others.

      Do you want then to pay more again?

      Sounds like strayamate

      • Ponsonby on 18/05/2022 - 14:42
        +1

        You are incorrect to say "the well off pay for their own system". - see discussion above - private health treatment is heavily subsidised by the taxpayer (and in more than one way) - private health insurance premiums would be very much higher if they covered all the costs.

        • mdavant on 18/05/2022 - 15:15

          Some problems

          1. You really aren't a high income earner if you get private health rebates.

          2. As an individual taxpayer you surely would cover your medical care in taxes over a lifetime.

          I know very well how hospital treatments are funded.

          • Ponsonby on 19/05/2022 - 11:42

            @mdavant: You say "As an individual taxpayer you surely would cover your medical care in taxes over a lifetime". As a life insurance customer, I paid all those premiums for decades and I am not dead yet - what a waste that was.

      • MessyG on 18/05/2022 - 17:50

        No they don't, private system still bills Medicare.

    • May4th on 18/05/2022 - 14:18
      +1

      NHS is a dumpster fire, you can tell by the number of UK trained doctors working in Australia.

    • dp1 on 18/05/2022 - 15:22

      The UK of the early 2000s was a lot better but there are several parts now where the waiting times are approaching a decade. The NHS functions as a rationing and access block system above all else, it's how they keep costs down. As a GP in Australia I can order a bone density test on Medicare within the week. NHS- I have to refer this to the local public hospital and the wait for this is TWO YEARS. Waits for most routine tests are measured in months and always have been. They put up with it because it's free not because it's good.
      I agree that when it was funded better it was up there with the best but now it's a barely functioning crisis service.

    • Hoolio on 19/05/2022 - 12:23

      I disagree, I think Australia has a good public system and a pretty good private system (for specific issues). We get very good outcomes compared to the money spent on healthcare which is one of the best metrics.

  • mdavant on 18/05/2022 - 13:10

    You have to pay.

    Otherwise people who don't pay won't be able to access it.

    Like almost everything, others need you to help them pay for it.

    • MessyG on 18/05/2022 - 17:51

      And one day, you will need that help too. Old age and infirmity is coming for us all whether you like it or not.

      • mdavant on 19/05/2022 - 06:07

        I am mainly talking about people who choose not to contribute to society as much as they could.

        I have no issues with paying for my own insurance.

        Don't worry about me. But thanks for caring.

  • johndoe789 on 18/05/2022 - 13:25
    +1

    If you get run over by a car and bleeding profusely, the last thing you want to hear from the ambos is:

    "medicare or private insurance? Can you show me your membership card?"

    • MessyG on 18/05/2022 - 17:52
      +1

      There's an American guy on Twitter who had a heart attack and the ambulance took him to the nearest hospital. Got charged hundreds of thousands of dollars afterward because while unconscious he failed to select an "in-network" doctor and the emergency department wasn't covered by that particular insurer. Terrifying.

      • mdavant on 19/05/2022 - 06:22
        +1

        There's an Australian guy who had sepsis and waited in ed for hours before seeing a doctor because people with stubbed toes and sore ears were clogging up the system.

        Free leads to inefficiencies too.

        • locknuts on 19/05/2022 - 11:58

          Copayment is the answer. Just $100 or so. In Japan I believe the government pays a portion of your healthcare up to around $6000 per year, then covers everything above that. That sounds like a better system.

          • mdavant on 19/05/2022 - 12:01

            @locknuts: Sounds good.

            Unfortunately the dependent many in our community would expect handouts to compensate them from the loss of their entitlement.

            • locknuts on 19/05/2022 - 12:29

              @mdavant: I think Tony Abbott tried a small copayment of $6.00. Labour demolished him, so you're right.

          • hogehoge51 on 19/05/2022 - 23:12

            @locknuts: Japan has a 30% co payment. Also covers dental.

            You may think 30% is high, but prices are also capped. In my experience you can almost always pay in loose coins, but you might need to break a note for dental work.

            Everything has a co payment, including hospital and emergency visits. Again, you might think it’s unfair to pay for emergency, but in my experience I didn’t mind paying after taking my son to the emergency room, as I was paying in small change, getting a prescription filled at the same time and leaving less than 30 mins after arriving.

            As you say if you spend mere than a threshold you can claim everything above that on tax. The threshold is lower than $6k from memory, and you can also get back things not covered by the insurance.

            There are some corner cases, long hospital stays can be very expensive upfront, and high income earners can pass a threshold where they are pay much more.

            You also pay very high premiums, but they are tax deductible. Public health insurance premiums are paid instead of income tax.

  • redslert on 18/05/2022 - 13:36
    +1

    You might not use it but how about your parents or your grand-parents?
    The system works because it is supported by people paying for those who otherwise cannot pay.

  • Miss B on 18/05/2022 - 14:20
    +2

    It would have to be opt out for life or people would just sign back up to Medicare when they're not working or need it for something with large out of pockets in private. Then they will just have to go without health cover. Except that's abhorrent and we wouldn't do it, because this isn't the US. So everyone else would just be subsidising these people.

    It's a terrible idea. They should scrap Private Health and put more into the public system to improve health care for everyone. There shouldn't be an opt out by paying money to a private business, even for the MLS. There shouldn't be rebates on private health insurance from the government, especially extras cover, but even hospital cover. If everyone has to use the public system, more people like politicians would be fighting to make it better.

  • banana365 on 18/05/2022 - 14:48
    +2

    If you think the private system offers anywhere near what the public system is capable of providing then you're deluded. The private system will, when the medical demands get too complex (AKA expensive), ship you off to the public system. Been there, done that, got the bills to show for it.

    Anyone who is willing to opt out of the public system must accept that they are cutting themselves off from the medical care that could well be what keeps them alive. Essentially, a lifelong "Do Not Resuscitate" order for people who think they're too good to pay for Medicare.

  • OzPandaGirl on 18/05/2022 - 15:08
    +2

    I have top private cover and it has paid for itself pretty much for the rest of my life.

    When I was diagnosed with early breast cancer in 2018 I chose to be a public patient and used my private health cover each time. The public hospitals, because they are teaching hospitals, have specialists who are involved with clinical trials and also have all of the expensive scanners etc that are not available in private hospitals. Using my private insurance meant that I would get a book of vouchers to cover my stay including a ticket for free parking each day (huge expense for visitors here), a voucher to use at the Cafe, free TV and wifi and a newspaper each day. Small things that can make a hospital stay more comfortable.

    The irony is that if I had gone private for my surgeries and chemo, I would possibly have been out of pocket thousands of dollars, something we couldn't have afforded. Anaesthetists are one of the biggest culprits for charging way above the scheduled fee.

    I have also in the past had all of the major surgery and everything in a public hospital (liver surgery) and then went to a private hospital to continue rehab to get well enough to be released. In this case, the private hospital was fully covered by my fund.

  • Real Bill Pullman on 18/05/2022 - 15:08
    +1

    There's no strong divide between the public and private system that would allow this. Private is great if you want choice of doctors and your own room, but complex cases are always going to be treated in a public hospital anyway because they have the scale to keep those facilities and practitioners around. Truly, exclusively, private healthcare would mean an entirely parallel system with no crossover and the cost would be phenomenal. Hugely more than the levy.

  • MrThing on 18/05/2022 - 15:32
    +1

    Private health insurance costs what it does because medicare exists. Medicare picks up in patient services to its limits then private cover takes over to fulfil the gap. If that medicare payment dissapears, private has to cover the shortfall so we pay more….or private has to cap what it pays so we lose again

    Make it optional and you'll break the system

  • seraphim2017 on 18/05/2022 - 15:49

    No.

    Excluding the fact you always pay to live in an enlightened society that can be measured by how it treats its most vulnerable (Yes, I know we do not do that well! But we still try).

    Also excluding the old chestnut about paying taxes generally "but I don't have kids, why pay taxes for childcare, schools etc. I don't take the train/drive, why pay. And even "smokers shouldn't be allowed to use health for respiratory because they do it to themselves, but then again, nanny state should ban a product that kills its users"

    Infrastructure costs money. Our politicians sadly pork barrel instead of acting in the public good, but if they were decent, that money would go to improving the ability of citizens to live their lives as freely as it is possible to do, in a society of mutual responsibility. Freedom without limits is just a word.

    If you can afford private healthcare, then you can afford the pittance that is the medicare costs in reality, you'd probably just waste it on Euro prestige cars!

    The NHS is funded through 11-12% of your income as national insurance. On every metric that matters other than cost, they provide the top 1 or 2 in treatment, they've just been deliberately undermined by the UK's equivalent of our Liberal National nuts, the Tories.

    No Doctor in Australia would leave you, Mr/Mrs "I am private" bleeding out in the ED when you have a massive accident that the private system can't deal with. That's just not how it works here, thankfully. In America, yes, they check your wallet before your pulse. Be glad you're not there.

    Also, if your premise really were a thing, then how much do you think your rpemium would be? premiums are realatively low as health insurers can get away with most of your costs still being covered by the system. Under your ide, private would be 100% funded, so your current few hundred $ a month would be several thousand. How much does a knee surgery cost? 8-12000? Plus the hospital, aftercare, you'd be looking at paying much more, who knows exactly, no one sane in health policy has done the math on it. 50-60k plus per knee, maybe more, if the state system didn't provide the infrastructure. And if it goes wrong? who pays for your ongoing treatment?

    (Apologies for grammar, starting sentences with conjunctions! I know technically it's fine, but it looks scruffy!)

  • Tzeeman on 18/05/2022 - 16:05

    One of the best things you can do is to use your private health insurance in a public hospital if you can. It helps out the public system

  • spurf on 18/05/2022 - 16:25

    Clearly the bulk of people opting out will be those that contribute the most, ie high earners. Kind of the reason why it is a percentage of your earnings and not a flat fee

  • trapper on 18/05/2022 - 16:56

    Good luck at that private hospital when you've been in a car accident.

  • DarkOz on 18/05/2022 - 17:01
    +3

    Our Medicare is the envy of most Americans. Keep it as it is and don’t ruin one of the few remaining good things in Australia.

    • try2bhelpful on 18/05/2022 - 17:14
      +1

      Even the LNP won't touch it. They shot their load with removing MediBank. You only had to see them go mental with the ALP "mediscare" before the last election.

      The interesting thing is that the NHS in the UK is thought of so highly they included a tribute to it in the their Olympic Games opener. (If you want to see something really hilarious there is a conspiracy theory that this tribute was foreshadowing Covid19).

      • DarkOz on 18/05/2022 - 17:29

        I remember a customer once told me that he fell ill while holidaying in the UK and ended up in hospital. After he was discharged from the hospital he was shocked to find that it’s free. He said that it could have been $30K but tourists are covered. So yeah that’s how good it is.

        • try2bhelpful on 18/05/2022 - 18:01
          +1

          Probably, not all tourists. We have a reciprocal agreement with a number of countries.

          https://www.servicesaustralia.gov.au/about-reciprocal-health…

          • DarkOz on 18/05/2022 - 18:16

            @try2bhelpful: Thanks for that! Now it makes sense. At least free for Australian tourists.

            • try2bhelpful on 20/05/2022 - 10:23

              @DarkOz: I’ve often thought “if I get sick in Europe what border should I cross to get reciprocal treatment”. It is good to know your options when travelling. First thing I do when heading to America is buy unlimited health insurance cover.

      • MessyG on 18/05/2022 - 17:54

        They've been quietly cancelling item numbers and removing things from the PBS over the last decade. They froze the Medicare rebate to GP practices in 2014 and it hasn't changed. That rebate covers practice costs and wages of staff including GPs. They're absolutely about killing it until it's nonfunctional, then advocating to shift people to privately owned corporations to run health while claiming Medicare has 'failed'.

        • try2bhelpful on 18/05/2022 - 18:02

          Yup, they are willing to starve it because they don't agree with it. Sods.

  • Narull on 18/05/2022 - 17:15
    +2

    As someone who has gone through a bunch of surgeries from bowel cancer and is still on the list for more, I got bored one day in hospital and decided to do some googling, if I was in the US I'd be either dead or well over $200k in debt by now, instead it's just cost me parking/travel and some meds (boy hospital parking is crazy, but that's another thing).

    Thank you to every single person who has paid the Medicare levy (ie everyone), my diagnoses came out of left field for me, was never expected and doctors/surgeons keep saying "but you're so young" and how it doesn't normally happen to people in their 30's BUT IT CAN and that's the main point I feel some forget.

    I'd much rather pay Medicare for the simple piece of mind of knowing myself and my friends are covered in most ways just in case something bad happens rather then have to worry about if someone breaks a leg or gets sick or worse if they would be able to afford to even go to hospital.

    Anyone who thinks the US's system is better or that 'who cares about the masses I pay my private health' are clearly selfish people who don't give a damn about others.

  • Blargman2001 on 18/05/2022 - 17:35

    Why would you only want private cover? Take for example a visit to the ED under your new scheme. If we shift the workload from public to private, demand for private ED's will go up because those with private cover will have no choice but to present to a private ED. In addition to a couple of hundred dollars out of pocket expense you'll now need to wait maybe just as long as a public ED (remember even if their caseload is lighter most private hospitals have a lot less beds than public ones so they can't treat as many people at once). Many 'private' procedures are actually partially rebated by the public system, so losing that rebate means the cost of your private procedures will increase, sometimes by thousands of dollars. Net result for the private patient is maybe you'll get slightly better care but you'll pay a lot more for it.

    On the other side the public system losing all of the privately covered people will then drive up their cost as well. The public system will then have to start slashing budgets and compromising on care. This will just break their system and we will end up paying through the nose just like the Americans do for crappier results. The systems is a lot more complex than you think it is and separating the two just increases cost for everyone.

    • illogicalerror on 19/05/2022 - 10:48

      Private companies require that they make an ever increasing profit as well. Money from everyone straight to the rich, even before healthcare is considered.

  • Danta on 18/05/2022 - 17:50
    +4

    As a doctor working in a public hospital as a junior surgeon I believe I can provide good perspective on this.

    The private health system is excellent for some conditions and provides and important service at offloading the public system.

    What I would say though is for patients of high acuity who are actually unwell the private system just isn’t set up in a way to be able to cope with them and provide the best care. If I was ever truely sick and unwell (I mean in a severe life threatening way) there is no way I’d want to be in a private hospital.

    Moving anyone to private only just wouldn’t work.

    • Blargman2001 on 18/05/2022 - 17:53

      Someone I know who worked in the private systems always complained their equipment was ancient. Public system is where all the swanky new gadgets are at.

      • star-ggg on 19/05/2022 - 12:31

        This is interesting as normally in ppl's minds- private is always going to be better because you're paying extra right? But it's not necessarily the case because ultimately the aim of private is to maximise profit margin. A public system that is well funded and managed is going pursue an aim of maximising quality of care. I think the medicare levy is such a bargain price to pay so that we can have the latter.

    • Hoolio on 19/05/2022 - 12:18
      +2

      Also a training doctor, totally agree Danta.

      The public and private system are not equivalent. 'Simple' patients (e.g. simple uncomplicated pneumonia, elective knee replacement etc.) do well in the private system. Some patients however present with acuity or complexity that requires the public system which is more robust in some metrics.

      I'll give two specific examples for the OP
      1. If you are in a private hospital for some unrelated issue and develop an acute organ failure (e.g. kidney or liver failure) and need an organ transplant to survive, only the public system is able to provide this service as it currently stands due to complexity and availability of the many teams involved. So in theory you may have to pay for this life-saving measure out of pocket if you hadn't opted for Medicare. The bill would probably be a few million dollars (guesstimate).
      2. If you develop acute symptoms of a stroke you may be eligible for a clot retrieval procedure (relatively new intervention). In Victoria this is only possible in two public hospitals which service the entire state. There is currently no mechanism to provide this in the private system.

      Of course you can modify the entire system to make private more viable but it would require tectonic shifts in many aspects of the healthcare system which would probably take decades and be incredibly complex. And I'm not sure if the end result would provide the same or better outcomes per dollar spent on healthcare.

  • loropy9 on 18/05/2022 - 19:10
    +1

    Yes. Please turn the Australian health system into an American one. What can possibly go wrong?

  • Freestyle on 18/05/2022 - 22:14

    This isnt Murica, country of the survival of the fittest, if these are your views go to that country

  • RatBargain on 18/05/2022 - 22:38
    -1

    I pay for basic hospital to avoid MLS

    It works out cheaper but I never use it.

    I would rather the premium go to Medicare entirely to improve public healthcare

  • AnophthalmiaCervidae on 19/05/2022 - 08:50

    After I opt out of Medicare can I opt out of Income Tax too?

    I don't qualify for any Government Benefits and I think I could obtain the services the Government provides to me personally Privately for much cheaper.

  • mroarsome on 19/05/2022 - 09:17

    If you don't like Medicare in Australia, maybe you should move to USA, the private health care they have is working really well….

  • [Deactivated] on 19/05/2022 - 09:37
    +1

    The private system doesn’t actually do most treatments etc. Because the public system is so cheap/efficient there’s no profit margin in them, the private system is setup to do things the public system doesn’t do perfectly, eg elective surgery.

    The question might as well be, should we all, including people who opt out, pay more for less.

    • [Deactivated] on 19/05/2022 - 10:56

      Also worth noting, you would need to add another 0 to the figure for private health only cover, just the federal government spends more than that per person on average, excluding co-payments, private health insurance etc. Your private only health insurance system would start in the $10-20k range per person before profits started to be added.

      Top this off with the fact you’re likely to get worse treatment in this new private system and heavy additional out of pocket expenses…

  • Rockets84 on 19/05/2022 - 10:24

    No for the opt out. There are some things that you can't get done through a fully private system. I live in WA and was diagnosed with a brain tumour. There's only one hospital here that will do the removal surgery and it's a public hospital. The tumour was removed a week after it was found and I had zero complaints about the health care I got from the public system. I went in as a private patient just so I had my own room but it didn't give me any other benefits.

  • illogicalerror on 19/05/2022 - 10:44
    +1

    Look at how great the medical system in the US is. Any serious illness that isn't covered by your overly expensive insurance will cost you your life savings and house or life.

    At least with Medicare the money is being spent on healthcare, not paying billions in dividends to insurance company shareholders.

  • zombrex on 19/05/2022 - 10:47
    +1

    I called an ambulance yesterday morning at 6.55 AM and no ambulance could come at all. They asked me to drive the patient to ED.
    We then went to the hospital and could not get a bed for the family member. The doctors agreed they needed a bed asap. Only beds would be available in the private sector at a very significant cost.

    The system is totally broken. We should be able to take all our money private if we choose. Would create more incentives for the public sector to improve. Captive market = poor service. Anyone who works in health can tell you that red tape, double handling and poor management are all causing problems. That's before the problem of recruiting and retaining staff.

  • lonewolf on 19/05/2022 - 11:25

    umm, Having both, Private health does crap all. It possibly gives back a little on hospital stays and surgeries or procedures. But at the end of the day you still need Medicare to cover a lot of stuff. And from my experience Private health just seems to be getting worse and giving back less but increasing prices to pay all their exorbitant admin staff / CEOs… It sounds like just another scam by the government to funnel money from the population to the private sector. Hence why more and more people are dropping out of any Private Health cover and deciding to just put some money aside incase they need it one day for health cover.

    If all the private health money is taken and put directly into Medicare, we would have a much better system right now, Medicare may not be perfect but it definitely gives back a lot more than Private health does.

  • locknuts on 19/05/2022 - 11:56
    +2

    The result of this poll depress me. Medicare is probably the best government run system in the world, but the whole system is fundamentally immoral. We need to drastically reduce income taxes and fund the system with taxes on things which aren't essential.

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