Health Inusrance

[FSM]

Originally Posted by BlueDevil

Knowing how slow things can be in the public system for non-urgent hospital treatment I wouldn't want to be without health insurance.

(my emphasis)
So you'd rather pay for potential to get possibly faster still non-urgent treatment?

Unless you are going for a triple bypass with quadruple tuck, many non-urgent operations aren't that expensive. And if you want fast, go private and pay the cost. It very often works out cheaper than being on high cost private health plan for your average healthy Joe.
It's any lengthy hospital stay that really costs the money.
So as long as you have basic hospital cover (which lowers your medicare levy, and you can actually pay less).
Your average healthy Joe has little need for a top shelf private health cover.

Dave.

[BlueDevil]

Originally Posted by FSM

(my emphasis)
So you'd rather pay for potential to get possibly faster still non-urgent treatment?

Unless you are going for a triple bypass with quadruple tuck, many non-urgent operations aren't that expensive. And if you want fast, go private and pay the cost. It very often works out cheaper than being on high cost private health plan for your average healthy Joe.
It's any lengthy hospital stay that really costs the money.
So as long as you have basic hospital cover (which lowers your medicare levy, and you can actually pay less).
Your average healthy Joe has little need for a top shelf private health cover.

Dave.

As an example you can wait years for a hip replacement in the public system. I know a guy in his late forties who was in agony with both hips to the point where he really couldn't work. It took around 2 years for him to get his surgery.

A hip replacement isn't cheap (particularly if you need both). There are many people who simply couldn't find that sort of money.

I can afford to pay private insurance, but I reckon I would really struggle to cover the cost of a double hip replacement if I had to find the cash. Even with private insurance I would expect to be a few thousand dollars out of pocket. But even a simpler procedure could set you back a few thousand if you were paying cash without insurance.

There is in effect a double advantage of me having private insurance. If I needed a hip replacement I can get it done reasonably quickly in the private system. And by me choosing to go private it means one less person in the public system, which then means that those who can't afford insurance won't have me in the queue in front of them.

[Sieveboy]

Originally Posted by BlueDevil

As an example you can wait years for a hip replacement in the public system. I know a guy in his late forties who was in agony with both hips to the point where he really couldn't work. It took around 2 years for him to get his surgery.

A hip replacement isn't cheap (particularly if you need both). There are many people who simply couldn't find that sort of money.

I can afford to pay private insurance, but I reckon I would really struggle to cover the cost of a double hip replacement if I had to find the cash. Even with private insurance I would expect to be a few thousand dollars out of pocket. But even a simpler procedure could set you back a few thousand if you were paying cash without insurance.

There is in effect a double advantage of me having private insurance. If I needed a hip replacement I can get it done reasonably quickly in the private system. And by me choosing to go private it means one less person in the public system, which then means that those who can't afford insurance won't have me in the queue in front of them.

BD is correct treatment in private hospitals is awesomely expensive. (Twin hips would cost $25k or more, before you pay the treating orthopaedic surgeon and you need to stump that much money up front). Plus one thing BD didn't mention is you have full choice of treating doctor, something you don't always get in the public system.

[Aldaron]

Plus one thing BD didn't mention is you have full choice of treating doctor, something you don't always get in the public system.

This one's always been the kicker for me. How does one choose one's doctor? What criteria does one use? Can you access his records on post-operative infection rates, on returns to theatre for dodgily inserted prostheses, on how many times he's been sued for malpractice and how many times he's been convicted over it?

And far, far more importantly, you may be able to choose your surgeon, but you don't get to choose your anaesthetist. It's whomever works with your surgeon.

I don't care about the surgeon; it's the anaesthetist I'm interested in. He's the one keeping you alive and brain-damage-free while some other idiot does his best to kill you.

Between us, my wife and I have over 40 years experience working in both public and private hospitals, mainly in operating theatres (me) and maternity (she). Neither of us have private health insurance - and I wouldn't go to a private hospital for surgery if my life depended on it. Too many corners cut to save money. To many single-use items reused. Too much of "shove 'em out the door so we can get the next one in". Too much of employing less-trained staff because they're cheaper.

[I_FH]

I had an injury that saw me shipped to the nearest ED and patched up by the public system. I later leant that the job was done by a surgical intern. While I know it's important to get hands on experience, the job wasn't entirely satisfactory and the scar left quite obvious.
When the time came for a follow-up I chose my surgeon bases on his reputation and a recommendation from my GP. I was much happier with my time in hospital, a private room is a nice bonus, and a much smaller scar as he told me he would tidy it up.
All covered by my insurance including my rehab. If you can afford it I highly recommend using the private system.

[Aldaron]

If you can afford it I highly recommend using the private system

I don't.

What you see in a private hospital is nice private rooms, nice carpet, nice food and (maybe) a smaller scar.

What you get, in the "behind the scenes" area, is shoddy standards, cost-cutting, unqualified (cheaper) staff, higher infection rates, higher rates of return to theatre, and shoved out the door before you really should be in order to free up the bed for the next money-bag (ie: patient).

One of the things that we used to love (sarcastically speaking) was getting hip- and knee-replacement patients from private hospitals with severe infections they'd picked up from their surgery. They'd be shipped over to the public hospital to have prostheses removed and antibiotic packs inserted before having to have repeat surgery afterwards (assuming they survived, of course).

Private hospitals are very good at keeping their morbidity stats low by shipping their failures over to public hospitals.

It's a bit like private/public schools and failing students...

[Aldaron]

I later leant that the job was done by a surgical intern. While I know it's important to get hands on experience, the job wasn't entirely satisfactory and the scar left quite obvious.

Incidentally, if it was a quick "sew" in casualty, then yeah, it may have been an intern (though under the supervision of a resident). If, however, it was a surgical procedure then there is no way in hell it was done by an intern. It would have been performed by the surgical registrar, who is not a kid straight out of medical school - it is someone training to become a consultant specialist, and who usually has at least 5 years of experience as a resident before becoming a registrar, and may well have many years working as the registrar, to boot.

[I_FH]

Bad bone break. It was a junior surgeon (may have used wrong term) who inserted the plate under supervision. There was an issue with the screws rubbing where they shouldn't and whoever stapled me back together did a lousy job.
ADD:
I'd still pick private, regardless of your bad experiences. When I wanted the plate out, non-essential surgery, it took less than a fortnight from first consult to recovery. Try find that in the public sector.

[Sieveboy]

Aldaron, I work in private hospitals, so I also see the back of the hospital and a couple of things i need to point out that involve my experience at a public hospital:

I was admitted for suspected appendicitis, I spent the first night in a store room. Much of the equipment in my ward was over 15 years old and in some cases was not fully functional (like my IV drip, it rolled about worse than a shopping trolley).

My wife was treated for appendicitis, after surgery she was given a pain relief by injection, the nurse gave the injection without alcohol swabbing to sterilise the skin and did not wear gloves (I was truly astonished at that).

Finally, when Spawn of Sievegirl broke her arm she received treatment in the ED, the treating nurse (an EN) was an agency nurse (one of several in that wing of the ED). Agency nurses can be awesome or they can be shit. The thing is the hospital use agency staff because they are short staffed, their rosters can't be filled by employed staff who suit the hospitals standards, therefore, the quality of care could be compromised as many agency nurses get a single quick interview then they are working.

Finally, your quip about not dealing with their own infections is a bit unfair if the private hospital does not have a HDU or ICU.

PS, my mum, who recently retired from teching theatre nurses tells me that I should avoid most public hospitals in NSW like the plague because they are shit.

[Aldaron]

Then we'll have to agree to disagree.

My experience - nearly all of it in operating theatres at four major Sydney public hospitals and three major private hospitals in Sydney and Victoria - tells me to avoid private hospitals like the plague.

Public hospitals often have older equipment, yes, but in my experience it is better cared for and the staff - which are the weakest link - are both more experienced and better trained, and have the appropriate qualifications for the area

For example: I think only nurses should be cleaning the theatres down after a surgical list each day. Sure, PCAs/cleaners can come in afterward and polish the floors, etc, but the theatre itself should be terminally cleaned from top-to-bottom by nursing staff. PCAs/cleaners cannot be expected to have the training and/or experience with aseptic techniques, bacteriology/epidemiology and the like which is part-and-parcel of a theatre nurse's training.

Two of the three private hospitals I worked in didn't run with this - because they wanted to shift the nursing staff out of theatre as soon as the list was finished and send them to relieve the day-stay staff. Meanwhile, the theatres were cleaned by the cleaning staff.