Elective surgery versus Private Health Cover

I'm curious about free elective surgery compared with private cover. You've probably heard the scenario of a man has a heart attack, is uninsured, he gets operated by the top heart man and it costs him nothing. Another man with private health insurance has a heart attack, gets operated on by the same man and has to mortgate his house to pay the gap. Is there anyone out there who has been on the waiting list and had a positive outcome. In other words, is our health system as crappy as we think it is.

Elective Surgery

Elective surgery is typically surgery that can be delayed for at least 24 hours. Patients are placed on a waiting list. More than 556,000 admissions in 2006-07 were for elective surgery from waiting list. For elective surgery specialists assess the clinical urgency of their patient’s condition and categorise it as one of three levels.

Category 1 Admission within 30 days desirable for a condition that has the potential to deteriorate quickly to the point that it may become an emergency.

Category 2 Admission within 90 days desirable for a condition causing some pain, dysfunction or disability but which is not likely to deteriorate quickly or become an emergency.

Category 3 Admission at some time in the future acceptable for a condition causing minimal or no pain, dysfunction or disability, which is unlikely to deteriorate quickly and which does not have the potential to become an emergency.

Other Surgery

Other procedures are not normally assigned an urgency category, for example, admissions for childbirth that results in caesarean surgery, or a newborn baby that requires surgery.



http://www.health.gov.au/internet/main/publishing.nsf/Content/E6CAF670D550F646CA25747700074A51/$File/Our%20surgery.pdf

7 comments

IMO Toot private cover really just gets you in the door quicker--but once you get there it costs fortune--

I was looking at those figures - 556,000 people had operations for free in 2006/2007. That's a lot of people who didn't have to pay a cent, as long as they were prepared to wait. I wonder if they were happy with the outcome.

I have been a public patient --and (crosses fingers) I haven't had to have anything "urgent" I did have to wait but was very happy in the end--had a good Dr--and was treated well--even though it was only a Colonoscopy- I do think that being in the fund just allows you to get in quicker--

Good to know there is at least one happy patient PB. My brother in law who lived in Batemans Bay had a heart attack and was rushed by ambulance to Canberra hospital, he got first class treatment for nothing and had the top heart surgeon all for nix. I have a daughter in the top health fund going into a private hospital to have a baby in September and the gap will be around $3,000 to $5,000. She's having an epidural and had to pay up front last week for it - another $1,000. It makes me wonder what's going on in the Private health industry.

Yes Toot if you are admitted via the emergency you get seen to rather quick--however if you aren't, there is a huge waiting time--like I said the private cover only gets you in the door quick--ie for elective--God knows they they would call it that when you may be in dreadful pain and need a new hip etc etc--I have a friend at the moment waiting for "urgent" heart surgery and he has to wait many more months and could very well die b4 he gets in

I wonder about these people in lots of pain PB, why wouldn't their doctor put them on the Category 1 list above. Maybe it's the doctor's fault. They have the choice of putting you on Category 1, 2 or 3, if you are 3, you're in big trouble.

Yes Toot I guess it all about the wating times and the dreadful mess the health system is in--not very nice when you are waiting with a time bomb waiting to go off

7 comments



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