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What happens for people who can't afford it? (cancer spin off)


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#26 qak

Posted 16 August 2012 - 10:06 AM

QUOTE (Wishing2011 @ 16/08/2012, 09:29 AM) <{POST_SNAPBACK}>
Oh sorry in that case yes i agree. I certainly couldn't afford that? Would income protection insurance come into place here maybe?


Probably not, but trauma insurance would.

#27 Bluenomi

Posted 16 August 2012 - 10:08 AM

QUOTE (Jenflea @ 16/08/2012, 09:01 AM) <{POST_SNAPBACK}>
What's the pint of PHI if nothing's covered????


Because there are plenty of other reasons to have it. Painful but not life threatening conditions have huge public waiting lists so I'd want to use my PHI for those. I'd rather go private for maternity than public. I get dental coverage with PHI, that's not covered under Medicare. The list goes on

#28 Herebedragons

Posted 16 August 2012 - 10:14 AM

Deleted

Edited by Willoughby Chase, 30 December 2012 - 10:46 PM.


#29 Holidayromp

Posted 16 August 2012 - 10:19 AM

QUOTE (mtilly @ 16/08/2012, 08:51 AM) <{POST_SNAPBACK}>
Not arguing whether private would be better,  saddened that even WITH private insurance you'd still be out of pocket $10,000 or so. Many people with PHI could not afford the extra out of pocket cost sad.gif


That is why private is a waste of money the cons far outweigh the small benefit of having it.

#30 Holidayromp

Posted 16 August 2012 - 10:23 AM

QUOTE (Bluenomi @ 16/08/2012, 10:08 AM) <{POST_SNAPBACK}>
Because there are plenty of other reasons to have it. Painful but not life threatening conditions have huge public waiting lists so I'd want to use my PHI for those. I'd rather go private for maternity than public. I get dental coverage with PHI, that's not covered under Medicare. The list goes on


I would like to know where the huge waiting lists are.  I did my knee (again) it was operated on within a few weeks.  I had a ct scan, mri and x-rays within days of the accident and am on an extensive physiotherapy programme.  I cannot fault the care I have had and has been the same as what I got on PHI so why would I have it?

#31 Boombox

Posted 16 August 2012 - 10:29 AM

louise81 I'm sorry to hear your husbands scary time with the cancer diagnosis, and I wish him a very speedy recovery!

I wonder did the surgeon give you an estimate of the wait time for the same procedure in a public hospital? My understanding is it usually isn't long, unless you're in a rural area with sadly decreased services.

#32 Gambit la Feralé

Posted 16 August 2012 - 10:31 AM

QUOTE (Holidayromp @ 16/08/2012, 10:23 AM) <{POST_SNAPBACK}>
I would like to know where the huge waiting lists are.  I did my knee (again) it was operated on within a few weeks.  I had a ct scan, mri and x-rays within days of the accident and am on an extensive physiotherapy programme.  I cannot fault the care I have had and has been the same as what I got on PHI so why would I have it?


Just an example of waiting lists at some hospitals in Qld -

an elective total knee replacement - up to 4 years in some places
an elective total hip replacement - up to 3 years in some places
a repair of a knee tendon (ACL) - up to 2-3 years
an elective shoulder repair - up to 2 years
an elective shoulder replacement up to 2 years

obviously if there is serious risk to life or limb then things get done quicker (eg infection) however having painful osteoarthritis that results in you walking with a stick or possibly even in a wheel chair is NOT considered by many hospitals as serious enough to "bump" you up the list and so you wait.

if however you have access to private health insurance, these surgeries can be done within months (sometimes weeks). So in that instance PHI is something that can significantly improve your quality of life.

#33 AmyP

Posted 16 August 2012 - 10:34 AM

My mum has just been through treatment for breast cancer - and she went private.  Had she gone public she would have gone on a waiting list for chemo in her area (country vic).  Waiting list!!  With private she was able to choose her surgeon, get a quick diganosis and prognosis and then get surgery done quickly.  Her ongoing treatment was managed by a team and she was given a full range of treament options.  The out-of-pocket costs seemed high initially, but she hit the medicare threshold very quickly and the costs were minimised after that.  Her treatment (not the surgery) did not go over $2000.  If I had to do the same I would certainly go private.  There was no waiting list, why should anyone have to wait to have chemo if they have been diagnosed with cancer?

#34 Maple Leaf

Posted 16 August 2012 - 10:34 AM

When my dad was diganosed with renal cancer, he was given a few days to live (9cm tumour was ripping apart his kidney and he was bleeding like a stuck pig in extreme pain) and he needed the kidney removed immediately.

The public hospital couldn't do it quickly enough and told him to wait a month for the surgery! They had a huge waiting list and they said there were people in worse shape than him! My god, I couldn't imagine it...! In actual fact they had written him off as his scans looked terrible so I think it was a case of "he's a lost cause so don't bother to operate".
I don't give up that easily, so I made a few calls and found a wonderful surgeon that could take him right away. (Thank you dr. burke!)

the private system quickly transferred him to Brisbane and operated within 3 days and saved his life. When he was transferred into the hospital my mother had to produce her credit card to pay about $8k right when he walked into the door. No money, no bed. Fair enough.

He had no PHI (was classed as self-insured) but the entire thing cost around $14k which we feel is a bargain. My parents had a separate bank account set up for their medical expenses and had a lot of money saved up in it, and that is where the payment came from so it wasn't a problem (they now have PHI in case another drama happens).

The surgeon charged him around $2500, the anaesthetist was about $1800 and the rest was the hospital stay of 4 nights, 5 days. Well worth it and I don't feel the surgeons cost was over the top for a nephrectomy at all, we were surprised at the cost as we expected it to be a lot more.

QUOTE
That is why private is a waste of money the cons far outweigh the small benefit of having it.


For our family, not having access to a private hospital and surgeon would have meant my dad would have died, so for us, the private system benefit really outweighed public! His scans didn't look great, but in actual fact the tumour was fully encased in the kidney and he is now cancer free and it's been a year of clear scans. Which wouldn't have been known unless he was operated on. Exactly what the public hospital didn't want to do quickly. Waiting would have killed him as the cancer would have spread outside of the kidney. Or he would have bled to death I suppose! Having access to a private hospital gives you choice, and for us that is worth it.

There wasn't a need for chemo or radiation so I can't comment on that side of it with costs etc... But the real expense for my dad was the hospital stay, not the doctors fees at all.

Edited by Maple Leaf, 16 August 2012 - 10:40 AM.


#35 gasgirl

Posted 16 August 2012 - 10:35 AM

OP i think your questions should be directed towards the PHI companies and the government not the doctors.
Doctors set their fees based on the level of skill and training required to perform a procedure, their huge medical indemnity costs (due to increasingly litigious world) and the expense of running a private practice, secretaries, practice nurses, real-estate,, continuing education to stay at the top of a field etc (every time a specialist takes several days off work to attend a conference so that he/she can stay cutting edge for patient care they lose several days of income). The actual hours spent on an operation is not necessarily related to its technical difficulty.
The numbers you quote as "profit" are nowhere close to what that doctor takes home.
It is the Government through medicare and PHI who should be justifying why they refuse to pay a rebate anywhere close to where it should be, that is why your gap is large not because doctors are greedy.
Similarly i think you are incorrect in assuming doctors like to financially gouge cancer pts, every person coming for surgery (except cosmetic) has some kind of painful or life threatening issue or they wouldn't be there. Where should the line be drawn?
We have excellent public hospitals in Aust where you will receive world class care, but yes you will wait your turn with all the others as resources are stretched. Its not entirely free as don't forget you are paying a large medicare levy each year to fund it.
And yes i am a specialist doctor so I know what I am talking about.
All the best with yours or your loved ones cancer surgery.

#36 babyinabackpack

Posted 16 August 2012 - 10:36 AM

We went 100% through the public system for dad and I couldn't fault them at all. They were always available in emergencies and we were even able to claim travel expenses to and from visits due to living a fair distance away.
To be honest, there was not a single time when we would have even questioned going private. The doctors, nurses, staff, everyone was amazing and even when he was put on Tarceva (a notoriously expensive drug) it was covered by the PBS and was really reasonable at about $25 (if i remember correctly.)
I highly recommend the RBH Oncology department.

They even sent flowers and made a donation to the Cancer research Foundation on dad's behalf after his passing.

ETA the only expenses we were out of pocket for were his medicines which didn't cost much at all, and parking at the hospital.

Edited by babyinabackpack, 16 August 2012 - 10:38 AM.


#37 Fright bat

Posted 16 August 2012 - 10:47 AM

Public cancer care in this country is exceptional. What patients don't see is that in public, every major case is discussed by a multidisciplinary team of surgeons, oncologists, radiotherapists, pathologists etc to make sure a comprehensive treatment plan is decided upon from the outset. In private, you are treated at the independent whim of one or two people. That's not to say their treatment isn't correct... But personally? For anything more than a skin cancer I would ask to be seen publicly.

Cancers also rarely progress as fast as people worry. A month is rarely the difference between life and death. In fact, a month of planning (which is actually what is happening while you 'wait' is far better than rapid, single opinion treatment, in my opinion.

And surgeons CAN justify $10k for surgery (which also includes ALL postop care) because you don't have to go private! It's your choice to do so, when an exceptionally good, world class public system exists.


#38 Crap Napper

Posted 16 August 2012 - 10:48 AM

QUOTE (Holidayromp @ 16/08/2012, 10:23 AM) <{POST_SNAPBACK}>
I would like to know where the huge waiting lists are.  I did my knee (again) it was operated on within a few weeks.  I had a ct scan, mri and x-rays within days of the accident and am on an extensive physiotherapy programme.  I cannot fault the care I have had and has been the same as what I got on PHI so why would I have it?


We are in Melbourne, and my DH has been on a public hospital waiting list for nearly 3 years to have a nose reconstruction due to a sports accident that left him with a collapsed septum. He is unable to breathe through his nose, and cannot wear his glasses due to pain. We do have PHI, but the out of pocket cost was going to be $6-8,000. He also had sports insurance cover through his sport club, but apparently that does not cover you for anything much beyond imaging - they are not allowed to cover out of pocket or gap payments, so really, it is next to useless.

My mum had a short illness from which she died, and she was treated in the private system. The medical bills were astronomical, but lots of her doctors kindly negotiated their fees with Dad to help out. What was incredible, however, was the care our family received from her nursing staff - they truly went above and beyond, and because we transferred her from the public to the private system during her illness, I can safely say that in this case, the private hospital really excelled in the pastoral care department.

#39 Holidayromp

Posted 16 August 2012 - 10:56 AM

I stand corrected  blush.gif  but I live on the mid north coast and the health care here is fantastic.  We have access to all levels of care that appear to be non-existant in major cities.  They talk about lack of services in smaller areas but I honestly think it is the other way round.

#40 Allymeg69

Posted 16 August 2012 - 11:07 AM

QUOTE (MsN @ 16/08/2012, 10:17 AM) <{POST_SNAPBACK}>
For anything more than a skin cancer I would ask to be seen publicly.


That depends on what sort of "skin cancer" you are talking about! I had a mole removed last year, it was skin cancer but of the worst kind, invasive malignant melanoma. I had all my initial treatment privately, I have no idea how long it would have taken in the public system to access the surgeons I needed for the procedures that had to be done, but I know private was extremely quick and that gave me peace of mind. Due to the arrangements my surgeons had with the private hospital, I didn't see a cent of medical bills except for some small gap payments for the anaethetists.

When my cancer recurred earlier this year, my local oncologist got me straight onto a major cancer care centre interstate, and I am now in that public system, receiving excellent care and at no cost to me, so I acknowledge the benefit of that wonderfui level of care we do have. However if I had to have more surgical procedures quickly here in Darwin I would definitely be using my private cover again for anything that could be done in the private hospital.


#41 BentoBaby

Posted 16 August 2012 - 11:48 AM

QUOTE (rosiebird @ 16/08/2012, 09:20 AM) <{POST_SNAPBACK}>
$10 000 doesn't go to one doctor as profit FFS!!! Sensationalistic nonsense. If you choose not to go through our publically finded health care system, you will need to pay for the use of theatre equipment (sterilizing or replacement), drugs, histopathology and point of care testing, cleaners, scrub nurse, nurse assistants, technicians, anaesthetist, anaesthetic nurse, surgical assistants, time in recovery etc etc etc


Rosiebird these costs come almost entirely from your private health fund. The $10,000 goes exclusively to the specialist & their assistant.

For example, my Dads prostate cancer surgery in a private hospital cost their PHI tens on thousands of dollars. This went on theatre, nurses, recovery, medications, anaethesist & surgeons fees. They were then ALSO out of pocket around $7000 for the surgeon & assistant (2-3ges work) & around $1500 for the anaethesist. Both drs also recieved their Medicare payment & extra from PHI. I'm sorry, but I don't think it is sensationalist to say that they are charging huge fees. In other parts of the country the out of pocket costs would be in the hundreds. The Sydney specialist are earning extra by around $7000!!! I do not think that being a Sydney specialist makes you entitled to charge 1000+% more! I think THAT is morally wrong.

#42 MrsLexiK

Posted 16 August 2012 - 12:14 PM

I haven't gotten though all the pages (I know it is only 5 pages I will get back to it on my real lunch break)

QUOTE (mtilly @ 16/08/2012, 08:24 AM) <{POST_SNAPBACK}>
I've just been reading in recent topics the out of pocket costs for treatment & surgery related to cancer. We are not currently affected by cancer but it still has me wondering what happens for everyone who can't afford these huge costs?

We have PHI but wouldn't be able to afford hundreds of dollars a week for chemo or $10,000 out of pocket for surgery!! What happens then? Is there no public availability? Is your chane of survival lower because you don't get the best/fastest treatment? How can Drs justify charging someone with cancer $10,000 ABOVE what Medicare PLUS their private health insurance costs for ONE surgery (that surely doesn't take more than a few hours??) That just seems so unethical, I don't think I could live with myself if I did that to a family who was suffering. It would mean they are earning $15-20,000 per survey PLUS all their consultation costs.


I have insurance to cover critical illness, if I deemed it worthy to go private I would use this insurance money to pay the bills, if not and I would go

QUOTE (Wishing2011 @ 16/08/2012, 08:48 AM) <{POST_SNAPBACK}>
Private 100% ! you can choose your surgeon and get seen to and have treatment vert quickly! That's why I pay for health insurance and it's one thing I would not want to mess with.


For something non urgent - yes you are correct.  For urgent things (such as cancer surgery) not correct.  My aunty could not get in to get a particular test done and see her doctor for close to 12 weeks, the person doing the booking mentioned she should go public - the wait was 3 weeks for the test and the appt would be arranged for a couple days after the test was done.  She had cervical cancer, she has had 3 lots of treatment eveytime they find another spot where it has spread.  However if she had to of waited the 12 weeks to get the test done in the first place she probably wouldn't of been lucky to get that first treatment.  

My uncle did not have insurance, he had the most wonderful care in both QLD and VIC from the public system.  

Based on the above and my knowledge of the industry I would be going public in a heartbeat.  What I would probably do is choose a dr who works privately and publically, and go through the public hospital, this was explained to me that the dr can then charge the health fund but there is no out of pocket expenses (not sure if my understanding is the truth or not) You do run the risk of being pushed back if someone more serious comes in but we are talking cancer surgery which is quit high on the priority list.

#43 louise81

Posted 16 August 2012 - 12:16 PM

I should of stated my husband has now been in remission for 5 years.

Umm from memory I think the Dr said it would of been around 3-6 month wait to see a Dr in the public system but then up to 18 months for the surgery. Apparently if I remeber correctly they said they new it was cancerous but it wasn't till they got in and did the testing that they knew what type it was. It was the worst type that you could get. Oh we live in Sydney.

I guess lucky for my husband he found it pretty quickly. We could of gone public yes but, to us when we found out that it was the worst type you could get every $ we spent was worth being seen and operated on so quickly.

#44 darcswan

Posted 16 August 2012 - 01:07 PM

$10,000 to potentially save or extend the life of someone I love seems like a bargain actually.

... I pay a lot more than that to my landlord each year, and all i get is a roof over my head.


#45 purplekitty

Posted 16 August 2012 - 02:56 PM

They should be treated in the public health system. It is excellent and world class, as PP have said.



#46 Bluenomi

Posted 16 August 2012 - 03:06 PM

QUOTE (MrsLexiK @ 16/08/2012, 12:14 PM) <{POST_SNAPBACK}>
For something non urgent - yes you are correct.  For urgent things (such as cancer surgery) not correct.  My aunty could not get in to get a particular test done and see her doctor for close to 12 weeks, the person doing the booking mentioned she should go public - the wait was 3 weeks for the test and the appt would be arranged for a couple days after the test was done.  She had cervical cancer, she has had 3 lots of treatment eveytime they find another spot where it has spread.  However if she had to of waited the 12 weeks to get the test done in the first place she probably wouldn't of been lucky to get that first treatment.


You'd love to think so but earlier I loked up the waiting times for surgery for cancer in the ACT and the shortest median waiting time was 2 weeks. For some types of surgery it was 50 days. That's almost 2 months. And that's the median, a lot of people had to wait longer.

If you happen to live right near a major hospital that is well staffed you might have no issues going public. But a lot of people don't.

#47 SmallPotatoes

Posted 16 August 2012 - 03:27 PM

QUOTE (Holidayromp @ 16/08/2012, 10:56 AM) <{POST_SNAPBACK}>
I stand corrected  blush.gif  but I live on the mid north coast and the health care here is fantastic.  We have access to all levels of care that appear to be non-existant in major cities.  They talk about lack of services in smaller areas but I honestly think it is the other way round.


I agree that it really depends where you live. Like I said in my post - mum received excellent and fast care at a major Sydney hsopital...  where I live (rurally about 3 hours west of Sydney) we barely ahve a specialist in town, and have to travel at least 50 mins to see most kind of medical specialists...  so it truely is very variable!

#48 TobiasFLK

Posted 16 August 2012 - 03:35 PM

QUOTE (mtilly @ 16/08/2012, 11:48 AM) <{POST_SNAPBACK}>
Rosiebird these costs come almost entirely from your private health fund. The $10,000 goes exclusively to the specialist & their assistant.

For example, my Dads prostate cancer surgery in a private hospital cost their PHI tens on thousands of dollars. This went on theatre, nurses, recovery, medications, anaethesist & surgeons fees. They were then ALSO out of pocket around $7000 for the surgeon & assistant (2-3ges work) & around $1500 for the anaethesist. Both drs also recieved their Medicare payment & extra from PHI. I'm sorry, but I don't think it is sensationalist to say that they are charging huge fees. In other parts of the country the out of pocket costs would be in the hundreds. The Sydney specialist are earning extra by around $7000!!! I do not think that being a Sydney specialist makes you entitled to charge 1000+% more! I think THAT is morally wrong.


Do you have ANY idea how expensive their insurance is! It is mind boggling.

FWIW my FIL (now passed) was not able to be treated as a private patient as the private hospitals did not have the facilities. The public hospitals were much more equipped with up to date equipment.

We were extrenely happy with his care.

#49 kmshunt

Posted 16 August 2012 - 04:00 PM

Not sure if someone else has already said this as I haven't had time to read all the replies but, PHI only covers the hosptial costs ie: accommodation, theatre fees, nursing care, PBS drugs. The DR's costs are totally seperate and cannot be covered by PHI. PHI & Medicare are 2 seperate systems. PHI companies sometimes come to an agreement with the Dr where they will lower their fee and the PHI chips in so there are no extra costs to the patient. Some Drs will not participate in these "gap" schemes so the patient must pay the difference bewtween any Dr fees and the scheduled item payment from Medicare. Often the gap is very large. Private hospitals & PHI are great for elective surgery where the wait in the public system can be years. Often the public hospitals are great for cancer treatment where they are the experts in the field and have all the knowledge and equipment. Some cancer treatments eg: Bone Marrow Tranpsplants are not covered in any private hospitals and the only option is public.

#50 MrsLexiK

Posted 16 August 2012 - 04:14 PM

QUOTE (Bluenomi @ 16/08/2012, 03:06 PM) <{POST_SNAPBACK}>
You'd love to think so but earlier I loked up the waiting times for surgery for cancer in the ACT and the shortest median waiting time was 2 weeks. For some types of surgery it was 50 days. That's almost 2 months. And that's the median, a lot of people had to wait longer.

If you happen to live right near a major hospital that is well staffed you might have no issues going public. But a lot of people don't.


And that also means that a lot of people didn't have to wait that long.  I looked up the wait times on my hospital website.  This is great in giving a picture of it for everyone however not one private hospital had the wait times listed.  This purely ancedote (sp?) but the guy I know who went through a very popular Malvern hospital for his cancer surgery waited over 2 weeks.  Actually his dr told him he could wait a few months and it wouldn't have been issue.  Clearly though people want to get the cancer out, but in reality for some cancers a few weeks, or a month or two will not do much harm.  In the case of my aunty she couldn't even get the test done through the private area without waiting close to 3 months, this is not even being able to see the Oncologist for close to 3 months to know what sort of cancer it was and what the treatment would be, before any sort of treatment even took place.

I don't actually live near a top public hospital (neither does my aunt) neither does anyone else I have known that has received public treatment, they have had to commute to the Alfred (which is a major hospital) My uncle in QLD lived in the bush, the hospital would not be classified as major at all but his care was fantastic, and there really was a team of dr's working for him.


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