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


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#51 Chchgirl

Posted 16 August 2012 - 04:17 PM

We have PHI and went fully public as the same oncologist (who was wonderful by the way) was the same one if we were private. The only thing we paid was the monthly bill to the hospital pharmacy which was around $200 odd a month.

My dh recently passed away but in the 2.5 years he had treatment he had the best treatment and fantastic doctors, public or private wouldn't have made a difference for him, but I was very happy. It may be different in country areas or where there isn't access to a good public hospital.

ETA there was no wait to get into Liverpool hospital, he was seen very quick.

Edited by Chchgirl, 16 August 2012 - 04:18 PM.


#52 Maple Leaf

Posted 16 August 2012 - 04:22 PM

QUOTE
I would like to know where the huge waiting lists are.


The Sunshine Coast is shocking.

#53 KT1978

Posted 16 August 2012 - 08:59 PM

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


what the small benefit of living? pffft.

I don't understand people who insure their 10 year old commodores before they insure their health. or insure "extras' so they can afford a $300 dental checkup each year, but not emergency surgery.

It varies, and it sucks but the reality is that many locations and types of surgery have long waiting lists.  DP would have waited 3 months for his bowel surgery.  He was seen to and operated within a week in the private system. Chemo wait was 6 weeks, he didn't wait at all. For every person who gets in straight away in the public system there is another who doesn't - we had both options open to us.

Would you like to wake up every day for three months and wonder, is today the day my cancer spreads into my lungs reducing my chances of living from 70% to 7%?  For the sake of the $4000 it cost us in excess and surgeons fees (two surgeons, 5 hours of what I imagine to be very stressful and hard surgery). The cancer was already in Dps lymph nodes, three months probably would have meant stage 4 cancer, which he was unlikely to survive.

And even though we paid $4000 the surgery, the two weeks in hospital, eight days in intensive care probably cost the health fund/medicare about $50,000.  Definitely worth the premiums.

#54 busy_bee

Posted 16 August 2012 - 09:08 PM

QUOTE (rosiebird @ 16/08/2012, 08:50 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





case example - 1 operation recently

- 6 specialist surgeons, 2 anaesthetists plus the various nursing staff involved in the operation

- 9 hour procedure - intra-op samples taken and processed by pathologists; intra-op blood tests taken and interpreted by biochemists; blood products required which needs input from haematologists

- pre-op and post-op care in ICU with 24hr 1:1 nursing and the involvement of a specialist intensivist

And that's just the people-related aspects of the care - let alone the hospital costs, medication costs, monnitoring costs, equipment costs

$10,000 doesn't spread that far when you really think about things properly

#55 Ollie83

Posted 16 August 2012 - 09:47 PM

My beautiful Mum went through the public system and honestly we couldn't fault the treatment care she was give, it was all very prompt, the only expense we had were when she went to pallative care was a weekly fee because she had been in there for over a certain time but it was minimal in the grand scheme of things. She did have out of pocket expense to do with blood tests, MRI's etc and medications which she paid, but what do you do you don't have a choice.

I agree it's not fair what some PH patients are up for however it is the same with any procedure you may have not very many are 100% covered.

#56 purplekitty

Posted 16 August 2012 - 09:54 PM

QUOTE (KT1978 @ 16/08/2012, 08:59 PM) <{POST_SNAPBACK}>
It varies, and it sucks but the reality is that many locations and types of surgery have long waiting lists.  DP would have waited 3 months for his bowel surgery.  He was seen to and operated within a week in the private system. Chemo wait was 6 weeks, he didn't wait at all. For every person who gets in straight away in the public system there is another who doesn't - we had both options open to us.
Those times seem excessive. Which public hospital gave you those wait times?




#57 KT1978

Posted 16 August 2012 - 10:03 PM

We are in the Illawarra.



#58 fionah

Posted 16 August 2012 - 10:08 PM

Ray, who is now 7yo, was treated for cancer as a toddler in the public system. He was seen to and operated on so quickly. There was no fault with the system for getting him treated promptly. My out of pocket costs were to do with travel, meals for me and loss of income as I was unable to work.

I have faith in our public health system.

Fi.

#59 JRA

Posted 16 August 2012 - 10:10 PM

Rarely with cancer would you need to wait. So many many people go public with cancer and it is not an issue.

Certainly when I went through cancer, most / all radio therapy was done in public anyway. It was only surgery and chemo that was really private in some cases

To me PHI and waiting lists are about elective surgery - tonsils, knee replacement etc. Cancer does not fit in that category

#60 Expelliarmus

Posted 16 August 2012 - 10:13 PM

QUOTE (Holidayromp @ 16/08/2012, 11:23 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?

In Adelaide if you are experiencing complications and pain as a result of a patella dislocation, torn cartilage or shallow grooves and require an arthroscopy, the wait in the public system is 12-18 months to see the surgeon. The actual list for the surgery is about 3 years after that.

You can have it done for less than $500 gap in two weeks with PHI.

If it's not an accident it's not an emergency and the wait is horrendous.




#61 KT1978

Posted 16 August 2012 - 10:17 PM

what about diagnosis?

How long would a healthy 40 year old with no family history of bowel cancer wait for a colonoscopy in the public system when their blood levels etc don't indicate cancer?

I understand what people are saying but I would rather have the option with extra expense, than have no choice.  And there are circumstances where PHI/ability to pay out of pockets gives you a choice that could make a difference to your prognosis.

ETA : the wait time for a colonoscopy in my area is about 18 months from my googling tonight. Roll the dice on whether a healthy 40 year old would be seen earlier becuase of his symptoms (a bleeding ass, nothing major).  Add that to the "published" wait for bowel cancer surgery (which I'm skeptical of) of 2 weeks (I think thats in addition to the time to see the specialist) and six weeks for chemo.... I'd be using the $4000 to pay for DP's funeral instead of surgery.  Does it really still sound like a "waste of money"?

I think I'm the only one who is offended by the flippant "waste of money" comments in this thread by people who have NFI the trauma of being told someone in your family has cancer (but we can't fix them for a month!).   But I've been at the hospital all day so maybe I'm being a bit sensitive.  wink.gif




Edited by KT1978, 16 August 2012 - 10:33 PM.


#62 Soontobegran

Posted 16 August 2012 - 10:24 PM

Cancers do NOT all have to be treated with the same matter of urgency.
Nobody in the public health system will be forced to wait for treatment on a cancer if there is a chance that it is going to negatively impact the outcome by waiting.
Every patient is assessed individually and according to need.

As for the cost of surgeons? We all have choices but what we need to know that if we've paid $10k out of pocket the surgery and hospital stay would have actually been at least 10 times that amount in actual costs. This would be free in the public system...trouble is that nobody knows what these surgeries cost to the public health system because nobody sees the bills except medicare.

We pay thousands to renovate our homes, if we have white ants we can spend thousands to get rid of them and replace structural damage yet we baulk at fixing the one thing that is really important and that is our health.

#63 bailee

Posted 16 August 2012 - 10:32 PM

I've had cancer. I was diagnosed in a public hospital because I initially went in for something else (changed because I hated the private dr I had been seeing) when it was discovered. There was no waiting list, I got treated immediately. I had my first op on the Monday when they found the cancer (unexpectedly), by Friday the test results were in and I was taken straight to the oncologist. I've had about 12 surgeries since - none of them urgent urgent, but I've never had to wait I've always been booked in on a day that suited me from the dr's schedule, longest wait was 3 weeks cause that suited me better. My treatment has been A1 I dont have even one complaint.

My out of pocket expenses have been a few hundred dollars over 8 years of treatment. I have PHI but I've only started using it since the hospital accept it but dont charge out of pocket expenses. But I see the same dr and use the same rooms/operating theatre, so I dont see the difference except the hospital get some extra funding.

I would never go private for cancer treatment. The two people I know who did (and I know many cancer survivors) are no longer here to talk about it and one in particular could have had access to a different treatment in the public hospital that could have saved her, but by the time she got there (referred by her private dr) it was too late to try it.

#64 adifferentme

Posted 16 August 2012 - 10:45 PM

RBWH in Brisbane told me 6-12 months wait for a colonoscopy. When they got results from my colonoscopy I had done privately (which showed cancer with high level tumour budding, and possible venous and lymphatic invasion) they booked me in for another colonoscopy the following week to 'tattoo' the section of my bowel they would be removing, then booked the surgery for 6 weeks later, which altogether would have been 3 months after I went to the ED following a haemorrhage (same hospital), despite being in the 'urgent' category. Fact is, there are only so many colorectal surgeons out there, and everyone above me on those lists had cancer.

ETA: those same surgeons operate at both public and private hospitals, but the lack of waiting to go privately was because of the actual beds available! The appts I did have at the public hospital were absolutely full - the day of my colonoscopy it was like a production line of us being wheeled in and out! In the private hospital there were empty rooms.

Edited by adifferentme, 16 August 2012 - 10:50 PM.


#65 Soontobegran

Posted 16 August 2012 - 10:57 PM

QUOTE (KT1978 @ 16/08/2012, 10:17 PM) <{POST_SNAPBACK}>
I think I'm the only one who is offended by the flippant "waste of money" comments in this thread by people who have NFI the trauma of being told someone in your family has cancer (but we can't fix them for a month!).   But I've been at the hospital all day so maybe I'm being a bit sensitive.  wink.gif


I really am sorry that you are going through a difficult time right now , I am sure there are actually many of us who can relate very well to what you are feeling and the frustrations involved. sad.gif
As I said in PP what needs to be remembered is that if someone is told they will be fixed within a month it means that it is believed that it will not negatively impact the outcome by doing so.
Many patients with PHI will actually not be attended to in a much better time frame to that either.

Unfortunately with no family history of bowel cancer (as you mentioned previously) most people will not have routine colonoscopies at age 40 whether they have PHI or not, the diagnosis is usually made after there have been symptoms.
Lots of luck

#66 Chchgirl

Posted 16 August 2012 - 11:14 PM

QUOTE (KT1978 @ 16/08/2012, 10:17 PM) <{POST_SNAPBACK}>
what about diagnosis?

How long would a healthy 40 year old with no family history of bowel cancer wait for a colonoscopy in the public system when their blood levels etc don't indicate cancer?

I understand what people are saying but I would rather have the option with extra expense, than have no choice.  And there are circumstances where PHI/ability to pay out of pockets gives you a choice that could make a difference to your prognosis.

ETA : the wait time for a colonoscopy in my area is about 18 months from my googling tonight. Roll the dice on whether a healthy 40 year old would be seen earlier becuase of his symptoms (a bleeding ass, nothing major).  Add that to the "published" wait for bowel cancer surgery (which I'm skeptical of) of 2 weeks (I think thats in addition to the time to see the specialist) and six weeks for chemo.... I'd be using the $4000 to pay for DP's funeral instead of surgery.  Does it really still sound like a "waste of money"?

I think I'm the only one who is offended by the flippant "waste of money" comments in this thread by people who have NFI the trauma of being told someone in your family has cancer (but we can't fix them for a month!).   But I've been at the hospital all day so maybe I'm being a bit sensitive.  wink.gif


No mate, you're not alone! No cancer in dh's family (well not bowel anyway) and I do hear you..that's why we came back to Oz from Nz as it was better here for that.

I have phi and have for many years and would have used it if needed, as I said in my post it definitely depends on the area, I think phi is very important and would have definitely used it if we needed to...we were buggered around in nz so know how you feel..

#67 Mumsyto2

Posted 16 August 2012 - 11:25 PM

QUOTE (mtilly @ 16/08/2012, 12:48 PM) <{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.

Personally I don't find their fees excessive considering their training and skill. Generally a lot more time is spent on the case than the number of hours they actually spend performing the op. Their insurance is a huge cost also.

The whole Sydney vs other locations thing ..... Trying not to be blunt but you tend to find that the higher the skill level the higher the chance they will be located in Sydney (using NSW as an example) than out the back of whoop whoop. Not many top surgeons tend to reside and work outside of major city centres. They tend to do interesting cases at tertiary hospitals and then bread and butter work privately. There may or may not be a visiting schedule regionally but they will not reside there.  That means that people regionally have to wait for a routine visit from the relevant specialist (however long the interval is) or they have to travel - dependent upon their issue.  So in essence you tend to get what you pay for if you chose to go privately in this situation. So if you went went the private route in Sydney with someone who is half decent you have to pay your share of financing the costs associated with private practice & the 'Sydney living costs' & lets face it, living here is FAR from cheap. If you object to this then go public and depending upon your issue you may/may not get someone half decent (the benefit of private is that you get to make the assessment and choose!). Generally you are better off having a very serious or 'interesting' issue than a run of the mill one in the public system in regards to provider.

Edited by Mumsyto2, 16 August 2012 - 11:27 PM.


#68 Kafkaesque

Posted 17 August 2012 - 01:55 AM

My sil went through ten years of cancer treatments on and off. She would go between public and private depending on what the treatment was. Emergency stuff when there would be high costs for icu and such she went to a punli tertiary hospital and always got immediate treatment. For the more routines planned things like chemo she mostly used phi so she got the extras and the comfort afforded by private. While there were out of pocket costs I don't think they were unmanagable for an average family.

#69 Fright bat

Posted 17 August 2012 - 04:11 AM

QUOTE (Mumsyto2 @ 16/08/2012, 11:25 PM) <{POST_SNAPBACK}>
Personally I don't find their fees excessive considering their training and skill. Generally a lot more time is spent on the case than the number of hours they actually spend performing the op. Their insurance is a huge cost also.

The whole Sydney vs other locations thing ..... Trying not to be blunt but you tend to find that the higher the skill level the higher the chance they will be located in Sydney (using NSW as an example) than out the back of whoop whoop. Not many top surgeons tend to reside and work outside of major city centres. They tend to do interesting cases at tertiary hospitals and then bread and butter work privately. There may or may not be a visiting schedule regionally but they will not reside there.  That means that people regionally have to wait for a routine visit from the relevant specialist (however long the interval is) or they have to travel - dependent upon their issue.  So in essence you tend to get what you pay for if you chose to go privately in this situation. So if you went went the private route in Sydney with someone who is half decent you have to pay your share of financing the costs associated with private practice & the 'Sydney living costs' & lets face it, living here is FAR from cheap. If you object to this then go public and depending upon your issue you may/may not get someone half decent (the benefit of private is that you get to make the assessment and choose!). Generally you are better off having a very serious or 'interesting' issue than a run of the mill one in the public system in regards to provider.


Some of the best surgeons I have ever known work in rural areas. The limitation on performing complex surgery in these areas is usually the complexity the local hospital is able to deal with, not what the surgeon can potentially do. Rural surgeons also often choose to work in those areas because they want to work in an area of need, rather than necessarily make money.

I will defend the rights of doctors to bill privately as they choose in a context where we have amazing free public health, but don't confuse a doctors rates with how 'good' they are. The top 10 best surgeons I have ever worked with don't have the highest out of pocket charges in town.

Specialists in Sydney notoriously charge more out of pockets than their counterparts in other cities.

#70 Pop-to-the-shops

Posted 17 August 2012 - 06:19 AM

The cost of liability insurance and running a practice is huge.

I have a friend who was a specialist surgeon, and moved from a major city to a regional area for a sea change. His income decreased, because his clientele were mainly retired elderly public patients, yet his expenses went up, as he was in a regional area, so the insurance risks were deemed to be greater.

Any complex, interesting, risky surgery was deemed to be too hard by the the local hospital and anaethatists and so most patients were shipped off to a capital city, referred to another surgeon. So the surgeon lost that income too. It was very hard to make ends meet as a specialist in a smaller town.

We have used our private health insurance for allergy treatment, sleep school, tonsils, wisdom teeth, dentists, physio. Not urgent but very worthwhile IMO. Luckily we haven't had to go down the path of making choices for cancer treatment, but if it came down to it I would spend the money.

As several people have pointed out, if the surgery is very urgent, it will be prioritized.

And yes there are some cases which are deemed to be too risky,  or not operable. And that is one of the risks that a surgeon has to insure against. Making decision that may effect the treatment or survival of the patient.



#71 shelbysmum

Posted 17 August 2012 - 06:26 AM

My partner is currently being treated for a suspicious looking lymph node- he had an appointment with the professor of head and neck surgery within 7 days- and that delay was simply due to the specialist being on holiday. He had a biopsy in that first appointment and a followup appointment 3 days later. With inconclusive test results the doctor is treating him as a category 1 patient which means his public surgery is scheduled within 30 days- he was booked in within 7 days.

The cost- out of pocket expenses after the medicare rebate (we are over the threshold as a family)- $8 per appointment.

To be honest we enquired about paying privately and the specialist (who is doing the surgery, publicly or privately) recommended that it would make no difference- in time or outcome.

#72 sueb31

Posted 17 August 2012 - 07:19 AM

In the last 6 months a few major hospitals in Qld (RBH, GCH) have sent out letters to patients referred for endoscopy / colonoscopy (with symptoms of cancer) saying the waiting lists are closed and they should look elsewhere. Of course they aren't going to have much luck if they are out of  the other hospital's areas.

And over the years, there are plenty of people who wait what I would think are unacceptable lengths of time for cancer surgery in the public system.

Hence my private insurance.

Sue

#73 ~~~

Posted 17 August 2012 - 08:11 AM

In  our case, we asked the public vs private differences:
Stage 4 neck cancer (metastasis to lymph glands) that will be treatable with surgery then chemo/radio.
Saw rural NSW specialist last week and had biopsy, referred straight to Sydney specialist - PET scan last Monday, specialist and head and neck clinic appt on Tuesday.

Private - booked in for surgery next Monday, surgeon of our choice, incl continuity of care - specialist will drop in daily.
Public - 6wk wait min as patients already waiting and surgeon only gets 1 theatre (day?) per week, surgeon supervising his registrar for actual op and less continuity of care with follow up.

Now, what it came down to for us, in this particular situation, would you risk waiting 6 weeks and really, what price would you put on your life? Its not great that it costs $$$$, but these guys eat breath and sleep head and neck cancer and frankly, we didn't want to take the risk of waiting, when symptoms have been prevalent for a few months already....

I just count myself lucky that its rare that we have had to even go to hospital so far...

#74 purplekitty

Posted 17 August 2012 - 11:33 AM

QUOTE (Akatara @ 17/08/2012, 06:19 AM) <{POST_SNAPBACK}>
Any complex, interesting, risky surgery was deemed to be too hard by the the local hospital and anaethatists and so most patients were shipped off to a capital city, referred to another surgeon. So the surgeon lost that income too. It was very hard to make ends meet as a specialist in a smaller town.
One of the reasons complex procedures are not done in smaller regional hospitals is because the statistics show that the outcomes are poorer.

Hospitals and surgeons need to be doing greater numbers and that is not possible because of a small population base.




#75 Maple Leaf

Posted 17 August 2012 - 04:01 PM

QUOTE
As I said in PP what needs to be remembered is that if someone is told they will be fixed within a month it means that it is believed that it will not negatively impact the outcome by doing so.
Many patients with PHI will actually not be attended to in a much better time frame to that either.


For MY family, this was completely not true.

He was told he would be operated on in a month in the public hospital (lack of urologists, lack of theatres and a huge waiting list). Private surgeon said he would be dead in a week so operated within 3 days.

So yeah the private system saved his life.

When the chart was transferred from the pubic hospital and the private surgeon saw the notes inside he really had no idea why my Dad wasn't operated on immediately considering his diagnosis. It was down to either lack of facilities or they had written him off, we don't know exactly. I will get the chart one day and have a good read but am not mentally ready for that yet.

There is no 100% fast rule here. People die in both systems. You all have to do what is best for your family and hope like hell you never need cancer treatment and if you do need it, that you have option to get the quickest care available. I really believe with cancer, that time is of the essence.


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