With private health insurance premiums sky-rocketing, a popular Australian pastime is to have endless discussions with family, friends and others about the benefits and costs.
I used to participate in these debates, too, and several times nearly dropped our insurance after hearing others say how unnecessary it is. Until, that is, I had a son who needed treatment for a serious mental illness which developed out of the blue and was life-threatening within a few months of first noticing it.
When that happened, I unwillingly discovered the yawning gap between what’s on offer in Australia to those with physical illnesses, and those with psychiatric ones. This chasm is enormous, dark and almost impossible to describe. But I’ll try.
When my son first became ill in 2016, he was immediately admitted to a private psychiatric institution. He was in and out of private hospitals for about 30 weeks that year and during 2017, 2018 and 2019 spent 30 further weeks as a private in-patient.
Despite being sick enough for hospital treatment for more than a year out of the past four, it’s unlikely he’d ever have been eligible for admission to a public facility. He was ill enough for hospital (and trust me, nobody is admitted to any hospital unless they need it) but not enough for a bed in a public ward.
Why? Because such places are so grossly over-crowded they’re forced to triage patients and limit entry only to those who are unequivocally suicidal or violent. And because my son has never been overtly suicidal or threatening to others, he’d never have been sick enough for a place.
So, what would have happened without private insurance? To be honest, I don’t really know. My son would’ve been entitled to the maximum 10 subsidised psychologist visits provided under Australia’s health system. Yet to truly get a sense of how insulting that program is, imagine someone with cancer who’s told the health system will pay only for 10 out-patient treatments, and after that they’re on their own. Yes, that’s an exact analogy.
Apart from that, we could have continued to visit psychiatrists, but with $400 out-of-pocket per time and lengthy wait lists, this would have been of limited use, particularly for the many, like my son, who are misdiagnosed or for whom medications aren’t effective. We may have been lucky enough to source some sort of extra psychiatric facility such as Orygen Youth Health, but these are also underfunded and overloaded, and don’t operate in our area.
Mostly, we’d have been able to do little but wait. Wait and watch him become sicker and sicker. At that point we might have got him a hospital bed, but who knows if it would have been too late? We’d have been on a revolving merry-go-round of short admissions to stabilise his most dire symptoms, then discharge, rinse and repeat. Before long my son would have become exhausted from the continuing fight, and then, perhaps, another sad statistic.
In that sense, private health insurance has probably saved his life.
The very fact that mental health treatments depend on the size of your wallet is abhorrent. This fact is killing people – fast, and in most cases quietly. It’s an utter, unmitigated disaster.
I’m not writing this as an advertisement for private health insurance. That would be a slap in the face to the millions who choose between eating and heating every week, many of whom are in that position because of mental illness. I want the exact opposite of the current system: one where any Australian can access services, and there’s no difference between physical or mental illnesses in how they’re treated.
What would happen if we really did respond to these serious illnesses like we treat cancer and car accidents? For a start, we’d stop giving tens of millions of wasted dollars to the useless, money-sucking “awareness raising” services, and start giving it to frontline operators who actually help really sick people.
Most importantly, we’d cancel those top-end-of-town tax cuts until we got suicide rates down. Way, way down.
The World Health Organisation advised recently that depression will overtake heart disease by 2030 as the leading cause of death worldwide. And suicide is already the main cause of death for those aged between 15 and 44. With these statistics and the knowledge that all our systems – police, jails, housing, disability and education, among others – are collapsing under the crushing, intertwined needs of mentally ill Australians, the funding that’s allocated is not just a joke, it’s unconscionable.
My son is alive, but thousands of other people’s sons and daughters are not. I’m so sad for them, and so angry on their behalf. I know how they feel, because my brother was also one of those who didn’t make it. And I’m so angry for the tens of thousands struggling from day to day with this illness that’s no more deserved than cancer is. Something has got to change. More people have got to care.
This is an absolute crisis. What will it take?