Health Insurance Does health insurance help me get elective surgery quicker in public hospitals?

Can someone please answer this .

If I am public, one big issue is the time it takes to get to see a consultant for anything other than clear cancers/heart condition ie immediate life threats.
If I have private Health Insurance , will they not have me on Consultants list a lot quicker?

Means that Private Health by getting (past) consultant hurdle ,means I get much? quicker service.?

From today's Indo.

Cheap health cover forcing patients on to waiting lists


"They may be covered for a private bed in a public hospital and believe they can jump the queue," said Prof O'Keeffe.

"But they are finding they have to wait in line and that they receive no privileges when it comes to quicker access."

This is very important. If I get sick, my first priority is to get treated quickly. I would much prefer to be treated quickly in a public ward than to wait 12 months and get a private room.

Brendan

Eithneangela said:

In my opinion, it is worth paying the consultant fee up front just to get the consultation as fast as possible. I would borrow the money if I had to in order to see the consultant as a matter of urgency - that action alone starts the process of treatment if required.

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Hi Eithne

It may be worth paying to see the consultant privately as it will get you a diagnosis. But you will not be treated any quicker.

"Can I see a consultant privately, and then go public for the procedure?"

From the Department's guidelines:

"Referrals from the public clinic should be placed above those referred from a private consultation until the normal waiting-period for an out-patient consultation has elapsed"

From the Department's guidelines:

"Referrals from the public clinic should be placed above those referred from a private consultation until the normal waiting-period for an out-patient consultation has elapsed"

That seems to suggest that people with private health insurance who are not covered for private hospitals, are penalised by having the insurance! If the referral is from the consultant's private clinic, does the same apply?

Hi Eithne

This is how I think it works...

People who pay to see the consultant privately are not penalised.
On 1 January, Johnny is referred to a specialist in the public system to check out his hip.
On 1 July, he sees the specialist who puts him on a public waiting list for an operation
On 1 December, Johnny has his operation

On 1 January Mary is referred to a specialist, but she pays to see him privately.
On 1 February she sees the specialist.
On 1 July, the specialist puts her on the public waiting list
On 1 December Mary has her operation.

So seeing a consultant privately does not speed up your treatment as a public patient.

On 1 January Paul is referred to a specialist and he pays for it privately.
On 1 February, he sees the specialist who puts him on a private list in a public hospital.
I suspect that he will be operated on at the same time as people who go on the public waiting list on 1 February.

So if you pay to see a consultant privately and you have insurance for a private bed in a public hospital, you will probably be operated on quicker.

However, if you pay to see a consultant privately, but you are relying on the public system for the operation, you won't be operated on any quicker.

There was an interesting discussion on Jonathan Healy Lunchtime Newstalk yesterday dealing with this type of issue. In the follow-on
chat with Dermot Goode, he highlighted a recent development in public hospitals, where they now have 'common waiting lists'. So it's
practically useless having a public only policy as you wait the 1-2 years for surgery regardless.

[broken link removed]

Snowyb

Hi snowy

But the key question is when do you get onto that list? If you have paid to see the consultant privately, can you go on that list immediately.

Brendan

Brendan,

I would assume you would get onto that list immediately, subject to correction. I've no personal experience of this but the point is
you don't need health insurance to see a consultant privately. Its a real grey area, you'd need to be working in the hospital system to
know the full story.

Snowyb

http://www.rte.ie/radio1/today-with...o-rourke-monday-16-march-2015/?clipid=1828783

Dermot Goode and Professor Michael O'Keefe were pretty clear on the Sean O'Rourke show yesterday (16 March 2015) that a private patient will not gain any preferential treatment in a public hospital in terms of diagnosis, treatment or accommodation. Semi-private beds are a thing of the past and the reality, apparently, is that private beds are simply not available.

I am starting to come to the conclusion that the only real value of private health insurance is as a mechanism for funding future private healthcare services - particularly in the areas of orthopaedics (hip replacements, etc.) and opthalmology (removal of cataracts, etc.). The problem is that a significant element of premium payments for all health insurance policies go to fund public healthcare services, which a patient would be entitled to receive whether or not they are insured. As such, it seems to me that you would invariably be better off "self-insuring" for private healthcare services (ie funding out of your own resources).

Have I jumped to the wrong conclusion? There seems to be so much conflicting information about the area that it is really difficult to know what to think.

The way around it, if money is tight, is to go for a plan that has all 3 levels of hospital cover, but with a higher excess say 250 or 500 etc.

[broken link removed]

At least you have all options open to you. For a hundred or two more you have more choice.
It makes more sense than taking out a plan with public only for 500approx.

Snowyb

snowyb said:

The way around it, if money is tight, is to go for a plan that has all 3 levels of hospital cover, but with a higher excess say 250 or 500 etc.

[broken link removed]

At least you have all options open to you. For a hundred or two more you have more choice.
It makes more sense than taking out a plan with public only for 500approx.

Snowyb

Click to expand...

Thanks Snowyb but in that case you're paying a premium of €700 per annum for very limited worthwhile cover (if we agree that a private patient does not get any preferential treatment in the public system).

Financially would it not make more sense to simply put the full €700 aside each year as a reserve to cover future possible private healthcare expenses? I'm pretty sure that's the way an underwriter would look at it and you're going to have to set significant funds aside in any event to meet the excesses.

I have also heard anecdotally that a private patient can get access to scans and procedures for a lower cost than an insured patient if they are paying from their own resources.

Cheers Sarenco,

It becomes a case of swings and roundabouts. It depends on what age bracket is in question, and it would take a lot of 700s to cover
certain surgeries. Figures of 15,000, 20,000+ are regarded as standard for orthopaedic.

I personally would prefer to deal with the excess amount which is do-able over time.

I was more thinking that if a person was considering taking out these new low cost public only plans, they are useless in terms of
waiting times for surgery. As the goal posts are now completely changed re public hospital cover for insured people, these plans are
practically a waste of money. So, in that scenario, the next best thing is to include private cover and build an excess fund to suit.
You would need a contingency fund anyway when you have health insurance to cover consultant fees, xrays, scans etc. Its costly whatever
way you turn.
I would prefer to spend say 630 on Laya Flex 500 Explore than waste 430 on Laya Assure Vitality or any other low cost public only plan.
Its about having reasonable choices if something happens and not to be left snookered on a list for 1-2 years in pain with no other options,
and paying to be there, into the bargain.

Your idea for savings is good in theory but I'm not sure how practical or realistic it would be in the long term.

I heard someone on radio making the suggestion recently that the providers need to come up with a new type of plan, covering private hospitals only. Its an interesting idea. This was when the public hospital charges for insured people changed and the common waiting lists came into effect.
There are some good explanations on the following link;

[broken link removed]


Regards, Snowyb

Thanks for your perspective Snowyb.

I certainly agree that a policy that only covers public hospitals is now practically worthless and a consumer would be far better advised to pay a somewhat higher premium for a high excess policy that covers public, private and high tech hospitals. I think it should, however, be emphasised that such policies are only suitable for people who have material savings to meet the relevant excesses and co-payments.

I am undecided whether it makes sense for a 35 year old to buy a high excess policy and build a high level of reserves to meet excesses or to skip insurance altogether and simply build an even bigger reserve to meet future private healthcare expenses. I am inclined to think that the latter is probably the better approach from a purely financial perspective but it really turns on your attitude to risk. However, it certainly makes sense, in my opinion, for anybody over 60 to take out the most comprehensive policy they can afford as their cover is heavily subsidised by younger policyholders.

A policy that excludes treatment in a public hospital would be an ideal solution. However, I'm pretty sure it would be unlawful for an insurer to offer such a policy (see Section 10 of the Health Insrance Act 1994 and the regulations made thereunder).

Brendan Burgess said:

Hi Eithne

This is how I think it works...

People who pay to see the consultant privately are not penalised.
On 1 January, Johnny is referred to a specialist in the public system to check out his hip.
On 1 July, he sees the specialist who puts him on a public waiting list for an operation
On 1 December, Johnny has his operation

On 1 January Mary is referred to a specialist, but she pays to see him privately.
On 1 February she sees the specialist.
On 1 July, the specialist puts her on the public waiting list
On 1 December Mary has her operation.

So seeing a consultant privately does not speed up your treatment as a public patient.

On 1 January Paul is referred to a specialist and he pays for it privately.
On 1 February, he sees the specialist who puts him on a private list in a public hospital.
I suspect that he will be operated on at the same time as people who go on the public waiting list on 1 February.

So if you pay to see a consultant privately and you have insurance for a private bed in a public hospital, you will probably be operated on quicker.

However, if you pay to see a consultant privately, but you are relying on the public system for the operation, you won't be operated on any quicker.

Click to expand...

I don't understand why the consultant does not put Mary on the waiting list on 1st February. Why does he/she wait until 1st July to do this? I paid to see a consultant about my hip in July 2012. He put me on the public waiting list for Cappagh at that point. I still had to wait as long as a non-insured person, but at least I was put on the list in July.

Eithneangela said:

I don't understand why the consultant does not put Mary on the waiting list on 1st February. Why does he/she wait until 1st July to do this? I paid to see a consultant about my hip in July 2012. He put me on the public waiting list for Cappagh at that point. I still had to wait as long as a non-insured person, but at least I was put on the list in July.

Click to expand...

My understanding (and I am very much open to correction on this point) is that Mary would have been added to the waiting list on 1 February but (at least in theory) any patients referred by a consultant in the public system would jump ahead of Mary until the normal waiting period for an out-patient consultation had elapsed (subject to urgent cases). In other words, a diagnosis from a private consultant will not speed up treatment in the public system.

That's the theory as I understand it but I have no idea whether that reflects the actual practice on the ground.

Brendan,

Thanks for setting out the various scenarios, they are very helpful.

If Mary pays privately to have a test and is discovered to have an urgent condition eg cancer, will she be dealt with publicly as quickly as if she had good health insurance?