Public vs private cost info

mellymell

Hi everyone I was diagnosed with breast cancer on Dec 7 and had a lumpectomy through a private hospital on the 15th. It all happened very fast and I am new to Australia so was trying to get my head around the system, Medicare etc. I do have health insurance but I've been a bit surprised at the amount of out of pocket costs so far. I am now looking at next steps with oncologist which could be radiotherapy, chemo and possibly double mastectomy and the thought of future mounting out of pocket costs is giving me anxiety. Is anyone able to comment on their experience with these? I've got no idea what other possible costs might come up apart from pathology, scans, consultations etc. Also any comments on moving from private to public and any feedback on that would be great  I'm in Melbourne. Thanks!  

lrb_03

Welcome @mellymell. These can be hard choices. You say you have health insurance and that you're new to Australia. Does your country of origin have reciprocal arrangements so that you can access our public system? If not, you may still face put of pocket costs even if going to a public hospital. Most large public hospitals will have someone you could talk to about these questions

I did a mix of public and private, having chemo in the public system, followed by surgery in the private system, then radiotherapy as a public patient. I can't  speak for Melbourne, but where I am, the private hospitals don't have the support services that the public hospitals do. However, the private hospital i Sydney where I had my surgery has amazing supports for inpatient care, and wonderful breast care nurses.
A coyple of things to think about in terms of any future surgery. Would you want the same surgeon? If so, does he/she work in the public sector anywhere. If you wait for furthet surgery until after the rest of your treatment, whatever that entails, it may be classified as elective and ad such you could potentially face an extended wait, especially if reconstruction is a consideration. If you opted for private radiotherapy if required, there could be considerable out of pocket costs but there are also some centres that will negotiate either the cost, or a payment plan. 
Seven years down the track, I have still got ongoing costs as a result of my bc but that's a whole other story. 

Julez1958

Hi @mellymell
I had all my treatment in the private system - double mastectomy , radiotherapy then DIEP flap reconstruction .
Even though I was in a private health fund I still had strep out of pocket expenses .
Both my breast cancer surgeon and plastic surgeon operate in the public system as well .
For the mastectomy the advantage of going private was I could pick my surgeon  and the facilities at the private hospital were nicer ( including a private room).
For the radiotherapy the facilities were nicer and the out of pockets were not that steep for that part .
For the reconstructive surgery I got to choose my surgeon and also wait a shorter period to have the surgery - also got to have it in the private hospital.
I know of ladies who had all tgtt at it treatment in the public system here in Sydney and were very happy ( including a couple who had the same breast care surgeon as me).
The other thing is all the scans etc can add up in the private system so that is also something to bear in mind as  they invariably had gap fees .
All the best .

Rowey

Hi @mellymell
I am in a large regional area and had a mastectomy in the public system. I haven’t needed radio or chemotherapy but am booked on the waiting list for DIEP reconstruction in the public system. 

I have been most happy with my treatment through the public system. My surgery was done well within the recommended time frame. My surgeon was the one of my choice, even though I don’t have private insurance. My GP asked me who I’d like to be referred to. (I had some knowledge of the local surgeons through my previous work).
My Oncolologist is one who takes on most of the breast cancer patients in our area and is well regarded. I was seen quickly and given great care and advice. 

My case was looked at in a multidisciplinary meeting so I feel I have had the best medical oversight, all in the public system.
I will have a wait for reconstruction but that doesn’t really bother me.

I have had very few out of pocket expenses. 

I don’t have a comparison with the private system to give you but I don’t believe I would have received better care. I will probably just have a longer wait for reconstruction.
I hope this helps a little. All the best

arpie

Hi @mellymell - sorry to see you joining our exclusive club ..... but hopefully we can help you with any queries that you may have xx

I went private for my surgery, just to get it 'done' asap ... but I believe my surgeon also works in the public system as well ..... over the first couple of years, I reckon my out of pocket costs were about $5,000 ... including $500 of a pathology bill, that really surprised me, as I thought medicare took care of ALL of them! Not so, apparently.

I went public for both my Oncologist and Radiation Oncologist and have always seen the same Oncs (once I got rid of my first one who was an arrogant, ignorant male onc ...)  Both my Oncs are female & are terrific.  I have nothing but praise for my experience with the Public System.  I paid nothing.  I've been seeing them for 5 years now ... my 5 year surgery anniversary is later this week!

Take care & all the best with your recovery & ongoing treatment xx

Abbydog

I'm not sure what type of Health Insurance you have.
I have BUPA Gold Cover with an excess of $250
Other than paying the excess only once a year, BUPA has paid all of my hospital admissions.
That is for Surgeries ie Mastectomy, Chemotherapy, Breast reconstruction surgeries.
The Gaps have come from the Drs and Surgeons. Other gaps come with Investigations, I now try to ask the Dr ordering the tests request to Bulk Bill.
I have been fortunate as my Surgeons have had a relatively low Gap charge.
In particular my Plastic Surgeon only Charged $1000 including 2 surgeries (8hr +2hrs) including all of the post op appointments. There were many appointments to drain seroma, and fill expanders.
I had Radiotherapy done through the Public system. If I had gone Private there would have been a $2000-$3000 gap even with my insurance. My R/T seemed excellent, and was scheduled ASAP as needed, referred from my Private Oncologist.
I have been very happy. Not much out of pocket at all.
If you have Chemo, ask if you can use the Cold Cap. If you do, you may not loose your hair. I can tell you more about this, if you want. It is often available Public and Private.

Kathryn2412

Hi @mellymell
I’m in Melbourne too and was diagnosed around the same time as you.
I have private insurance too but I went public for my surgery (also a lumpectomy) at St Vincent’s. I was diagnosed through Breastscreen at St Vincent’s and met one of the breast surgeons who operated at both St Vincent’s Public and St Vincent’s Private. I really liked her but she was booked out in Private so I went Public- she was one of 3 excellent breast surgeons at St Vincent’s and she was the one who did my surgery! I had incredible care from all the team at St Vincent’s - you are assessed by the MDT. There were no costs for my surgery and stay in hospital. Also no costs for scans, biopsies etc. pre surgery.

I will continue my treatment at St Vincent’s- radiotherapy, hormone therapy and possibly chemotherapy. 

In my view, we are incredibly lucky in Australia to have an excellent public health system and the big teaching hospitals are excellent. I feel very comfortable with my decision.
Good luck making your decisions 😊

mellymell

thanks for your reply @Kathryn2412 . amazing how quickly you progressed through the process given it was public! i didn't realise st vincents was also public. best of luck to you too

DaisyJ

I was diagnosed early December and in Melbourne. I started with chemotherapy and went private as my GP recommended it and through my own research found going public would be approx 2 month wait. And due to Christmas I just didn’t want to get stuck waiting.  I’ve now had two rounds chemo and hd to be admitted to the ward for dehydration as I was vomiting which would’ve been more difficult public. 

Many people in my ear saying go public go private. I just wanted to start. I found it unhelpful. I am unsure if I will continue private for surgery and radiation but will keep going for chemotherapy. I have PH and my PET scan and biopsies were free.

Keeping_positive1

I went public and had a 2 month wait from diagnosis to surgery, and that was pre "the virus".  Bear in mind that you may very well be in a mixed ward (males and females), which I find quite inappropriate considering we are suppose to be a first world country.  I was in a ward with 2 men and myself and another woman.  Many third world countries have women only wards to this day!  I had not even considered that I would find myself in a mixed ward after having breast surgery.  Something you may like to consider whether this bothers you or not.

Wishing you all the best in what you decide, and for all your treatment moving forward.