Double excision

From time to time some of my blog posts are about personal stuff, rather than the wider world. This is one of those posts.

Yesterday was a day of excisions.

I had many thousands of hairs excised from my head at the barber. Easy.

And I got the lump taken out of my leg.

You may recall from my last post the quandary of paying for private vs getting it done in the public system. Multiple health professionals had said it would take ages to get through the public system elective surgery queue. They were wrong.

In fact within a few weeks of getting onto the list, Southern Health Monash Health contacted me and said they could do it at Cranbourne, sometime on the 10th of September — the precise time TBA. This was not just surprising, but also amusing, because I’d made an appointment on the same day (at 4:30pm) to get it done privately, at the rooms in Dandenong of the surgeon who had seen me at Monash Medical Centre in Moorabbin (East Bentleigh).

I ummed and ahhed and eventually cancelled the public appointment, on the basis that it was worth paying the $150 to be able to know a definite time, to not have to potentially wait for long periods, for the possibly nicer service and environs, and to not have to travel as far.

Plus, although I have a philosophical objection to private health insurance, I have the income that I can afford an occasional burst of money to get something like this done, and save a space on the public queue for someone who can’t.

So anyway, similar to last time, they took a look, shaved some hair off, and gave me a local anaesthetic. I asked if this would render my leg unusable — a question I almost immediately felt foolish for. No — it really is a local anaesthetic, so only the surface near the lump is affected. The rest of the leg is fine.

Then they drew lines on my skin, and sliced me open. I didn’t watch, but from what I can gather, the surgeon simply made an incision, then basically squeezed out the lump.

It came out in bits, and he proclaimed it harmless — if I heard him right, it was calciosis aka calcinosis, specifically dystrophic calcinosis — a build-up of calcium in soft tissue, often caused by previous damage, such as injury. He asked me, and I couldn’t recall any injury in my right leg. I couldn’t. Any football injuries? Unlikely! I did fall off my bike as a teenager once, but I don’t recall if I fell on that part of my leg. Oh well.

Anyway, the bits will be sent off to pathology for analysis. The nurse joked that some people like to take photos of what comes out, and so I decided to too. But I’ll spare showing you that here. It ain’t pretty.

The lump

I’ve got a small lump on my thigh. Not painful at all. Probably harmless, the GP said, but he wrote me a referral to get it removed.

He asked if I private health insurance. Nope. I gave it up several years ago. It cost me thousands each year (and increasing) and rarely paid out anything at all.

He gave me a little lecture, along the lines of “You insure your house, your car… why not your health?”

I had a previous lump in my chest removed at Cabrini, when I did have insurance. It was very good — they examined it and took it out on the spot.

How much would that cost if I paid it myself? Heaps, the GP said, perhaps $1500 or more. Yikes. Public would be free, but he said getting it done would take ages in the queue. Ah well.

Monash Medical Centre, Moorabbin

The referral went off, and a letter arrived — appointment at Monash Medical Centre Moorabbin, which isn’t in Moorabbin, nor in City of Monash, but is a medical centre.

The wait had only been a couple of weeks. I went in thinking hey, they might chop it out same day. Take that, private insurance! BEHOLD, THE POWER OF UNIVERSAL HEALTHCARE!

The specialist took a look, agreed it was probably harmless (probably a lump of skin growth, rather than the fatty blob the last one was) and said I’d go on a waiting list to get it out.

The waiting list would take a year to get through.

A year.

Whatdaya know, my GP knew what he was talking about.

Knowing that many specialists do both public and private work, I asked the specialist how long it’d take and roughly how much it’d cost if I paid myself to have it done privately. ‘Cos I’m in no particular rush, but it’d be nice to get it done and dusted. And this is a variation on self-insuring… not giving the insurance companies their profits, but being willing to spend money on your health where it’s beneficial. At this stage in my life, I’m well ahead doing that.

He said it’d cost $150-200, in about 4 weeks.

Wow, that’s great, I’ll be in that. Sold!

Health insurance

The Medicare levy surcharge is, in my opinion, an stupid tax designed to force some people into getting private health insurance, whether they want it or not, by taxing them more than the cost of the premium if they don’t, all in order to subsidise the otherwise unprofitable private health industry.

I earn enough to be stung by it, but with the insurers bumping up premiums, it’s getting close to the point where the costs are comparable. My Medibank Private policy (covering myself and the kids, for hospital) jumps about 10% this month to $99.60 per month. By my rough calculations that’s now quite a bit more than the surcharge would cost me.

At the same time the premium jumps, the brochure says a bunch of services that were previously “Restricted” will no longer be covered at all — including major eye surgery, assisted reproductive services, renal dialysis, and hip and knee joint replacement surgery.

Not that I expect to need any of these anyway (in fact, I never, ever, claim anything). But they’ve got some cheek marketing it as giving me “more certainty about the benefits you can receive”.

Dental cover

Meanwhile, we’ve found that Jeremy’s going to need braces. Not that he’s delighted, but he understands that now is the best time to do it, while he’s growing.

I don’t know how much it may end up costing at this stage, but the Australian Society of Orthodontists says fees involved can vary between $4500 and $8000. Ouch. I should find out in a few weeks what I’m looking at, but even if I wanted to join a health fund, there’s a 12 month waiting period for orthodontic benefits.

How much would I get back if I did have major dental cover? Comparing a few of the policies on the government’s private health insurance comparison web site, it would seem that as is typical in this game, the benefits from the fund for orthodontic work are far, far out-weighed by the premiums.

If I wanted that cover, I’d be paying more than $1000 per year more to Medibank, for a maximum benefit of $300 per year (though it may rise a bit each year).

Now, I’m not expecting them to hand out so much money that they go broke. But surely for something for which there is a waiting period, which is a major dental expense, for which you pay a huge extra premium to be covered, and is likely to be once per lifetime for people (if it’s done properly), they could do better than a measly $300 per year? Surely that’s the sort of case where (in that year), the insurance company should pay out more than you’ve been paying in.

Even looking around at other companies’ plans, I could have been paying $2000 per year more than at present, and only be getting 75% of the cost back, which is also not a winning proposition given the cost of the braces is likely to be spread over several years.

Insurance is a little like gambling, but it seems incredibly unlikely that anything will happen other than the private health insurers making money hand over fist.

Perhaps I’m misreading all this information I’m looking at (it’s amazingly complicated; looking through iSelect as well helped a bit), but I come away with the impression that even if you make some claims, private health insurance in Australia is a ripoff, unless you’re chronically unwell and repeatedly claim for a wide range of different services (eg not too much of anything so you hit any annual limits).

And of course these premiums are after the 30% private health insurance rebate has been applied. The rebate is a massive subsidy of the private insurance companies, costing around $4 billion a year — apparently up from $2.6 billion back in 2003-04.

Jeez; I can think of better ways of spending that amount of dosh in the health sector without propping-up inherently unprofitable enterprises, but for all the talk of reform in health, that seems to be one Howard government policy Mr Rudd apparently doesn’t want to roll back.