SHOP around or pay the price.
That's the message Louise Peters wants people to understand after being lobbed with a quote for huge out-of-pocket expenses from a specialist in Brisbane.
Mrs Peters and husband Warren have premium private health cover, which she said had always given them peace of mind.
But they are now considering dropping their cover altogether after being hit with a proposed bill of $4102 for a routine shoulder operation of which they would only see $1432 return.
"I just broke down in tears when I first opened the email ... I thought I was going to be left with a sore shoulder," she said.
And with premiums set to rise an average 4.84% across the board from today, Mrs Peters is, like many Australians, at a loss as to what her $6000 a year is actually paying for.
The kicker here though is that Mrs Peters had the same operation - an arthroscopy to repair tissue damage inside her shoulder joint - in 2012 and was only charged $686 in out-of-pocket costs.
The bill for the surgery was required upfront and did not include the cost for the anaesthetist, Mrs Peters said.
Mrs Peters said patients were at the whim of greedy surgeons who charged above the scheduled fee set by Medicare and more still than the fee recommended by the Australian Medical Association.
"The surgeons have to be reined in. It isn't about patient care any more, it's about money," Mrs Peters said.
"It's scandalous. I'd like the private health funds to explain to us (why) we're left to pick up the slack. Where do people get the money to pay for these out-of-pocket expenses?
"The surgeons are out of touch with the middle-class workers. It's about how much money can be made from someone's illness."
Making matters worse, Mrs Peters said, was private health card holders were also being made to wait for surgeries that weren't considered urgent, putting to an end one of the proposed benefits of having cover in the first place.
"You don't get in any earlier. The surgeons dictate to you when you'll get your surgery," she said.
With the government's Medicare Levy Surcharge catching people over a certain income without cover at tax time, and others hit by the lifetime coverage loading applied each year you are over 30 without cover, Mrs Peters said people were being backed into a corner when it came to their health.
"Private patients are paying for the public patients," Mrs Peters said.
"If you're really sick, then public health will look after you."
Thankfully Mrs Peters has been able to find a surgeon in Bundaberg who will do the same procedure for a fraction of the cost. She will be left to pay just $400.
"People need to shop around for surgeons," she said.
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