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HMS, HAG 2020 HSC 25

Describe the advantages and disadvantages of having private health insurance for the individual.   (5 marks)

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Advantages:

  • Private health insurance provides individuals with choice of specialist doctors and faster access to elective procedures.
  • Patients can select preferred hospitals and receive private accommodation during treatment if available.
  • Coverage can include ancillary services like physiotherapy, dental care and optical services not fully covered by Medicare.
  • Individuals avoid long public hospital waiting lists for non-urgent surgeries, enabling quicker treatment and recovery.
  • Insurance holders can schedule procedures at convenient times and maintain continuity of care with chosen healthcare providers.

Disadvantages:

  • High annual premiums create financial burden, particularly for low-income families.
  • Many policies include significant excess payments and gap fees that increase out-of-pocket costs.
  • Coverage limitations through exclusions and waiting periods restrict immediate access to certain treatments.
  • Complex policy structures make it difficult for individuals to understand their actual entitlements.
  • Some procedures may still require substantial personal payments despite insurance coverage.
  • Annual premium increases often exceed inflation rates, making insurance less affordable over time.
Show Worked Solution

Advantages:

  • Private health insurance provides individuals with choice of specialist doctors and faster access to elective procedures.
  • Patients can select preferred hospitals and receive private accommodation during treatment if available.
  • Coverage can include ancillary services like physiotherapy, dental care and optical services not fully covered by Medicare.
  • Individuals avoid long public hospital waiting lists for non-urgent surgeries, enabling quicker treatment and recovery.
  • Insurance holders can schedule procedures at convenient times and maintain continuity of care with chosen healthcare providers.

Disadvantages:

  • High annual premiums create financial burden, particularly for low-income families.
  • Many policies include significant excess payments and gap fees that increase out-of-pocket costs.
  • Coverage limitations through exclusions and waiting periods restrict immediate access to certain treatments.
  • Complex policy structures make it difficult for individuals to understand their actual entitlements.
  • Some procedures may still require substantial personal payments despite insurance coverage.
  • Annual premium increases often exceed inflation rates, making insurance less affordable over time.

Filed Under: Healthcare System effectiveness Tagged With: Band 4, smc-5479-10-Access equity

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