Private vs public hospitals – what’s the difference?

How does the private and public healthcare system in Australia work?

Australia’s healthcare system consists of both government and privately-funded services.

Medicare is the government-funded system, and everyone with a current Medicare number can be admitted free-of-charge as a public patient in a public hospital for treatment deemed clinically necessary. Medicare holders also have part, or all, of the costs of seeing a GP or specialist subsidised (called bulk-billing), as well as the cost of some approved medications through the Pharmaceutical Benefits Scheme (PBS).

There are also privately run hospitals and centres that do not receive the same funding from Medicare and therefore charge patients directly for services. Private health insurance can help cover some of the costs of being treated in a privately run facility. You can compare private health insurance on Canstar’s database.

What is the difference between a public and private hospital?

Private Hospital

If you opt to be treated in a private hospital, you will generally have more choice about the care you receive. This can include choosing which doctor treats you and the type of treatment for a condition. You will usually have a shorter wait time for your treatment, and while in hospital you are more likely to be offered a private room and other optional extras that could make your stay more comfortable.

If your private health insurance includes hospital cover, it will most likely help fund some of your costs during a private hospital stay, although it may not cover all costs. It is a good idea to check with your insurer or read your PDS and other policy documentation to understand what excess (the amount you pay your insurer when you make a claim) and out-of-pocket expenses you may need to pay for your particular treatment.

Public Hospital

Public hospitals in Australia are typically considered to be of a high standard, with highly trained medical professionals and world-leading facilities. Public hospitals may have better medical facilities for some conditions than private hospitals, and may also be equipped to handle complex cases, such as treating those with multiple conditions or chronic illnesses.

Assuming it’s deemed medically necessary, the care you receive in a public hospital will be free of charge, although you may have to wait longer for elective surgeries. Elective surgery refers to surgeries that are not conducted as a result of an emergency, but are still medically necessary and may even be required urgently.

How do public and private hospitals compare?

Private patient in a private hospital

• Accommodation type: You will generally stay in a private room.
  
• Choice of doctor: You can typically choose which doctor you see.
  
• Choice of treatment: You may be able to choose a specific type of treatment if multiple options are available.
  
• Waiting period: You will be able to avoid public hospital waiting times, though your health insurance policy may have a waiting period of its own before you can claim your hospital cover.
  
• Complex care: If your private hospital does not have the facilities or means to treat your condition, you will be transferred to a public hospital that can. Even if you’re treated in a public hospital as a private patient, you may be later transferred back to your original private hospital for follow-up care.
  
• Cost: Your accommodation and specialist fees will be either partly or fully funded by your private health insurer. Depending on your level of cover, you may have to pay excess and out-of-pocket expenses.

Public patient in a public hospital

• Accommodation type: Typically you will be in shared accommodation.
  
• Choice of doctor: You will generally be treated by whichever doctor is available.
  
• Choice of treatment: You will generally receive the treatment recommended by the doctor.
  
• Waiting period: There can often be lengthy waiting periods for elective surgery.
  
• Complex care: Many complex care cases are undertaken in public hospitals as they are often better equipped to manage them.
  
• Cost: Access to public hospital services is provided based on clinical necessity, but anyone in Australia with a Medicare card will receive care free of charge as a public patient. However, this is not applicable for all services. For example, you may need to make co-payments for pharmaceuticals you receive as part of your hospital care.

Can you be treated as a private patient in a public hospital?

If you have private health insurance and are admitted into a public hospital, you may be asked if you would like to be admitted as a private patient. If you choose to be treated as a private patient in a public hospital, you will receive similar services as you would in a private hospital, such as being able to choose your own doctor and staying in a single room if availability allows. You may also be later transferred to a private hospital for follow-up care.

While some hospitals may offer benefits such as private rooms, free parking and coffee vouchers to their private patients, being treated as a private patient in a public hospital generally has no effect on the quality of medical care patients receive.

Check with your insurer about any excess or out-of-pocket expenses you may incur should you choose to be a private patient. You can check and also compare health insurance with Canstar.

Should you be treated at a private or public hospital?

Ultimately, the decision on whether to opt for treatment in a private or public hospital is a personal choice. In Australia, we are fortunate to have access to high-quality care and world-leading medical professionals regardless of which option you go with.

If you have private health insurance, it could be a good idea to consider the pros and cons, check what your policy covers and any out-of-pocket expenses you may incur, so that if you do opt for private treatment there aren’t any surprise fees and charges to greet you upon discharge.