How a Dodgy Shoulder cost me thousands and what it taught me

As a father I feel the only responsible thing to do when it comes to health insurance is have the top private health cover.

So my wife and I decided to make some sacrifices and pay a premium with one of the large insurers… we call it paying for peace of mind.

We’ve been doing that for many years, and it seems the only reward in recent times has been to see our premium increased by around 9 per cent a year for no extra cover (around 3% more than the average).

But with two beautiful and boisterous young sons we decided not to take any chances.

Little did we know it would be Dad who’d be making most of the claims this year!

I have recently had shoulder surgery on my rotator cuff, which I’ve learned is called ‘old man’s shoulder’. (Hang on. At 58 I’m not that old, am I?)

“Just bad luck,” said the Doctor, “You’ve worn them out, and after we’ve fixed the left one we will have to operate on the right one”.

So it was off to the specialist, more money, mostly out of my pocket. He wanted x-rays, an MRI and an ultrasound – so even more money, again most out of my pocket.

Fortunately, my two nights in hospital for the surgery were completely covered. But then I got the bills for the surgeon and the anesthetist … you guessed it, more money out of my pocket.

The injury has so far cost me directly more than $4000, above and beyond the amount we spend annually on top cover. I am still in a sling, and now I have six months of costly physiotherapy to look forward to.

Don’t get me wrong. I am grateful for the cover, and the great medical service available to enable me to return to normal in a relatively short space of time.

And I’m not alone – plenty of people go through this experience or something like it every day, and not all can afford top cover.

But, ouch. As if we don’t have enough bills already.

And as a fortunate individual who’s enjoyed good health all of my life (read no claims) this has come from nowhere.

But the reality is that out-of-pocket health costs are higher than they have been for a decade, according to the Australian Institute of Health and Welfare. And this is happening despite the fact most of our health insurance premiums have doubled in about a decade.

Here at the FiftyUp Club, we know health insurance premiums for the Over 50s rose by roughly 1.5 times the federal government’s published national average. That’s why we launched a petition asking for more detailed disclosure of premium increases, which was signed by 13,000 members and which I delivered to the Federal Health Minister earlier this year.

We’ve also asked the government to consider the impact of proposed co-payments on GP visits, X-Ray and Pharmaceuticals given the already-soaring healthcare costs of older Australians.

At least the controversial co-payments appear to have been ditched for now (our information is that they are buried, which is a good result for all Australians – but particularly for those over 50 on fixed incomes).

Now that the federal government is preparing to sell off Medibank Private, we’ve launched a campaign to ask that they do more to ensure the sale doesn’t ratchet up healthcare costs yet again.

How much will it cost to fix an old man’s shoulder a decade from now, when you add up the cost of top cover and the gap payments?

How will an average salary-earner afford it, let alone a pensioner?

That’s why we think healthcare costs are the big barbeque stopper for baby boomers and older Australians. And that’s why we’ll keep fighting with our 100,000 members to make it clear to businesses and governments around the country.