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Understanding the public and private hospital systems

4-minute read

In Australia, patients can often choose whether they want treatment in a public or a private hospital. Your choice of hospital will depend on your condition, where you live, whether you want to choose your own doctor, and whether you have private health insurance cover.

How the system works

Australia’s healthcare system is made up of both government and private organisations. The government supports the cost of healthcare under the Medicare system. It also pays extra healthcare benefits to veterans and people on low incomes. If you are new to Australia, you can check with the Australian Department of Human Services whether you are eligible for Medicare or other benefits. 

Everyone in Australia with a Medicare number is entitled to free treatment as a public patient in a public hospital, paid for by Medicare. Medicare also covers part or all of the cost of going to a GP, a specialist, and some allied health services such as physiotherapy and occupational therapy.

Australians are also encouraged to have private health insurance, although it is not compulsory. There are many different private health insurance schemes, but most entitle you to choose your doctor or specialist, to be treated in a private hospital, or to be treated as a private patient in a public hospital. Just over 2 out of every 5 hospitalisations in Australia are in a private hospital. 

Private hospital cover helps to pay the costs of treatment by a doctor. It may also cover expenses such as operating theatre fees, pathology services and the cost of accommodation in a private hospital. However, private insurance may not cover all of these costs. Check with your fund before you choose care in a private hospital.

If you have private health insurance, you are still entitled to free care in a public hospital.

Why choose a private hospital?

If you are treated in a private hospital, you will have more choice about your care. For example, you can choose your own doctor. In some cases, your doctor may operate only in a private hospital.

Waiting times for elective (planned) surgery are usually shorter in a private hospital. You may get extra services like your own room and a more pleasant environment. You are also more likely to be in hospital for fewer days and are at slightly lower risk of something going wrong if you are in a private hospital.

About 3 out of 10 babies are born in a private hospital. There is more chance of having an intervention, such as a caesarean, in a private hospital. 

Why choose a public hospital?

Australia’s public hospitals provide high quality medical care and are free of charge. They tend to be more widely accessible and offer more services than private hospitals. Public hospitals may have better medical facilities for your condition than private hospitals and are usually equipped to handle more complex cases.

Also, public hospitals are usually the first choice for emergencies or acute health issues. Almost all emergency department and outpatient services in Australia are provided by public hospitals. If you need to call an ambulance, it will take you to a public hospital.

Waiting periods for elective surgery are usually longer in public hospitals. 

Private patient in a public hospital

You can choose to be treated as a private patient in a public hospital. That means you will be treated by your own doctor, you will be given a single room if one is available, and you may be transferred to a private hospital for follow-up care. You will likely keep seeing the same doctor later in his or her private rooms. 

Who can help?

Deciding whether to go to a public or private hospital can be confusing, especially when you are unwell. Many people rely on previous experience, the advice of friends and family, or their doctor when choosing a hospital. 

If you have one, it is important to consider what your private health fund will cover. Find out about any out-of-pocket costs, waiting periods, and what facilities are available. You can learn more about private health insurance at the Private Health Insurance Ombudsman website.

The Australian Institute of Health and Welfare’s My Hospitals website enables you to compare performance information for more than 1,000 public and private hospitals in Australia.

Last reviewed: December 2017

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