Skip to content
Western Orthopaedic Clinic logo
Western Orthopaedic Clinic logo

Self-Insurance and Self-Funding Surgery

As the public hospital system becomes increasingly overloaded, we are seeing more and more patients who choose to pay for their surgery themselves. This is called self-insurance or self-funding surgery. Self-funding surgery makes sense for many people who do not have private health insurance. There are many benefits to paying for your surgery in a private hospital.

1. Avoid the overburdened public hospital system
Waiting times for an initial appointment may stretch out over a year in some centres, and then it may be another similar wait for a date for your surgery. Many orthopaedic conditions are classified as elective rather than urgent in the public hospital system. However, even an elective condition such as a torn cartilage (meniscus) in the knee may be enough to stop you from working. If you are self-employed, this may lead to significant loss of income.

Furthermore, long delays can impact on the results of surgery, even for elective surgery. If you have an anterior cruciate ligament (ACL) tear, your knee is unstable and you may sustain further injuries while waiting for surgery. If you have a rotator cuff tear, the tendons may retract and then muscles can waste away. In some cases this can make the tear irreparable over time.

2. The right to choose your surgeon
The public hospital system does not allow you to choose your treating doctor. Your surgery may be performed by a doctor in training, under the supervision of a qualified consultant specialist.

3. Optimal and personalised follow up
In the public hospital system, you may be attending extremely busy clinics with long waiting times. Often you will not see the person who did your surgery. You may see a different doctor at every consultation as staff rotate regularly. Public physiotherapy and rehabilitation services can be overstretched. In the private sector, you can see your surgeon as often as is required. I personally liaise with physiotherapists regarding rehabilitation plans.

4. Private health insurance costs are increasing rapidly
The percentage of people with full private health insurance in Australia is decreasing.

5. Avoid the policy exclusion trap
After you have paid for private health insurance, you may find that your policy does not cover the treatment you require.

6. Procedures
Self-funding surgery is generally best suited to short stay and low risk surgical procedures. Suitable procedures may include knee and shoulder arthroscopy, anterior cruciate (ACL) reconstruction, rotator cuff repair, shoulder dislocations and fractures.

If you think that self-funding surgery may be something that would assist you, Dr Colvin is happy to see you and discuss the process.

Back to All Articles