Public vs Private: two systems, one broken whole

There’s this assumption that floats around:

Private care = better care.

We believe it because we pay for it.

We believe it because the hospitals look modern, the beds have better linen, and we assume the extra cost must mean better service.

But here’s the truth I’ve come to realise — it’s not about appearances. It’s about systems. And both our public and private hospital systems in Australia are under pressure. One is stretched. The other is under-regulated.

Two systems, same crisis — and patients caught in the middle.

Let’s start with public hospitals.

In Queensland, nurse-to-patient ratios are legally mandated in the public system. That means there’s a minimum number of nurses that must be present on a shift. It’s not perfect, but it’s something — and it’s designed to protect both patients and staff.

Now compare that to private hospitals.

Private hospitals aren’t held to the same staffing standards.They’re governed under federal law, not state law — and there’s no legal requirement for safe nurse-to-patient ratios. The result? They can (and often do) run lean to keep costs down.

So while the private system might feel more “premium” on the surface, it’s not necessarily safer.

It’s not necessarily better staffed.

And in some cases, it’s far more fragile than we realise.

Here’s the kicker — both systems are being propped up with government money.

Public hospitals are state-funded.

Private hospitals receive federal support — and people are financially incentivised (via tax breaks) to hold private cover and ease the pressure on public facilities.

And while it might sound like everything’s falling apart, here’s the reality check:

Australia still ranks relatively well globally. According to the Commonwealth Fund’s 2021 comparison of 11 high-income countries, Australia’s healthcare system was ranked 3rd overall, behind only Norway and the Netherlands.

But there’s context.

We have a much smaller population — under 27 million — compared to countries like the UK or the US. This makes our system easier to manage on paper, but it also hides the cracks forming beneath the surface. And as our population ages, and demand grows, we’re heading in the same direction as other overwhelmed systems.

So we’re caught in a squeeze:

The public system is underfunded and overstretched.

The private system is under-regulated and profit-driven.

And the government is throwing money at both just to keep things moving.

We’ve split healthcare into two streams — but neither is coping.

And when the floor gives way in one, the other feels it instantly.

This isn’t about blaming one side or praising the other.

It’s about calling out the bigger issue:

we’ve built two flawed systems, hoping they’ll hold each other up — and they’re both starting to wobble.

So maybe instead of patching up two crumbling systems…

We start thinking about what comes next.

B x

Just a note: Everything I’ve shared here is based on my personal experience and views. I’m not naming names or pointing fingers — just being honest about what I saw and felt. It’s not about blame. It’s about trying to do better. This is shared in the hope of encouraging conversation, not conflict.