Wednesday, November 23, 2016

Health care in Australia #101

Firstly, we pay a tax levy for our health care. It does not cover the cost of health care but it does significantly contribute towards the cost of Australia's health care costs. It is around 2% or 2.5% of taxpayers income. I've never heard of anyone objecting to pay the levy.

Should you have a heart attack, a stroke, cancer or childhood meningitis, you will get the best of care in our public hospitals and there will be minimal, if any, out of pocket expenses. You can expect to wait a long time in Emergency at public hospitals with a minor complaint as you are triaged into the most serious are dealt with first. A splinter in your finger to be removed will have you at the end of the list and you could wait many many hours in the waiting room, as you see drug addict overdoses treated before you and even drunk people who behaved badly and hurt themselves. You can go to Emergency for any health reason but I expect you are advised if it is minor, to go elsewhere. Nevertheless, you have a right to be seen.

There are many ailments that you will have to wait for in the public system. Allergies? Hip replacement? Dietician. The list is long. These items are wrongly called Elective Surgery, although often they are anything but elective, but generally they are not life threatening. What you can do is shop around public hospitals, including in the country and may get on a shorter waiting list, but note, generally the best surgeons work at what are known as our major teaching hospitals.

There are in capital cities and some smaller cities, hospitals dedicated to an area of health, such as the Women's Hospital, Children's Hospital and cancer hospitals.

Using tax rebates and penalties, typical carrot and stick approach, the government strongly encourages those who could afford it to take out private health insurance.

Mother has top hospital private health cover that her children pay for. Her recent hospital stay cost her nothing, aside from about $250 excess when she was admitted to the first hospital. That is a one off annual cost, so you never pay it again in the same year.

When I had surgery several years ago, I paid the $250 too, but as I was not an old age pensioner, I was charged more by the surgeon than health insurance or the government would pay and I had to make up the difference, which added to the $250 brought the bill up to around $1000. It wasn't urgent surgery and I should have used the public system.

But what I have since learnt is that you can use the public hospital system as a private patient. You have to do a bit bargaining. Tell them that you will attend as a private patient but tell them you don't want out of pocket costs. They win and so do you. Private patients are quite profitable for public hospitals.

I'd better mention doctors, general practitioners. I pay around $70 to my doctor. The government gives me back about $33. There are what are known as bulk billing clinics, where you can be treated for the cost of what the government pays. But there as not as many as there used to be as the $33 has been frozen and it is a pretty minimal return for a doctor. You will get good enough care, but it is not like having your own doctor.

Mother attends a clinic that is halfway in between,  and as a poor pensioner, she would probably not be charged at any doctor practice anyway. She sees her own doctor who works there and she has come to know and complains about endlessly.  R as a not so poor pensioner pays to see his doctor. His doctor knows his income in limited, and so at times does not charge R if it is quick visit. R pays for a necessary drug that for some reason is not subsidised by our government as many drugs are. It costs him  around $40 per month. As a pensioner, most drugs are for him are about $5. For me, I pay the full price up to around $30 and then a government subsidy kicks in.

In summary, you are entitled to free health care in Australia. You just may have to wait at times, a long time in some cases and there are some aspects about it that aren't very good. If you have the time, generally you can get your required medications from public hospitals as a public patient for free (not entirely sure about that). Our system is not too bad, but disincentives for overuse of the public system are in place.

23 comments:

  1. I have top hospital cover too,plus dental and optical, paid by my kids as I can't afford it. I'm rarely ill, so haven't used the hospital component at all, but I'm grateful that I can get my teeth looked after with the extra costs covered by myself, although it takes me a while to save for it. My dentist gives me a quote for work that needs doing, I contact the health fund to see how much they'll pay per procedure and I save the necessary difference before making the appointment.
    I think our hospital system is pretty good.

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    1. All good River. I often wonder about the economics of health insurance and I wonder if your children wouldn't be better to put the money in the bank for you for health care. Clearly though, should you want private hospital care, and as an age pensioner, after my mother's experience, it will be a good experience. I note, you ask questions about cost. Many of us don't and pay an awful lot.

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    2. money in the bank would go straight to the health care fund anyway, so they pay it right to the company.
      You should always contact your health care provider and ask them for quotes on how much they will pay for whatever you are planning. in an emergency situation that may not be possible, but if you have an appointment coming up for anything, any type of procedure, get a quote from the doctor and one from the health care provider. Then you'll know the difference you'll have to pay and can budget accordingly.

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  2. Andrew i think that comparing to Europe your health system works perfectly..

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    1. It doesn't Gosia. Former western European countries seem to be better than here.

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  3. I pay my taxes and pay Medibank insurance as well, so I was expecting no problems when I went to hospital this year. In fact the hospital was excellent! But my doctor didn't have access for his patients in any of the big public hospitals. So I had to either 1] change my specialist physician after all these years or 2] go to his remote, religious, private hospital.

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    1. Not good Hels. Remote and religious hospital? I would like to know. Privately if you like. andrew highriser at gmail.com

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    2. Oops, I did not mean geographically remote. Cabrini was not that far from home. And the staff were lovely.

      But it had no contact with the public hospitals where ongoing medical education is considered essential. The large crucifix above each bed was to expected in a private Catholic hospital, but I wanted a public hospital with no religious visions.

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    3. Hels, the world has changed. I expect the crucifixes have gone, as have the nuns from Cabrini and even five years ago I was served a ham sandwich for lunch at Masada.

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  4. In my thoughts your health system is a lot better then here in United States. In the morning I'm going and talk to a state health care counselor to see what my options for 2017. Maybe I will blog about it tomorrow or when I get back from Thanksgiving.
    Coffee is on

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    1. Dora, health care decisions which could all be made redundant by you know who.

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  5. I think we have more or less exactly the same health system as you have ! We also took an extra hospital insurance but that's it. We can choose the doctors as we want, but we have to pay the bill first then and you will be reimbursed by the official healthcare this is to avoid that one runs for nothing to a doctor. If you have to pay first you think it over twice. Poor people can go for free to hospitals.

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    1. Gattina, we used to pay like that, that is pay the full amount and then go to the department and claim the money back, but now it happens electronically. You just hand over your credit or debit card.

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  6. An excellent summary, and also summarises why I think ours is probably the best health care system of all the countries I can think of.

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    1. Jackie, I am really not sure. Some European countries have very good systems.

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  7. I think our system works really well Andrew, but then again 'touch wood' I don't have call to use it very often. When my eyes fell apart a few years ago, everything was covered by my health cover, except for the 250 excess but considering I had one of the best specialists in the world doing the job that was a small price to pay. My heart goes out to the US, if they do away with Obamacare .

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    1. Grace, your experience is good to hear. Obamacare is not very good, but better than what the US had. Who knows what Trumpet will do.

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  8. Thanks for sharing this. I'm always interested to see what other countries offer. As you know we're currently in turmoil. It will be interesting to see what we end up with.

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    1. Sandra, and the last thing you want is 'interesting' when referring to health care.

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  9. Sometimes our system works and other times it doesn't.
    We have private health cover, have had for years and wouldn't be without it. Certainly paid for itself over the years with my husbands operations.
    Husband spent last night as a patient in the public emergency as he was an emergency :) but alright now....potassium level was extremely high, had the blood test at private etc. in the early morning, Dr. phoned 5.50pm and said get to the Public Hospital - no waiting either even though the waiting room was full! Excellent service, patient care...

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    1. Margaret, good experience for you then. I hope you husband is ok. Generally our system works well and when it doesn't we do hear about it, though at times too late.

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  10. Our health care is not free at all here, but we wait long hours in the ER every time. I've heard all kinds of complaints, even at Urgent Care, it better not really be urgent. Haha! Typically there are gofundme's all over the place to help people in the states pay for care for cancer, broken limbs, infections, all kinds of treatment because many people end up in bankruptcy even if they have insurance should they suffer one medical emergency. It's really messed up.

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    1. Strayer, while I know he was politically hamstrung, nothing in the world disappointed me more than that Obama did not fix your health system. May you live a long and healthy life and die of a heart attack in your old age in bed.

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