How does Australian health care work?

[marnie723 0]

Hi.. a little off topic but I was wondering how your health care system works. I am a Canadian living in the US right now & I have been following along all the debates on how public vs.private health systems work. Here in the US you're screwed if you don't have insurance or money & in Canada there is long wait lists for some operations. I understand how it works in Britain & France and most Countries have a socialized health system. In Canada they are debating about having a 2-tier system one publically funded & one privately for people who can pay cash. Most people are against this because they fear it will end up like the US system, where it's for profit. I am wondering if this system has worked in other countries from people who actually use it, not politicians or medical associations who warp the facts to fit there cause. We have health insurance here in the US but I still can't get use to how much each appointment costs(you have to pay a portion) & annual deductibles. Neighbours of ours who are self employed pay 1200$ a month for health insurance for a family of 3 in their early 30's. So are people living in Australia happy with their health system ??

[cwt3844 0]

Hi.. a little off topic but I was wondering how your health care system works. I am a Canadian living in the US right now & I have been following along all the debates on how public vs.private health systems work. Here in the US you're screwed if you don't have insurance or money & in Canada there is long wait lists for some operations. I understand how it works in Britain & France and most Countries have a socialized health system. In Canada they are debating about having a 2-tier system one publically funded & one privately for people who can pay cash. Most people are against this because they fear it will end up like the US system, where it's for profit. I am wondering if this system has worked in other countries from people who actually use it, not politicians or medical associations who warp the facts to fit there cause. We have health insurance here in the US but I still can't get use to how much each appointment costs(you have to pay a portion) & annual deductibles. Neighbours of ours who are self employed pay 1200$ a month for health insurance for a family of 3 in their early 30's. So are people living in Australia happy with their health system ??

Hi Marnie, Australia also has two tier system - a socialised health system (Medicare) which covers all residents for treatment in public hospitals and also provides refunds which cover all/most/some cost of consultations for general practitioners, medical imaging, pathology, psychology, most medical specialists etc etc. A large number of our hospitals are public, but increasing numbers of private hospitals are springing up too. Medicare is funded through the taxation system but, if you don't earn enough to pay income tax, you are still covered by the system. Of course, the pressures on the health system are increasing and many people who are in the financial position opt to take out private health insurance (roughly $100 a month for a single, and double that for families). This also covers you for the majority of cost of treatment in a private hospital and also gives you the option of a private room and your own choice of doctor in a public hospital. Downside is there are out of pocket costs when you opt to be treated as a private patient patient in a public hospital. Lap banding is, in theory, available in the public system but many hospitals have closed the waiting lists for the procedure as the list is so long. In reality, most lapbanding is done in the private hospital system - depending on your insurer you are usually out of pocket about $3000 or you fund the whole lot yourself for around $13-15000. The out of pocket costs come about as most surgeons / anaesthetists etc charge what the Australian Medical Association recommends and Medicare and the private insurers all base their refunds on what the Government call the Standard Fee (Of ourse, there is a discrepancy between the two!)

Our private insurance system is fairly transparent in that you know when you take a particular policy with any given insurer what you are and are not covered for (provided you ask the questions) - you can opt for a lesser coverage and then not be covered for orthodontics or joint replacement surgery etc etc. Only around 40% of Australians have private health insurance and a lot of them opt to be treated as a Medicare patient in public hospitals a lot of the time. The Medicare system still provides the same level of rebate wheIf you were turning up at your local hospital's Accident and Emergency department you would receive essentially the same treatment regardless of whether you did or did not have private insurance. If you needed surgery, you may have more options with private insurance. Our system is not perfect but its pretty good compared to many countries. Enough! - its nice that you are interested in health systems in place around the world. I hope this makes some sense.

[oldspark 0]

IT DOESN'T !!!!!!!!!!!!!!!!!!!!!!!:speechles

[marnie723 0]

Thanks for your reply CW8. I've heard the Canadian gov't use other countries 2-tier system as examples. I don't think anyone has a perfect health-care system except maybe France & maybe that can't last forever. Everyone is critical of their own countries health care but I think people have to be thankful for what they have. Living here in the U.S. now I had to take my 2year old to an emergency room one night due to a high fever & being disoriented. The facilities were nice, new & the doctor spend 5mintures with us, told me my son had an ear infection & gave me a prescription for antibiotics. Cost of the visit to the E.R......3500$... separate doctors bill 68$. Luckily we had our deductible paid already of 600$. So my out of pocket expense was 418$ for this one quick visit to the E.R

I had to pay a 10% copay, & the doctors bill. WOW! I almost fell over.....that was my portion of the bill WITH good health insurance. I was use to never paying a dime in Canada.

The worry in Canada is that a 2-tier system will not solve wait times for operations because doctors will take the private health insurance patients first where they are able to make more money essentially allowing the affluent people to receive better care. I am waiting to rent the Michael Moore movie "Sicko" about different healthcare systems.

[sewenup1 0]

The doctors here in Australia tend to take the private insurance patient first as well, but if the surgery is emergency surgery then the Public Health system is the way to go. It is only elective surgery like lap-banding, or non-urgent surgery that have to weight.

In Aus. going to the emergency room for an Aust citizen is free, so we would never hesitate to do so. I have travelled to the US on holidays several times and always make sure that my travel insurance and health insurance are top level as I'm afraid I would never be able to afford medical help there.

[cwt3844 0]

Thanks for your reply CW8. I've heard the Canadian gov't use other countries 2-tier system as examples. I don't think anyone has a perfect health-care system except maybe France & maybe that can't last forever. Everyone is critical of their own countries health care but I think people have to be thankful for what they have. Living here in the U.S. now I had to take my 2year old to an emergency room one night due to a high fever & being disoriented. The facilities were nice, new & the doctor spend 5mintures with us, told me my son had an ear infection & gave me a prescription for antibiotics. Cost of the visit to the E.R......3500$... separate doctors bill 68$. Luckily we had our deductible paid already of 600$. So my out of pocket expense was 418$ for this one quick visit to the E.R

I had to pay a 10% copay, & the doctors bill. WOW! I almost fell over.....that was my portion of the bill WITH good health insurance. I was use to never paying a dime in Canada.

The worry in Canada is that a 2-tier system will not solve wait times for operations because doctors will take the private health insurance patients first where they are able to make more money essentially allowing the affluent people to receive better care. I am waiting to rent the Michael Moore movie "Sicko" about different healthcare systems.

My understanding is that, in our public hospital system, surgeons are allocated a given number of theatre hours and they have to prioritise to fit their patients into that time. The Medicare system (Government) covers all those costs. If surgeons have privately insured patients (ie patients' insurance funds will pay theatre costs) the surgeon can access additional theatre time, even in the public system as long as theatre space is available. Of course, in a private hospital those rules don't apply. I might be naive but think the tracking system used in public hospitals is probably tight enough that surgeons can't put private patients in, in preference to private patients. Surgeons tend to direct private patients off to private hospitals as it allows both the doctor and the patient much more flexibility ie what day / time / hospital). I saw my surgeon yesterday for the first time re lapband surgery and with the benefit of private insurance we were able to get our diaries together and sort out best day for both he and I and which private hospital was most convenient for us both. Sadly, not everyone is lucky to have that level of choice.

I'm very impressed at your level of interest and knowledge of other health systems. You're right though whilst what we have is not perfect, at least we don't have seriously ill people being dropped outside ER depts without ID as neither they nor their families have a hope of footing hefty hospital bills for essential services.

Cheers - Cath

[blytheswideshut 0]

IT DOESN'T !!!!!!!!!!!!!!!!!!!!!!!:speechles

Makes sense to me...

[Jachut 487]

Oh, our system has its faults, I think its easy to say its wonderful from my position as a high income earning middle class white person with private health insurance.

i think you might look at it differently from a postion of less priviledge. Lapbanding must seem a ridiculous dream for many people facing 7 year waiting lists at The Alfred and no private health insurance. My surgeon wont take self pay patients at all, because they can run out of cash VERY quickly if complications occur. So you need to have private health insurance.

But I'd take Australia's system ANY day over what people in the US have to go through. You dont get denied anything if you have private health insurance here, if the surgeon will do the operation, you're covered. To have to jump through hoops to qualify for things when you've paid the premiums is ridiculous.