Australian Healthcare system??
May 1st 2009, 9:47 pm
#31
Lost in BE Cyberspace
Joined: Apr 2004
Posts: 10,375
Re: Australian Healthcare system??
In a word, Medicare is a shambles.
You can be bulk billed and pay nothing. The sam doctor might charge you $60 and Medicare refunds about $30. It seems totally random.
Many people will say it works very well, but perhaps have never been near a hospital here. Or have been in a hospital in another state. It's random!
Since Mrs Wol and I arrived, four and a bit years ago and both in good health, we have paid out $46,252 for healthcare, minus Medicare rebates of $8630 and private insurance refunds of $1463. These figures include prescriptions and dentists visits. Hospital charges that were incurred are not included - they were extra and paid by insurance.
The thing to note is that private insurance only refunds the "gap" - the difference between the Medicare assessed fee and the 85% of that. But the actual charge is likely to be well over the Medicare assessment. So if an anaesthetist charges $800, and the Medicare assessed fee is $100, you will only get back $85 from Medicare and, if privately insured, $15 from the insurance! Leaving you with a bill for $700.
I could go on, because the randomness is comical!
You can be bulk billed and pay nothing. The sam doctor might charge you $60 and Medicare refunds about $30. It seems totally random.
Many people will say it works very well, but perhaps have never been near a hospital here. Or have been in a hospital in another state. It's random!
Since Mrs Wol and I arrived, four and a bit years ago and both in good health, we have paid out $46,252 for healthcare, minus Medicare rebates of $8630 and private insurance refunds of $1463. These figures include prescriptions and dentists visits. Hospital charges that were incurred are not included - they were extra and paid by insurance.
The thing to note is that private insurance only refunds the "gap" - the difference between the Medicare assessed fee and the 85% of that. But the actual charge is likely to be well over the Medicare assessment. So if an anaesthetist charges $800, and the Medicare assessed fee is $100, you will only get back $85 from Medicare and, if privately insured, $15 from the insurance! Leaving you with a bill for $700.
I could go on, because the randomness is comical!
Wol, I certainly get your point.
Our kids dental care this year will be around $12,000 private rebates will pay about $4000 of that and the 20% tax rebate, however it still leaves us a scary amount out of pocket.
Ive read on here medicare is great, dont worry about it
, the person is usually talking about the emergency system, of course thats quick/free, if your having a heart attack someone is going to see you!!! However need some eye surgery/elective surgery of any type, ie non emergency and you might wait 7 bloody years or pay for it, entering the world your talking about, big bills and a bloody nightmare of paper etc.
Specialists are interesting with the medicare schedule fee, like $300 appointments that refund $65, freak now when I hear the words specialst
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May 2nd 2009, 2:30 am
#32
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Re: Australian Healthcare system??
As mine Bulk bills, I don't get to see anything on these GP's that people pay for, but I would like to try to find out exactly why some only get 85% back.
At the moment I can only assume that it comes down to the differences between "GP services" & "other out-of-hospital services", one being 100% and the other 85%.
May 2nd 2009, 2:58 am
#33
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Posts: n/a
Re: Australian Healthcare system??
I just checked online records, and a standard quick GP appointment, to renew a Prescription...
Item Number 23
Surgery consultation - Level B (less than 20 minutes) $33.55
$33.55 is 85% of $39.47
The rebate was changed from $32.80 to $33.55 between Aug and Nov 2008
Item Number 23
Surgery consultation - Level B (less than 20 minutes) $33.55
$33.55 is 85% of $39.47
The rebate was changed from $32.80 to $33.55 between Aug and Nov 2008
May 2nd 2009, 3:59 am
#34
Lost in BE Cyberspace
Joined: Dec 2008
Posts: 6,039
Re: Australian Healthcare system??
ABCD: The figures locally for a GP are: 20m consultattion $60, medicare refund $33.55. If the refund is 100%, as you say, then the scheduled fee must be $33.55. Si I think the figure must be 85% too for a GP?
Oh, and Yes: our hospital treatment has been private - not much point in paying for insurance and not using it!
I have no intention of posting our medical history on a public forum, but I keep good records and the figures above are up to date and correct!
Oh, and Yes: our hospital treatment has been private - not much point in paying for insurance and not using it!
I have no intention of posting our medical history on a public forum, but I keep good records and the figures above are up to date and correct!
The public system, medicare, is similar to the NHS. It has great outcomes in many area's...you are way better off getting cancer in Australia as our 5 year survival rates are world class whereas the NHS is down the bottom of Europe near Poland, you are treated a lot better for stroke here etc. In some other ways I'm sure the NHS is better - cheaper prescriptions, more cheap dental available than medicare for a start.
I have talked to one of my sisters going through the public system the last few years and she has been treated well but I don't think personal anecdotes count for a lot. The stats say it is comparable and sometimes better than the NHS so I think shambles is very harsh. Unless you think all public health systems around the world are in shambles
You'll see a lot of people on this forum not even know they can go to medicare specialists as an outpatient at a public hospital for free. They assume that because the GP referred them to a specialist and they then claimed part of that specialist fee back from medicare that they are using the public system and that it is very expensive. They aren't, they are being treated by a private specialist. They do not realise that you can ask your doctor to refer you to a public specialist and have the treatment free as my sister has done for the last few years and had no complaints about waiting too long. Some do know, but choose not to wait.
I'm sure the system is not perfect but none of them are
May 2nd 2009, 4:01 am
#35
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Joined: Jun 2004
Location: Hills District
Posts: 1,399
Re: Australian Healthcare system??
I am one of those who believe that medicare messed up the whole health system. Before medicare, everyone had to have private health insurance, it was cheap and you got all your expenses paid, in fact after one birth I got a cash rebate as I had cover for a private room but had to go into a public ward! Pensioners and the unemployed got free care.
May 2nd 2009, 4:06 am
#36
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Joined: May 2004
Location: Umina, NSW
Posts: 2,453
Re: Australian Healthcare system??
dependent).
You'll see a lot of people on this forum not even know they can go to medicare specialists as an outpatient at a public hospital for free. They assume that because the GP referred them to a specialist and they then claimed part of that specialist fee back from medicare that they are using the public system and that it is very expensive. They aren't, they are being treated by a private specialist. They do not realise that you can ask your doctor to refer you to a public specialist and have the treatment free as my sister has done for the last few years and had no complaints about waiting too long. Some do know, but choose not to wait.
I'm sure the system is not perfect but none of them are
You'll see a lot of people on this forum not even know they can go to medicare specialists as an outpatient at a public hospital for free. They assume that because the GP referred them to a specialist and they then claimed part of that specialist fee back from medicare that they are using the public system and that it is very expensive. They aren't, they are being treated by a private specialist. They do not realise that you can ask your doctor to refer you to a public specialist and have the treatment free as my sister has done for the last few years and had no complaints about waiting too long. Some do know, but choose not to wait.
I'm sure the system is not perfect but none of them are
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May 2nd 2009, 4:11 am
#37
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Joined: Jun 2004
Location: North Wales > Manly, Brisbane > Gympie!
Posts: 530
Re: Australian Healthcare system??
[QUOTE=ShoreyM;7532046]
If the doctor that bulk bills is crap! The one I went to was so I would rather pay and have a doctor I trust. If you find a good doctor that bulk bills then thats great!
Although the migrant Poms seem to have this big think about finding "free" medical coverage from doctors who "bulk bill" - must be a throw back to their NHS expectations. QUOTE]
Guilty as charged !!
Why pay for something if you don't have to? I don't understand why anyone would chose to pay if you can get it bulk billed? Please enlighten me.
Guilty as charged !!
Why pay for something if you don't have to? I don't understand why anyone would chose to pay if you can get it bulk billed? Please enlighten me.
May 2nd 2009, 4:49 am
#38
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Posts: n/a
Re: Australian Healthcare system??
Percentages are only correct if the doctors charge the fee the government thinks they should. My doctor charges $50 for a standard consultation, so $33.55 isn't 85%!! However, your doctor bulk bills and is happy to accept the $33.55 that the gornment gives him.
I am one of those who believe that medicare messed up the whole health system. Before medicare, everyone had to have private health insurance, it was cheap and you got all your expenses paid, in fact after one birth I got a cash rebate as I had cover for a private room but had to go into a public ward! Pensioners and the unemployed got free care.
I am one of those who believe that medicare messed up the whole health system. Before medicare, everyone had to have private health insurance, it was cheap and you got all your expenses paid, in fact after one birth I got a cash rebate as I had cover for a private room but had to go into a public ward! Pensioners and the unemployed got free care.
You get 85%, or whatever the % is, of the scheduled fee for that consultation rebated.
If the scheduded fee is $37.95 (which is what I found to be the scheduled fee for a Cat A consultation), then you get back the % of that $37.95, whether you actually paid the doctor $40, $50 or $60.
The confusion, in my mind, is that the current payment/rebate made by medicare for a "Surgery consultation - Level B." is $33.55. That is either 85% or 100% of the current scheduled fee for that consulation level.
But it doesn't seem to agree with the scheduled fees that I have seen quoted.
May 2nd 2009, 5:14 am
#39
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Posts: n/a
Re: Australian Healthcare system??
Scheduled fees may have changed.
I have just found a document that quotes different "scheduled fees" to the original one that I had, but it also confirms the 100% benefit:
Item 3
SURGERY CONSULTATION (Professional attendance at consulting rooms)
(Professional attendance for an obvious problem characterised by the straightforward nature of the task)
Fee: $15.35 Benefit: 100% = $15.35
Item 23
SURGERY CONSULTATION (Professional attendance at consulting rooms)
(under 20 minutes)
Schedule Fee: $33.55
Benefit: 100% = $33.55
Item 36
SURGERY CONSULTATION (Professional attendance at consulting rooms)
(at least 20 minutes)
Schedule Fee: $63.75
Benefit: 100% = $63.75
Item 44
SURGERY CONSULTATION (Professional attendance at consulting rooms)
(at least 40 minutes)
Schedule Fee: $93.80
Benefit: 100% = $93.80
I would have expected a repeat prescription to come under item 3, for $15.35, not item 23 for $33.55
I have just found a document that quotes different "scheduled fees" to the original one that I had, but it also confirms the 100% benefit:
Item 3
SURGERY CONSULTATION (Professional attendance at consulting rooms)
(Professional attendance for an obvious problem characterised by the straightforward nature of the task)
Fee: $15.35 Benefit: 100% = $15.35
Item 23
SURGERY CONSULTATION (Professional attendance at consulting rooms)
(under 20 minutes)
Schedule Fee: $33.55
Benefit: 100% = $33.55
Item 36
SURGERY CONSULTATION (Professional attendance at consulting rooms)
(at least 20 minutes)
Schedule Fee: $63.75
Benefit: 100% = $63.75
Item 44
SURGERY CONSULTATION (Professional attendance at consulting rooms)
(at least 40 minutes)
Schedule Fee: $93.80
Benefit: 100% = $93.80
I would have expected a repeat prescription to come under item 3, for $15.35, not item 23 for $33.55
May 2nd 2009, 5:50 am
#40
Lost in BE Cyberspace
Joined: Sep 2007
Location: Canberra
Posts: 8,378
Re: Australian Healthcare system??
[QUOTE=OzWannabee;7534450]
Asbolutely! You would be hard pushed to find a universal bulk billing GP in ACT anyway - maybe that is because bulk billing was initially intended to provide the service to those who could not afford the co payment not those who didnt want to fork out and ACT definitely ranks amongst the more affluent areas. We do have some medical centres which bulk bill but you dont necessarily get continuity of care and just take whoever happens to be on shift that day.
May 2nd 2009, 9:22 am
#42
Has left the building
Joined: Mar 2007
Posts: 4,079
Re: Australian Healthcare system??
Good to know. I've definitely spent more than $1500 this year already 
I'll be quite happy to go back to 'normal' medical expenses.
May 2nd 2009, 9:32 am
#44
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Joined: May 2004
Location: Umina, NSW
Posts: 2,453
Re: Australian Healthcare system??
On another note, hubby has psoriasis and he goes 3 times a week for UV treatment - bulk billed, sees the skin specialist - bulk billed.
I think on the whole we do well out of the system and are lucky we have been so, we never asked for free we just happpend to get the free doctors.
Lucky for us we didnt know about my condition before or we wouldn't have been here anyway (MS). We did declare hubby's condition though.
If we go to dentist our health fund covers 2 checkups and cleans a year as well as xrays (had some other day no charge for any of it) Just having a mouth guard done which will cost $460 but my fund will pay half so not so bad. Lucky for us one of my kids already had his braces on when we moved here, the other doesnt desperately need them but is in navy now so all treatment is free. Daughter may just escape if only she would stop sucking her thumb (14 years old).
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May 2nd 2009, 10:07 am
#45
Lost in BE Cyberspace
Joined: Mar 2003
Posts: 9,397
Re: Australian Healthcare system??
I think people new to Australia and Australian healthcare should dig a little into the pros and cons of the system: don't assume that the private insurance works the same way as the UK model, with basically just an excess to pay if you need treatment.
Yes, you will usually pay an excess, but you will also pay a great deal on top of that which neither Medicare nor the insurance will cover.
And be prepared, especially outside major cities, for disintegrating public hospitals and lack of doctors and nurses.
(Our local public hospital is near collapse - only this week there was a rally to try and make the NSW government aware of this. Fat chance - they only spend any money at all on marginal Labor seats. They have had to close the maternity unit because all the staff have left.)
Yes, you will usually pay an excess, but you will also pay a great deal on top of that which neither Medicare nor the insurance will cover.
And be prepared, especially outside major cities, for disintegrating public hospitals and lack of doctors and nurses.
(Our local public hospital is near collapse - only this week there was a rally to try and make the NSW government aware of this. Fat chance - they only spend any money at all on marginal Labor seats. They have had to close the maternity unit because all the staff have left.)