Pine Cone

Latest topic on our OZ research is medical care/costs. From current experience so far we have.....

UK
Visit to GP - Free

Prescriptions - free for kids and pensioners, everyone else pays unless except.

Hospital treatment in or out patient - free

Seeing specialist - free, wait for an appointment to arrive in post.

Dental care - reasonable price NHS dentist (if you can find one). Quality of treatment not great by international standards, but OK. Kids free.

Optical - kids and pensioners free, plus those with some medical conditions. Glasses can be as cheap or expensive as you choose. Kids can usually get free/very cheap glasses once subsidy taken off price.

Maternity care - Free, GP refers you to midwife or hospital for care. Can be lack of continuity of care.


NZ
Visit to GP - Costs vary alot but most people pay (often young children under 6 still pay $10-$15, but sometimes free).

Prescriptions - $3 if subsidised, more if not (e.g brand name ventolin inhaler $14).

Hospital treatment in or out patient - sometimes free but not always.

Seeing specialist - sometimes free, have been charged up to $120 per appointment for non-free stuff, even for kids. Often have to self-diagnose and find own specialist if GP unable to refer you to someone suitable.

Dental care - Very expensive indeed. Quality of dental work superb. Young kids only get one free checkup per year. Older kids only one free checkup if they can find a dentist who will accept them.

Optical - between $60 to $100 per checkup for adults, kids usually get $10-$15 discount. No subsidy on glasses unless on low income and even then it is only once every 2 years and doesn't cover full cost. Adults glasses very expensive. Specialists charge up to $100 per appointment, even for kids.

Maternity care - You have to find your own midwife which can be difficult, or book yourself into a hospital for maternity care. Lots of chasing round involved with little guidance, but more continuity of care if you can find a local midwife.




Oz ?

Also do costs vary in Oz dependant upon whether you have PR or hold a 457 visa?

ABCDiamond

Australia

GP's: About 80% of visits to GPs are free under the bulk billing system. The rest may pay $50 to $60, but get back about $33 from Medicare.

Specialists: Free at Public Hospitals, but expensive everywhere else.

Prescriptions: Normally a maximum of about $33, with subsidies for those on benefits. Prices apply to Children and Adults. Some prescriptions are not covered under the PBS scheme, and are therefore not subsidised at all, meaning that these can be quite expensive.

Emergency Hospital treatment: Normally Free.

Dental care: Almost everyone pays.

Optical: Those on benefits get free treatment and glasses. Everyone can get a free Full Check every 2 years, plus smaller checks in between.

Maternity: You get paid about $5,000 per child.

mark213

Australia

A note on medicare - there is this lovely thing called a Safety Net and Extended Safety Net. Its a real education. Some get lower thresholds some high, depending on your family circumstances ( it if you are on FTB-A, concession etc). For the sake of that and each individual circumstances, you may find medical costly or not. Oh and where some things are "free" they are only free once Medicare pays you back 100% of the cost. You still have to fund the payment to the person. In some events medicare will write a cheque to the specialist, then post it to you, then you have to get it to the specialist along with any gap in the payment.

A second not on Private Health. Its expensive and only really covers private hospital costs. It also gives a refund on dental/optical etc if you pay for that in your plan. You will need to do the maths to work out if you want that sort of cover. In all circumstances you are likely to pay some proportion of costs.

GP's: More like $66 before Medicare refund. And not sure about 80% bulk bill. Some bulk bill kids, some not. You have to really look and then you'll only get 5 minutes attention on bulk bill. I find that i usually can get an appointment on the same day at full price, unlike the UK.

Specialists: Not free at Public Hospitals. You pay them and get a refund from Medicare again depending on your circumstances how much you get back. Expensive everywhere else. In-patient hospital specialist costs are usually free (unless private). Out patient are Medicare refunded as rule.

Prescriptions: Maximum of about $33 per drug per repeat (ie if you have 2 medication and 6 repeats then its 2x6x$33) , with subsidies for those on benefits or if you have reached the PBS Safety Net (different level and scheme to that under medicare).
(Same as ABCDiamond comment [Prices apply to Children and Adults. Some prescriptions are not covered under the PBS scheme, and are therefore not subsidised at all, meaning that these can be quite expensive.]

Emergency Hospital treatment: Normally Free unless you are not on medicare - but usually they waive.

Dental care: Almost everyone pays - some concession cards are covered like OAP's - no choice there - unless you have Private Insurance, but again you still have to pay sometimes 50% or more of the cost of the visit. Quality is usually pretty good, depends on who and how they have arranged their insurance alliances.

Optical: Those on benefits get free treatment and glasses. Everyone can get a free Full Check every 2 years, plus smaller checks in between.

Maternity: You get paid about $5,000 per child - which is means tested now and paid fortnightly. You also get child care tax credits, and other advantages - FTB-A and FTB-B again all means tested.

On maternity its usually free in public hospitals for the OB, midwife etc and the delivery, but you will be in public wards, and have the on-call doctor. However all GP visits are chargeable, as are all scans and blood tests etc, medicare will offer limited refunds. Expect at least $300 of out of pocket costs - maybe more if you have antenatals, more trips to the doc, etc

Private maternity is VERY expensive - we've been hit with the new rules. Even if you Private Health covers you for maternity, its only for in-patient benefits, and does not pay for the OB or the Anesthetist (if you have one). OB charges are between $2000-$7000 plus visits, scans, tests. None covered by Private Health and only $600 or so covered by medicare.

Thanks Labour. Just dont get sick.

Tubbs2Oz

Just a note on prescriptions:

UK - if you have a lot you can prepay for a year for just over £100 and then all prescriptions are free, regardless of your status (employed / age).

Oz - safety net does exist as mentioned in previous post, but I think it's about $1600 for a family. Once you've paid that much then you only pay $7 or $8 for prescriptions after that.
To give you an idea of different medicines - steroid inhalers cost just over $33 and ventolin about $8 (cheap version).

Amazulu

It will be interesting to see what happens to the 'free' NHS in the UK in the coming years.

I reckon that soon, some things that are now 'free' will no longer be.

Buzzy--Bee

I think that I would have now been paying 61% tax in the UK, if you include NI as a tax which of course it is. Here I pay a lot less.

And we go to a bulk billing GP and its free for the whole family.

BB

Pine Cone

So when we're searching for a GP, what sort of questions should we be asking first?

Should we be asking if they do they do bulk billing? (still trying to get head around how this works)

Do you register with a single GP or a GP practice, and if so does it cost more to see a Dr that isn't yours but at the same surgery?

Also do you get blood tests etc done at your GP surgery or do they send you off elsewhere? And do you have to pay for them separately or is it included in the Dr consultation fee? In NZ there seems to be no consistency with this. The first surgery we were with had a nurse but didn't do blood tests so we have to treck across town to get them done. Our current surgery does it all there.

Lastly, for the $1600 prescription limit...how do you keep track of that. Do you keep reciepts for stuff yourself or is the info stored on a computer system at a pharmacy or similar?

Buzzy--Bee

You register with the practice. You can register with as many as you like for free.

Most offer bulk-billing to under 16s. Some offer bulk billing to everybody. Normally there is a sign outside the door explaining their policy on this, if not the receptionist will know.

Don't worry about how bulk billing works. All you need to know is at the end of the consultation you sign a piece of paper confirming you have been seen by a doctor and then you leave. At a non-bulk billing doctors you don't sign the piece of paper and you pay on the way out about $50. Medicare then reimburses about $30 of that.

Blood tests you seem to have to pay for at all doctors. I haven't found any bulk-billed tests yet. We get sent an invoice by the testing company, its about $50 I think.

BB

mark213

Really? All my tests in WA with Clinipath were bulk billed and here in QLD my wife got hers bulked too.

Not seen a doctor charging $50 ever in the last 2 years. Its always been $60 or above. Latest fee at my practice is $66.
Wife got charged $50 but was quoted when she first arrived $65. Think it was a mistake being only charged $50 but we didnt complain.

Amazulu

Yes, tax rises in the UK have been big - and are only going to get worse.

I think the health system in Australia strikes a fairly good balance between state and private - and is far more sustainable long term than the state pays everything model in the UK.

Amazulu

In WA St John of God seem to charge you yet Pathwest bulk bill.

That has been our experience anyway.

Wol

It's a minefield!

Around here there are virtually no bulk billing doctors - and those that are available people say "don't bother".

But all path tests *are* bulk billed.

The public hospital here is very underfunded (it's not a "Labor" area, you see) and is having to make big cuts in the number of operations it carries out: patients have to go up to Sydney or Liverpool instead. But the Medicare treatment will be free - if you can actually get an appointment.

If you have insurance not only will you pay the premiums but the equivalent of excesses will cost a small fortune. On the other hand you will not have to pay the extra Medicare tax levy.

People's impressions of the system in Australia vary markedly depending on their state, whether they have had to be admitted to hospital, whether it was emergency or private etc etc - it's almost impossible to give answers since the way you are charged seems almost haphazard.

coolshadows

In oz you have to pay for ambulance cover (one way or another).

I guess if you are ever going to suffer a prolonged illness (and don't have any insurance) you're better off in the UK. If you going to remain reasonbly healthy, you're better off in Oz.

Pine Cone

Interesting point!

We have a choice between Sydney or Melbourne, although we are swayed towards Melbourne at the moment.....sounds like it might be a better fit for us. Are people generally able to find bulk-billing doctors there or are they few and far between.....we are talking about family friendly suburbs (in the NE, E or S) here as we have school age children. One of our current problems in NZ is that due to the way our local primary care trust thing is funded it actually costs more to take our school age (6+) children to see a GP than is does for us as adults and when all of our kids are ill at once this can cost us a small fortune.

DadAgain

yes - but in Qld that is included in your electricity bill (??? go figure?!) so its impossible not to have ambulance cover.

The previously menitoned medicare safety net is a bit of a con - theres LOTS of medical expenses that arent included in the safety net, and arent covered by private health insurance! - So you'll end up paying no matter what. We got shafted in the early years of childhood when our daughter had a number of issues resulting in seeing a orthopedic specialist (and using some equipment), a ENT specialist and an opthomologist. We paid out THOUSANDS expecting the safety net to limit our exposure only to find out when we claimed at eth mnedicare office that various costs (I forget which ones) werent included in the safety net total.

However, private health cover , if you have the right policy, can cover almost ALL dental and optical costs. My wife gets all her contact lenses paid for and I recently got a couple of pairs of glasses for $0. Last time our family went to the dentist - all 4 of us went for checkup, clean, polish and it cost us $2!