CDM

I've lived in the UK and the US and will be Oz bound sometime in the near future (hopefully).

I'm just wondering what I should expect from the health care system in Oz. Although I've not had cause to complain about the actual quality of the medical health care itself in either the US or the UK, both systems are completely different.

The US system is, in my humble opinion, the most broken. It's hugely expensive and a massive headache to deal with. Indeed it's one of the prime reasons why I left the States some years ago. The NHS in the UK has its failings (waiting lists immedaitely comes to mind), but if I'm ill or in need of medical health care services, I at least don't have to worry about whether I can afford to get treated.

How does the health care system in Oz compare to the US & UK systems? Is it expensive like in teh US? Is there automatic coverage like in the UK? What are it's good and bad points?

- CDM

Wol

Do a search - there's too much to reiterate!

It does seem to depend on which state you are in: the NSW system is seriously broken.

ABCDiamond

Just what I was thinking.......

It can also vary in different parts of the same State, or even different parts of Brisbane for example.

Sammy T

It's all been said before, depends on where you live.

Here in Tas, I'm not not impressed

You pay for pretty much everything, optical, dental, GP appointments, even national things like smear tests are charged for. If you can get a bulk billing GP you'll save on your GP appointments.

I haven't really got any experience on inpatient costs, think it should be covered by Medicare but as you'll find if you do a search on here, some people have great opinions about the system and some have definitely not!

Having worked in the NHS for over 20 years, I'm shocked by the disjointed health care here, particularly in relation to primary care but maybe compared to the US, its not so bad?

Sam

CDM

Thanks for the suggestions above. I have already reviewed a lot of past posts but I wanted to raise this again to see if there were any fresh views on the subject.

- CDM

Petals

Having a lot to do with health care as my daughter has several life threatening conditions. I have nothing bad to say about it, she gets the best of care, her doctors are wonderful and I am pleased that we have to pay for things.

Paying for non life threatening things like physio, dentist, makes people only use when they have to and this is a good thing.

Drugs I agree with paying for them as well as makes us think about what we are taking and ask the questions. Also agree with a co payment at the docs after all its not a drop in shop.

Some pain in health makes for a better system and stops malingering.

ABCDiamond

Not sure I agree with you on that 1st bit... (personally speaking I like the free bulk billing doctors )

But I do agree with the 2nd bit for everyone else...

Although it isn't perfect, it isn't bad at all for what we pay.

Sometimes I do wonder how good it would be if they increased the medicare levy to 5% ?

OzSheila

Have to say we have been disappointed with the health system here in Melb.

We pay $257pm (soon to go up significantly thanks to KRudd) for the highest level of family cover, rarely use it and when we do are never fully recompensed.

Secondly don't like doctors "up-selling" (I believe it is called) ie selling you a higher level of testing than that covered by Medicare. And they make it very hard for you to say "no". Presumably the backhanders from the path services make it very attractive for them.

Thirdly think it is ridiculous that OH had to wait 9 months to see a skin cancer specialist in a country with the highest incidence of melonomas in the world and he has a family history of the condition.

Eldest son has to have plate, braces, and crowns over next 5+ years costing (in todays prices) $5K and we will be lucky to get back $1000.

Youngest son was diagnosed with a condition at 18 months in the UK and despite seeing specialists here at the Children's Hospital both as public and private patients ($ out of our own pocket and not reimbursed at all), all have looked at us stupidly when we name the condition and made us to feel like idiots. Feel like telling them to Google it where there is plenty of info. 3.5 years later and a visit to the Children's Sleep Unit at Monash and guess what - recognition and at long last a plan of action. And of course the GPs did all right out of the whole process - each time we wanted a referral, a fee was extracted!

As I say not impressed and health insurance here is one of the biggest cons ever!

MartinLuther

I think it's only been a couple of weeks since this was last done. I suspect it hasn't changed much since then

tomcruise

The system in Australia is a combination of public and private system .

You are not compelled to have private insurance and indeed most Aussies don't have one I think. However, due to the taxation system, it is better to get private insurance if the family income is above a certain threshold (currently at 150K).

Private insurance is however very affordable (approx 3k/year for a family of 4). However, as someone pointed out earlier, it does not cover everything. For example, it will only cover visits to private hospital emergency rooms if you get warded. If not, it is not covered. Coming from Canada where the system is entirely public and being used to overcrowded emergency rooms, I am happy that an option for private hospital ER exist in Australia.

As for the GP and specialist doctor visits, private insurance is no good (That is how they keep the cost down. It is one of the significant difference with the American private insurance schemes). However, there are 2 kinds of GPs here. The bulk billing type and the private billing type. The bulk billing types are usually new practice, new doctors, doctors who have relocated or doctors with practices in low-income neighborhoods . A visit to a bulk billing GP cost nothing as they bill everything to medicare. It is approximately $35 for a routine visit. However, a visit to a private billing GP will cost $50-60 . You will have to pay the surgery from your pocket . Out of this, you will get approx $35 back from medicare (it is easy to get the refund... You just need to supply a receipt from the surgery). Some surgeries allow you to lodge the claim automatically from their office . For others, you will need to visit the local medicare office to get the money back (immediate refund). The number of bulk and non bulk GPs vary according to the economic condition as well. Right now, the trend is to bulk bill due to the economic condition. People are cutting down on their visit to the doctor due to the economic hardship and hence with less patients, more doctors are forced bulk bill to attract enough patients. (It is basically economics here. usually, once a new doctor has built up the practice, they go private).
However, most non-bulk GPs have a policy to bulk bill children. seniors and people on pension cards (Please note that in other countries pension card holders are also called welfare recipients. There is another group called "aged pensioner" which is different ).

As for drugs, most drugs are subsidized by govt (pbs) with PBS drugs NOT costing above $33 for a month's supply. However, for the non subsidized ones (usually latest drugs, etc), insurance (with pharmacy benefits) will pay any amount above $33. To protect against high drug cost, there is also the pbs safety net.
You can read about it here...
http://www.medicareaustralia.gov.au/.../msn/index.jsp
http://www.medicareaustralia.gov.au/...thresholds.jsp
http://www.medicareaustralia.gov.au/...cripts/pbs.jsp
(Similarly there is a medical safety net)
For any major surgery, this is where private insurance will help most. It will cover almost all costs. Those without the private cover, there is the public hospital. However, you will be prioritized in the public hospital and depending on the condition, there may be a waiting list. Of course if the condition is life threatening, there is no waiting list. The best hospitals (mostly public hospitals) are found in the capital city (e.g. Brisbane) or beside major teaching hospitals. Even in the capital cities, only a few hospitals are centers of excellence. They employ the best specialist and have the latest equipment. The public regional hospitals and the non centres of excellence hospitals in the cities are a little stretched for resources. There usually sits a private hospital beside a public hospital (probably a marketing thing).

In summary, the system is not that costly as in the U.S (due to a variety subsidy schemes and due to the availability of medicare for all). Public system is probably a bit stretched but that is where you also find the latest and best . I like the private hospital option that is always available.

Hope this helps.

ABCDiamond

That is, as you say, ridiculous. Up here, it takes only days.

MartinLuther

Mine took about a week but that was down to me rather than them.

OzSheila

I truly couldn't believe it at the time. I was led to believe that one of the key reasons for taking out private health insurance was to go straight to the front of the queue - or atleast somewhere closer to the front. Such a long wait can turn something from treatable to potentially life-threatening.

I've been told that there is a dire shortage of such specialists in Melbourne which may well explain the situation - doesn't make it right though.

ABCDiamond

I don't know about the health insurance side of things, we don't have it.

Budawang

The Australian system is mix of public and private. The big difference with the U.S. is there is a good safety net for everyone. People are encouraged to take private insurance. This is as much for tax reasons as any additional benefits it provides. A friend had a severe stroke and his private insurance was of absolutely no use as "private hospitals" generally don't cater for intensive care treatment. By all accounts his treatment has been excellent.

I would think twice before opting for private insurance, particularly if you are in good health.

Overall, the Australian system is rated highly and costs much less than the U.S. system - around 9% of GDP compared to 17%.