What is the healthcare like in Australia?

[Harpodom]

Tough one to answer

 

I think the healthcare here is very good, if you can afford it or have comprehensive insurance that will cover it. My wife is currently getting excellent obstetric care, far better than she had in the NHS, but they're very very keen to refer to to Uncle Tom Cobley and all for more tests/consultations. No worries for us as we aren't directly paying, but some of the bills are eye-watering. She's had a minor glandular issue and the endocrinologist and associated path fees must be well north of $2000 by now. By the time the whole process is played out with all the various specialists, tests, accommodation and everything I suspect our insurer won't be getting much change out of $15K, which seems pretty salty

 

The billing and refund systems are simple on the face of it - you pay a separate bill to each service provider, so each specialist, GP, path lab etc etc will bill you separately. Then just stick them on one claim form to your insurer and get refunded - but as has been alluded to above, it's being able to get any sort of prediction as to what treatment is likely to cost that is difficult. It's a similar scenario with Medicare - most treatments are partially refundable, but it's not knowing in advance how much you might be exposed for that's hard to assess.

 

Under Medicare you are entitled to free treatment in a public hospital, much like the NHS. I can't speak for how that works because I have no experience

 

Would also like to point out I actually like the way you have to pay to see the GP - just like it used to be in Sweden where I once lived - stops the surgeries being full up of hypochondriacs. I also like the way you can choose the specialist you like, just as you'd choose any other service, and just ring them up and make your own appointments rather than get lost in some bureaucratic referral system that's still in the 1960s, where you wait weeks for a letter telling you when to attend, and then enter Dante's first circle if you have the temerity to try and change it.

 

NHS, I'm not sure about. I am 90% sure at times in the UK we experienced GP fundholders making decisions with one eye on their budgets rather than based on strictly clinical need, which I hate. Once you're in "the system" I think it's pretty good, but there's a lot wrong with the bureaucracy that runs it.

 

Ultimately any healthcare system in the western world is up against it with ageing populations and treatments that get a lot more expensive a lot more rapidly than inflation. And with rising expectations - people read about a new (and expensive) treatment and expect to get it. Not sure any government has successfully grappled with the answer to that one yet

 

agree with everything except the highlighted part. Hypochondriacs will usually find a bulk billing GP!

 

I think there is a fundemental inequity in the way some patients are bulk billed, others not. For example, some clinic will bulk bill everyone, others no one, others only pensioners, others only kids, others only pensioners and kids.

 

Surely a fairer system would be to bulk bill all kids and pensioners/health care card holders across the board, everyone else pays. Simple. Fair.

[ali]

That's what our GP's does Dom - bulk bill for children and pensioners. I have to say that for me service is important and I don't mind paying for it. The surgery we go to is a 2 Dr. Practise, both GPs are excellent, but they also do an out of hours surgery and weekend surgery so we have access to them 7 days a week. For me the benefit is that we see our GP's and therefore have consistent care.

 

I've found that the bulk billing practises are often difficult to get appointments at and people then tend to rock up to ED for non emergency care.

 

As I work in MH one of the worst things for me is people Dr. shopping for medications such as benzodiazapines, makes care quite difficult and you have no-one to really liaise with.

 

I've recently been in hospital and although I was private, my surgeon is a no gap Dr. so I didn't pay anything after the consultation fee, I paid the gap for the anaethatist, and for a couple of genetic blood tests that aren't bulk billed and for the injections I had to take on discharge. All in all I probably paid about $300, but was able to choose when I had the opereation.

[Chortlepuss]

I do wish they would bulk bill children and students. My daughter is 18, has no income, is at university full time and still needs me to come to the Drs with her due to the need to pay. I think it's a real intrusion on her privacy, even though we have a great relationship. I was so glad in the UK when I could go to a GP on my own as a teen without my parents' consent and permission

[Quinkla]

All in all I probably paid about $300...

And that's for a procedure allegedly covered by insurance with a no gap doctor.

 

Imagine if home insurance worked the same way. You have fully comprehensive insurance and your house burns down. You call the insurance company who tells you not to worry, you're fully insured - just get the builders in.

 

In due course, the bills come in. To your surprise, you are expected to pay immediately and then claim back from the insurers. You haven't actually got the money in the bank but now you know why your credit card has such a high limit. Then you get a cheque back from the insurers. It is less than you expected. The letter explaining it tells you that your cover will only reimburse 80% of the reasonable building costs. Although you spent $250,000 on rebuilding, the insurer tells you that the book price for a house is $130,000. So you'll only get 80% of that. But then there's a ceiling - you can only claim $50,000 of rebuilding work in any given year. Plus, you find that the plasterers, glaziers, electricians and plumbers were not covered because they aren't registered with your insurer.

Edited November 26, 2012 by Quinkla

[northshorepom]

Where are you getting comprehensive medical cover? I thought they were limited by law in the amount they could reimburse but would be glad to be wrong.

 

Dunno, it comes with the job. (very few) questions asked and paid in full

[fizzybangs]

I'm with BUPA and we pay around $3,000 per year for good coverage but out of pocket expenses this year have already exceeded that as there is a gap between what the specialists etc charge and what BUPA will pay and it's getting wider (currently news articles about it). I do have a bulk billing doctor but you can see a different doctor each time which is not optimal as they don't really know you or your history. I have had two operations this year and both times the anesthetists fees alone have cost us over $1000 and in a private hospital they even charge you for all medications given! I have also found in private health care that they seem to find things wrong with you that you never know you had - kind of like touting for business! After recent operation I had to go back to casualty a week later and was charged nearly $300 for assistance for problems related to operation - that even amazed us! However, if you go to a public hospital you can wait many, many hours to be seen. We also have a crisis in our area (SE Brisbane) where hospitals close there doors and will not accept even the most urgent of cases coming in by ambulance (it's called being on by-pass) and even when they will the ambulances have to queue up and wait or patients are left in hospital corridors. The free public health system here used to be incredibly good. I've decided to return to England to get more sound advice over my health! My daughter was in UK last year and the doctors there were very worried about her low white blood cell count but she had to come home suddenly to look after me unfortunately as he was getting superb help in UK. As she hasn't got private health care here they told her it doesn't matter her white blood count is low! No explanation, no investigation and she is tired all the time and bruises easily! So my opinion is not very high. Also I have found out from many friends that the assistance for kids with problems like aspergers, autism and a myriad of other problems is far, far superior in the UK and trying to get educational help for children in Oz is an absolute nightmare. I am well aware of the problems in the UK but I have more trust in the National Health system overall and from what I have read they are way ahead of Oz in all areas.

[Rugby Lad]

That's what our GP's does Dom - bulk bill for children and pensioners. I have to say that for me service is important and I don't mind paying for it. The surgery we go to is a 2 Dr. Practise, both GPs are excellent, but they also do an out of hours surgery and weekend surgery so we have access to them 7 days a week. For me the benefit is that we see our GP's and therefore have consistent care.

 

I've found that the bulk billing practises are often difficult to get appointments at and people then tend to rock up to ED for non emergency care.

 

As I work in MH one of the worst things for me is people Dr. shopping for medications such as benzodiazapines, makes care quite difficult and you have no-one to really liaise with.

I've recently been in hospital and although I was private, my surgeon is a no gap Dr. so I didn't pay anything after the consultation fee, I paid the gap for the anaethatist, and for a couple of genetic blood tests that aren't bulk billed and for the injections I had to take on discharge. All in all I probably paid about $300, but was able to choose when I had the opereation.

 

Both the points I've highlighted are massive problems and very under-reported. I was going to talk about doctor shopping for oxys / benzos etc. in my earlier reply but felt I'd waffled enough.

 

You know how when your kids have swimming lessons at the RSL and it's brilliant but a tiny voice in the back of your brain reminds you that your kids are getting this excellent facility at a cheap price because it's being subsidised by some poorer kid's lunch money being lost on the pokies and it makes you feel a bit sh1t - well I reckon it's the same when you sit in the waiting room of a bulk billing GPs seeing your appointment subsidised by what is essentially a semi-legal rort in supplying junkies.

 

Harpo - I think most GPs have gone to the system you describe - bulk billing for under 18s and pensioners / health card holders, everyone else pays - certainly every GP I've ever looked at signing up with. But in more overpopulated areas they might try and get away with not bulk-billing at all or you have the cases like I described above.

Edited November 26, 2012 by Rugby Lad

[ali]

And that's for a procedure allegedly covered by insurance with a no gap doctor.

 

Imagine if home insurance worked the same way. You have fully comprehensive insurance and your house burns down. You call the insurance company who tells you not to worry, you're fully insured - just get the builders in.

 

In due course, the bills come in. To your surprise, you are expected to pay immediately and then claim back from the insurers. You haven't actually got the money in the bank but now you know why your credit card has such a high limit. Then you get a cheque back from the insurers. It is less than you expected. The letter explaining it tells you that your cover will only reimburse 80% of the reasonable building costs. Although you spent $250,000 on rebuilding, the insurer tells you that the book price for a house is $130,000. So you'll only get 80% of that. But then there's a ceiling - you can only claim $50,000 of rebuilding work in any given year. Plus, you find that the plasterers, glaziers, electricians and plumbers were not covered because they aren't registered with your insurer.

 

There wasn't anything alleged about the no gap Dr - as I didn't pay for the surgeon and I didn't pay for him performing the operation -I have to say he was brilliant - he checked on me at 8.30 at night post op, was there again at 7.30am the day after and came to see me at least 3 times a day to see how I was recovering - throughout my stay the consultant was the only Dr. I dealt with.

 

 

The gap I paid was for the anaethatist and some genetic tests requested by my haematologist that aren't covered by medicare, plus the injections I had to administer on discharge from hospital.

Edited November 26, 2012 by ali

[Harpodom]

I do wish they would bulk bill children and students. My daughter is 18, has no income, is at university full time and still needs me to come to the Drs with her due to the need to pay. I think it's a real intrusion on her privacy, even though we have a great relationship. I was so glad in the UK when I could go to a GP on my own as a teen without my parents' consent and permission

TBH just because you're paying, it doesnt mean you have to be in on the consultation, does it?

[Harpodom]

Both the points I've highlighted are massive problems and very under-reported. I was going to talk about doctor shopping for oxys / benzos etc. in my earlier reply but felt I'd waffled enough.

 

You know how when your kids have swimming lessons at the RSL and it's brilliant but a tiny voice in the back of your brain reminds you that your kids are getting this excellent facility at a cheap price because it's being subsidised by some poorer kid's lunch money being lost on the pokies and it makes you feel a bit sh1t - well I reckon it's the same when you sit in the waiting room of a bulk billing GPs seeing your appointment subsidised by what is essentially a semi-legal rort in supplying junkies.

 

Harpo - I think most GPs have gone to the system you describe - bulk billing for under 18s and pensioners / health card holders, everyone else pays - certainly every GP I've ever looked at signing up with. But in more overpopulated areas they might try and get away with not bulk-billing at all or you have the cases like I described above.

As it s entirely at the GPs discretion, I'd find that hard to believe. In Geelong, it seems a random scattering of full/part private/public is what you get.

[ali]

I do wish they would bulk bill children and students. My daughter is 18, has no income, is at university full time and still needs me to come to the Drs with her due to the need to pay. I think it's a real intrusion on her privacy, even though we have a great relationship. I was so glad in the UK when I could go to a GP on my own as a teen without my parents' consent and permission

 

Give her cash to pay the consult

[Quinkla]

TBH just because you're paying, it doesnt mean you have to be in on the consultation, does it?

I can understand Chortlepuss's concern. When I was 18 I didn't want my parents to even know that I was going to the doctor because, unless I had a chesty cough and a temperature, my parents would have made assumptions about what I was going for. That would have made them worry; they would have wanted to ask me to ease their worries. This may or may not have eased their worries and would certainly have violated my privacy.

[jasepom]

I think the standard of the hospitals in Oz is much better, and the level of care is fantastic. I believe the medicare system gives good value for money, since everyone is entitled to emergency treatment similar to the nhs, and doctors appointments and prescriptions give good rebates.

 

It's when you get to non-emergency procedures that it can put you severely out of pocket. Dental care is an example where it can be very example (thousands) to pay for braces or other on-trivial procedures (root canals, crowns etc).

[Harpodom]

I can understand Chortlepuss's concern. When I was 18 I didn't want my parents to even know that I was going to the doctor because, unless I had a chesty cough and a temperature, my parents would have made assumptions about what I was going for. That would have made them worry; they would have wanted to ask me to ease their worries. This may or may not have eased their worries and would certainly have violated my privacy.

 

I agree that there are all sorts of privacy concerns with the system, eg having an itemised bill of the consultation, which might including a pregnancy test, but still the consultation can be private/confidential. I agree with Ali, give her cash so she can go alone.

[Ken]

I've only been in Oz for 3 1/2 months so obviously I haven't experienced every aspect of the Oz health system, but what I have seen (from 3 or 4 visits to the Doctors - most to arrange for my medication as I have diabetes, one for a cold that lingered for 2 weeks so I thought I'd get it checked out) has impressed me far more than the NHS. I've never had to make an appointment, you just turn up and wait - never longer than 10mins to see a Doctor (it always irritated me how at my UK surgery you had to make an appointment 2 weeks in advance, and while there was a drop-in clinic nearby half the time you were only able to see a nurse). It's all bulk billed. I do have to pay for the prescriptions (something I didn't have to do in the UK) but $35 for 6 months supply of insulin didn't seem unreasonable.

[Guest littlesarah]

I do wish they would bulk bill children and students. My daughter is 18, has no income, is at university full time and still needs me to come to the Drs with her due to the need to pay. I think it's a real intrusion on her privacy, even though we have a great relationship. I was so glad in the UK when I could go to a GP on my own as a teen without my parents' consent and permission

 

Doesn't the university run a health service? Ours does, they bulk bill all patients (only staff, students & students' kids at this institution can register), and as they're on campus it can make it a lot easier to fit in an appointment around classes.

[Quinkla]

I agree that there are all sorts of privacy concerns with the system, eg having an itemised bill of the consultation, which might including a pregnancy test, but still the consultation can be private/confidential. I agree with Ali, give her cash so she can go alone.

But even having to disclose the fact that there is a consultation taking place (when asking for the cash) means that privacy has been lost.

[Petals]

I do wish they would bulk bill children and students. My daughter is 18, has no income, is at university full time and still needs me to come to the Drs with her due to the need to pay. I think it's a real intrusion on her privacy, even though we have a great relationship. I was so glad in the UK when I could go to a GP on my own as a teen without my parents' consent and permission

 

When my children turned 16 and were still at school I went into medicare and arranged for them to have their own medicare card. They were then able to obtain a low income health care card which they could use at the docs. All they had to do was show their bank books (bank books were still around then) to show that they had low income and they got one no problem.

 

You do not need to keep your children on your medicare card just because you are paying.

 

Also with the ambulance which we have to take out in Victoria, our children only took out there own insurance when they started to work and were no longer students and being supported by us. Make sure you check this though.

 

My daughter has type 1 diabetes and I stopped going to the doc with her when she was 15 and the specialist told me there was no need for me to go in with her. After that she always went in to the docs on her own.

[Harpodom]

But even having to disclose the fact that there is a consultation taking place (when asking for the cash) means that privacy has been lost.

I don't disagree with you on that, but whatever occurs in the consultation is strictly private

[ali]

But even having to disclose the fact that there is a consultation taking place (when asking for the cash) means that privacy has been lost.

 

I think you can apply for your own medicare card at 15 that way you can maintain your privacy if you don't want your parents knowing about going to the Dr's, although You'd have to have some income to pay the bill (unless you can find a bulk billing Dr.).

[missymon212]

Another example of how the system works here: I was recently asked by my doctor to have an MRI done. Neither Medicare or my private healthcare covers outpatient radiology so I had to pay $328 out of pocket. Had I been referred by a specialist my private healthcare would have contributed $200 towards it. However the hospital doing the test jack the price up to $528 for specialist referrals and I would also have had to pay to see the specialist - so in this case the private cover was of zero benefit.

 

Personally, I think the health insurance companies have you over a barrel. When families are forced to choose a. give extra money to the tax man or b. take out health insurance, it doesn't offer the companies much incentive for competition.

 

I too was recently referred by my doctor for a MRI and I didn't have to pay a cent. Medicare paid for it.

[Paul1Perth]

Tough one to answer

 

I think the healthcare here is very good, if you can afford it or have comprehensive insurance that will cover it. My wife is currently getting excellent obstetric care, far better than she had in the NHS, but they're very very keen to refer to to Uncle Tom Cobley and all for more tests/consultations. No worries for us as we aren't directly paying, but some of the bills are eye-watering. She's had a minor glandular issue and the endocrinologist and associated path fees must be well north of $2000 by now. By the time the whole process is played out with all the various specialists, tests, accommodation and everything I suspect our insurer won't be getting much change out of $15K, which seems pretty salty

 

The billing and refund systems are simple on the face of it - you pay a separate bill to each service provider, so each specialist, GP, path lab etc etc will bill you separately. Then just stick them on one claim form to your insurer and get refunded - but as has been alluded to above, it's being able to get any sort of prediction as to what treatment is likely to cost that is difficult. It's a similar scenario with Medicare - most treatments are partially refundable, but it's not knowing in advance how much you might be exposed for that's hard to assess.

 

Under Medicare you are entitled to free treatment in a public hospital, much like the NHS. I can't speak for how that works because I have no experience

 

Would also like to point out I actually like the way you have to pay to see the GP - just like it used to be in Sweden where I once lived - stops the surgeries being full up of hypochondriacs. I also like the way you can choose the specialist you like, just as you'd choose any other service, and just ring them up and make your own appointments rather than get lost in some bureaucratic referral system that's still in the 1960s, where you wait weeks for a letter telling you when to attend, and then enter Dante's first circle if you have the temerity to try and change it.

 

NHS, I'm not sure about. I am 90% sure at times in the UK we experienced GP fundholders making decisions with one eye on their budgets rather than based on strictly clinical need, which I hate. Once you're in "the system" I think it's pretty good, but there's a lot wrong with the bureaucracy that runs it.

 

Ultimately any healthcare system in the western world is up against it with ageing populations and treatments that get a lot more expensive a lot more rapidly than inflation. And with rising expectations - people read about a new (and expensive) treatment and expect to get it. Not sure any government has successfully grappled with the answer to that one yet

 

We have a doctor who bulk bills so never get charged for a doctors visit. Shop around they are out there. We are lucky, ours is just across the road from where we live. If we are ill and ring up he will usually fit you in the same day, sometimes just ring and walk across and you're in in minutes.

I had a vasectomy done at a local doctors. Didn't cost me a thing, all bulk billed. Sure you can go and pay a lot of money. A friend of mine was having his done at the same time and I told him where I was going. He thought there must be something fishy as it was free, so chose to pay and go somewhere else. I think the only difference was I got a local anesthetic and he got a general and the op I had involved 2 cuts, one on each side and the one he had was done from underneath, through one cut. Recovery was about the same for us both.

 

We have had our kids in hospital for broken bones, me a couple of times, dislocated ribs from my sternum and swallowed a bee when running. The last one I had to stay in overnight. My wife's had a couple of overnight stays with migraine. Last time they did heaps of tests and x-rays. Not cost us a thing for any of it. Felt to me just like the NHS but the hospital emergency department has been quieter and quicker than any I remeber going to in the UK.

 

We had our youngest at the family birth centre at King Edwards Hospital. Had our own room and you could have the baby where you wanted it, in the huge bath if you fancied it. The midwife came to the room when you were ready to deliver. We had complications after the birth and our boy was in an incubator and up on the intensive baby care ward in minutes. Again didn't cost us a thing, all a part of the system and billed to our medicare cards I guess.

 

Really been pleased with the health care here and can't see much difference between this and the NHS.

 

Just edited to add I have a 6 monthly check up since I was 50. Doctor sends for me and does the usual blood pressure and other tests. He sends me for a full blood analysis, whatever that is, I just see it on the form. I take it down to a clinic which opens at 7:00am, give them the forms, nurse takes the blood and off I go to work and the results are sent back to the docs. Never cost me anything yet so it must be all bulk billed.

Edited November 26, 2012 by Paul1Perth

[Paul1Perth]

I'm with BUPA and we pay around $3,000 per year for good coverage but out of pocket expenses this year have already exceeded that as there is a gap between what the specialists etc charge and what BUPA will pay and it's getting wider (currently news articles about it). I do have a bulk billing doctor but you can see a different doctor each time which is not optimal as they don't really know you or your history. I have had two operations this year and both times the anesthetists fees alone have cost us over $1000 and in a private hospital they even charge you for all medications given! I have also found in private health care that they seem to find things wrong with you that you never know you had - kind of like touting for business! After recent operation I had to go back to casualty a week later and was charged nearly $300 for assistance for problems related to operation - that even amazed us! However, if you go to a public hospital you can wait many, many hours to be seen. We also have a crisis in our area (SE Brisbane) where hospitals close there doors and will not accept even the most urgent of cases coming in by ambulance (it's called being on by-pass) and even when they will the ambulances have to queue up and wait or patients are left in hospital corridors. The free public health system here used to be incredibly good. I've decided to return to England to get more sound advice over my health! My daughter was in UK last year and the doctors there were very worried about her low white blood cell count but she had to come home suddenly to look after me unfortunately as he was getting superb help in UK. As she hasn't got private health care here they told her it doesn't matter her white blood count is low! No explanation, no investigation and she is tired all the time and bruises easily! So my opinion is not very high. Also I have found out from many friends that the assistance for kids with problems like aspergers, autism and a myriad of other problems is far, far superior in the UK and trying to get educational help for children in Oz is an absolute nightmare. I am well aware of the problems in the UK but I have more trust in the National Health system overall and from what I have read they are way ahead of Oz in all areas.

 

Our youngest has autism and has been seeing a doctor who specialises in that area for years. He's turned 17 now and the doctor has signed him off and said he doesn't need to see him again. He has also been going to the Play and learning centre in West Perth where he see another doctor who has followed his medical and emotional history for years. At one stage he was having anxiety problems and we got help from both the doctor and the place in West Perth. We were referred by our own doctor to a specialist geneticist which didn't cost us anything. We ended up all having to go for blood tests and back to see the doc. He had found that our youngster has a rare malformation in his cells and DNA which can be passed on. We were checked out to see if we had it in the family, Neither of us or his brother has the same thing, just bad luck. Upshot is though he has a 50% chance of passing it on, should he have kids, so it's good to know. They don't know whether that caused his autism and other problems (ADHD and epilepsy) but the doctor showed us a folder of people with the same malformation and what it can cause. Seeing some of those we were lucky.

 

I know there is Autism West but don't know what they do. Never been involved with them. Not really on a healthcare matter but an agency called edge managed to place our son in work experience in year 10 of school and managed to find him a paying job where he is doing a cert 3 in business. He went to school 3 days and the job for 2 for his last 6 months at school. We are hoping it might turn into a real job as we had been worried for years as to what he would be capable of doing. Edge have been great. I think they are a not for profit organisation and run out of Subi.

[Lambethlad]

The Medicare system here is great. I've never had private health insurance. I had two kidney stone operations and it didn't cost a cent.

[russ and claire]

Wow thank you for the replies, so it is similar to the nhs, where it depends where you are and what is available to you but obviously with some costs involved. Also like the nhs, some people have had fab care but others haven't but it is certainly an eye opener.