Why comparisons between British and Australian health systems are distorted

[Marisawright]

Yesterday my oh had day surgery and it made me think about that old chestnut - the "Australian healthcare vs British healthcare" debate.

A lot of people (myself included) would say Australian healthcare is better, but that's not a fair statement. The difference has more to do with the culture in both countries, and the difference in the way private health insurance works in each country.

My oh had a dark spot on his nose, and it turned out it was a melanoma.  He doesn't have health insurance, so the GP offered to refer him to a hospital specialist instead of a private one.  He could see the private surgeon next day, but would have to wait for the hospital one.  He chose the private surgeon, and a week later, he's been operated on (and it looks as if it's all clear, thankfully).  He's now got $6,000 on his credit card, but he thinks it's worth it for peace of mind - and he will get some of it back on Medicare.

And that's one of the differences right there.  If you choose to bypass NHS waiting lists in the UK by going private, you pay the full price. The NHS doesn't step up and pay you what it would have cost to do it on the NHS.  So even for people without health insurance, private health care isn't necessarily out of reach in Australia - and importantly, we all know it isn't.  In fact we access it often, without much thought, every time we get referred for a CT scan or a specialist consultation.  

So you see, when you ask a typical Aussie what healthcare in Australia is like, you're likely to get a rosy picture - because our willingness to use  private healthcare means that we're not comparing like with like.

[ali]

A good point Marisa .. Apples and Oranges.  I think for me the difference has been the accessibility and being able to be seen quickly for specialists appointments with some reimbursement.   I know that some parts of the UK it's easy to see a Dr whilst for other it's not.  I don't know how GP practises work in the UK now as I've been left so long, but my own bulk billing practise is open 7 days a week and have now extending their operational hours to 10pm week nights making it a lot more flexible.

[MARYROSE02]

Thanks Marisa (and Ali) for reminding me to  investigate the merits of health insurance. I have never taken it out apart from my first year in Australia when my employer either paid half the premium or paid the lot. I remember I used it six months later to have a hernia operated on privately. At that time - 1979 - it meant a week in hospital whereas my last hernia was one night extended to  two. That second hernia, in 2014, took me four weeks from initial diagnosis by the GP to the operation itself because I was willing to pay for it. $9,000 I think including an extra thousand for the second night in hospital at St George Private. As I spent over $3,000 I was able to claim some of that bill on my tax. I'm not sure if it's still the case.

You can do the same think the UK of course. My Dad had a hernia done privately - opulent private room at, I think, the Nuffield private hospital in Chandlers Ford. In his case the operation was OK but the wound "festered" and he needed an SRN to come at home every day to treat it and that was on the NHS.

I can't make up my mind about health insurance. At the moment I bulk bill when I can, eg for my GP and annual blood tests, pay the fee and take the small Medicare rebate for my annual skin cancer check - $100 and $37 back, and just pay the lot for podiatrist and dentist.

I think health insurance comes into its own when a really expensive operation comes along? $6,000 or $9,000 is "doable" but what about a hip operation? Or an operation where you need a long stay? Of course if you are taken ill suddenly you go straight into the public sector regardless. My brother had pleurisy in January and he was in St Vinnies in Sydney for 4 nights. Having lived in the US for a long time he was surprised when he did not have to pay a cent.

[CaptainR]

Due to the Medicare Levy Surcharge it works out better for us paying for private healthcare insurance and overall we seem to get many benefits from it, especially dental. I don't really know what would happen if we couldn't access that.

Some things that I like here are the that you can be referred to anyone you choose and then medicare covers its part and you pay the gap. I've seen the GP over various issues in recent years and have been in for ultrasounds, MRI's and lab tests within 48 hours, and these aren't critical/urgent issues. The treatment I've had in Australia has been swift and professional. 

 My experiences of the NHS were of long waiting lists and within my family in the UK we have had some unfortunate and bad experiences with the NHS (not the medical staff, but the processes). The thing here is that as I understand it most of the outpatient services are privatised and they only get paid the amount that is determined by Medicare when you swipe the card. The NHS privatises/outsources things but through long tender processes that reward big companies charging big fees, but the government like to pretend that the NHS isn't really privatised... 

 But that said, the NHS varies enormously depending on where you live. I should imagine that when you get further away from major cities in Australia the medical quality deteriorates as well. 

[MARYROSE02]

7 minutes ago, CaptainR said:

Due to the Medicare Levy Surcharge it works out better for us paying for private healthcare insurance and overall we seem to get many benefits from it, especially dental. I don't really know what would happen if we couldn't access that.

Some things that I like here are the that you can be referred to anyone you choose and then medicare covers its part and you pay the gap. I've seen the GP over various issues in recent years and have been in for ultrasounds, MRI's and lab tests within 48 hours, and these aren't critical/urgent issues. The treatment I've had in Australia has been swift and professional. 

 My experiences of the NHS were of long waiting lists and within my family in the UK we have had some unfortunate and bad experiences with the NHS (not the medical staff, but the processes). The thing here is that as I understand it most of the outpatient services are privatised and they only get paid the amount that is determined by Medicare when you swipe the card. The NHS privatises/outsources things but through long tender processes that reward big companies charging big fees, but the government like to pretend that the NHS isn't really privatised... 

 But that said, the NHS varies enormously depending on where you live. I should imagine that when you get further away from major cities in Australia the medical quality deteriorates as well. 

Thanks for that Captain R. Come to think of it I have to see my tax agent to find out if I get a refund and I shall ask him about the financial benefits of medical insurance. 

I just Googled the question "why do I need health insurance in Australia" and found this Choice site which explains that, if I have my income right at about $50 000 I am not subject to the Medicare levy and if I do take out medical insurance I will have to pay an extra $1,333 a year. I will still double check with my accountant.

Do I Need Health Insurance? Use our quick quiz - CHOICE

https://www.doineedhealthinsurance.com.au/

1.  
2.  

If you're not sure whether you should be forking out that hard earned cash for private health insurance, our quick quiz will help you find ou

[bristolman]

In the end it all comes down to personal experiences, we have twin boys, one broke their arm at school in Brisbane and the other broke the opposite arm in Hereford. The difference in treatment was night and day. In Brisbane our eldest was left waiting on a trolley for hour after hour literally until we almost had to drag a doctor to see him and she wasn't at all impressed. Bear in mind this was a 6 year old child in a lot of pain. Because it was at school he had to be taken by Ambulance, I asked the Paramedics whether they were going to the local Logan Hospital and he said 'Oh god no, we won't take him there' so I assumed the Brisbane Children's Hospital was the better option. As it turned out it really wasn't. My other son sent into Hereford Hospital and his treatment was bloody brilliant quite frankly. My wife after having the twins was sent home next day after fainting a couple of times and still being clearly unwell. Following an operation on my lower back in Brisbane I was released with the would infected and had to go back in for intravenous antibiotics.

Of course these things can and do happen everywhere but I'm afraid no-one will convince me that the Australian system is better than here. My wife is having a health issue at the moment, at every stage she has been seen promptly and the care has been 2nd to none. Next day to see a specialist, 5 days for a full body scan, no excessive waiting and not a single penny out of pocket etc etc. 

Now I realise there will be those who think I am making this up of course as part of my agenda, afterall I read on here only yesterday that I hate Australia.

Clearly in BOTH countries the treatment you get depends on where you live, that is very obvious. It certainly isn't restricted to just the NHS or indeed to out in the country in Australia as for us it was right in the centre of Brisbane.

Based on our personal experiences if it has to come down to which is better then the choice is very easy indeed, the NHS wins hands down..for us.

Edited March 4, 2018 by bristolman

[Bulya]

I can walk into a health centre on a Sunday and get an X-ray without an appointment for no charge.  That simply isn’t going to happen under the NHS

[newjez]

18 minutes ago, Bulya said:

I can walk into a health centre on a Sunday and get an X-ray without an appointment for no charge.  That simply isn’t going to happen under the NHS

Well I've done it several times. I might expect a delay for a CT scan, but I've had several x-ray same day.

[newjez]

On 04/03/2018 at 08:10, bristolman said:

In the end it all comes down to personal experiences, we have twin boys, one broke their arm at school in Brisbane and the other broke the opposite arm in Hereford. The difference in treatment was night and day. In Brisbane our eldest was left waiting on a trolley for hour after hour literally until we almost had to drag a doctor to see him and she wasn't at all impressed. Bear in mind this was a 6 year old child in a lot of pain. Because it was at school he had to be taken by Ambulance, I asked the Paramedics whether they were going to the local Logan Hospital and he said 'Oh god no, we won't take him there' so I assumed the Brisbane Children's Hospital was the better option. As it turned out it really wasn't. My other son sent into Hereford Hospital and his treatment was bloody brilliant quite frankly. My wife after having the twins was sent home next day after fainting a couple of times and still being clearly unwell. Following an operation on my lower back in Brisbane I was released with the would infected and had to go back in for intravenous antibiotics.

Of course these things can and do happen everywhere but I'm afraid no-one will convince me that the Australian system is better than here. My wife is having a health issue at the moment, at every stage she has been seen promptly and the care has been 2nd to none. Next day to see a specialist, 5 days for a full body scan, no excessive waiting and not a single penny out of pocket etc etc. 

Now I realise there will be those who think I am making this up of course as part of my agenda, afterall I read on here only yesterday that I hate Australia.

Clearly in BOTH countries the treatment you get depends on where you live, that is very obvious. It certainly isn't restricted to just the NHS or indeed to out in the country in Australia as for us it was right in the centre of Brisbane.

Based on our personal experiences if it has to come down to which is better then the choice is very easy indeed, the NHS wins hands down..for us.

My mum always says Australian health care is better than the NHS, but she doesn't seem to understand she is comparing her private cover to my public cover. 

[Bulya]

3 minutes ago, newjez said:

Well I've done it several times. I might expect a delay for a CT scan, but I've had several x-ray same day.

On a Sunday?

[bristolman]

8 hours ago, newjez said:

My mum always says Australian health care is better than the NHS, but she doesn't seem to understand she is comparing her private cover to my public cover. 

Yes exactly, get private cover here and it's like being in a 5 star hotel but it just isn't necessary. 

[newjez]

9 hours ago, Bulya said:

On a Sunday?

Yes. Makes no difference with A&E what day of the week it is.

[Bulya]

19 minutes ago, newjez said:

Yes. Makes no difference with A&E what day of the week it is.

We’re not talking about A&E

[newjez]

2 hours ago, Bulya said:

We’re not talking about A&E

Probably not then.

But why would I need one on a Sunday if it wasn't an emergency?

I thought most people had to pay for X ray outside of hospital?

[Bulya]

1 minute ago, newjez said:

Probably not then.

But why would I need one on a Sunday if it wasn't an emergency?

I thought most people had to pay for X ray outside of hospital?

no, you don’t have to pay for X-rays outside of hospital.  

[newjez]

4 minutes ago, Bulya said:

8 minutes ago, newjez said:

Probably not then.

But why would I need one on a Sunday if it wasn't an emergency?

I thought most people had to pay for X ray outside of hospital?

no, you don’t have to pay for X-rays outside of hospital.  

Is that just you or everybody?

[Bulya]

1 minute ago, newjez said:

Is that just you or everybody?

Everybody I guess 

[newjez]

2 minutes ago, Bulya said:

Everybody I guess 

Fair enough then, that's a point for Australia.

[bristolman]

23 minutes ago, newjez said:

Is that just you or everybody?

Out of pocket costs for an X Ray is around $54 but could be increasing to $100. Those on benefits, OAPs etc don't pay. 

[calNgary]

Myself and my daughter have had a few x rays over the years and we have gone to the ''x ray type shops'' and they have all been bulk billed costing us nothing. Even daughters MRI was bulk billed but we had to go to Ipswich for that (about 35 mins away). 

I go to the public hospital in Brisbane for my bone density scans, endoscopys etc and they are all bulk billed too.

I dont think the UK was any better or any worse (i said was, as i last used it 11 years ago) than here, both just different systems, although as Ali said the bonus here is being able to see a Dr within a few hours of ringing 7 days a week.

Cal x

[bristolman]

We can see a GP here same day but not 7 days a week, not rural where we are but our Brisbane GP clinic was 5 days as well. 

Edited March 14, 2018 by bristolman

[Marisawright]

1 hour ago, newjez said:

Probably not then.

But why would I need one on a Sunday if it wasn't an emergency?

I thought most people had to pay for X ray outside of hospital?

I think the point being made is that in both countries, if you've got a life-threatening situation and you go to hospital, you're going to get decent free treatment.  We're talking about other aspects of the health system.

[ramot]

My Dr is only open 5 days a week, but there are 3 Drs surgeries open 7 days a week close to us, plus 1 open 24hrs a day on the Sunny Coast.

I do like that I don't have to go to hospital for X-rays or scans here,  and that the results from our local imaging service go electronically straight through to my Dr. 

Edited March 14, 2018 by ramot

[Booma]

the thing i like most about the oz system apart from the speed you can get tests & results for things like MRIs etc is you dont  need to register with a doctor & its easy to get second opinions if you want one or just go to different doctors if it suits you better. when we lived in uk i had to choose if I registered with a doctor near my home or one near my work. 

[Sandgroper]

On 3/15/2018 at 09:30, Booma said:

the thing i like most about the oz system apart from the speed you can get tests & results for things like MRIs etc is you dont  need to register with a doctor & its easy to get second opinions if you want one or just go to different doctors if it suits you better. when we lived in uk i had to choose if I registered with a doctor near my home or one near my work. 

Have to agree I like the speed at which the system works here I've had a doctors appointment in the morning been referred for an ultrasound and had it the same day no chance of that ever happening on the NHS ever. I was given a physio appointment in 16 weeks time in the UK totally unacceptable what was the point I ended up going private and as mention earlier I got nothing back......all those years paying taxes to be forced to go private! 

The Aus system just seems to work better IMO, I need an operation on my knee and my GP has said we can either go public where there would be around a 2-3 month wait which is totally acceptable as it isn't an emergency the actual wait time stated by WA health is 6 months so they are well under, or I can go private which I am planning on doing for a few reasons I can choose the surgeon, the hospital and the date and it is all covered by my health insurance apart from a gap of about $3-400 for the anesthetist and his technician.  I wanted to make sure I had the correct diagnosis on my knee so asked my Dr for a referral to a different consultant which he did no problem, the I visited the consultant who sent me upstairs in the same building for some xrays (bulk billed) and confirmed the diagnosis cost for the referral was $130 of which I got around $40 back from memory all happened within days, that would have took ages on the NHS that's even if I could get to see a second consultant.

 

Edited March 16, 2018 by Sandgroper