Why comparisons between British and Australian health systems are distorted

[Guest The Pom Queen]

47 minutes ago, Wa7 said:

I have never quite got my head around it.

Doctors have mostly been bulk billed but anytime we have seen a specialist for a child we have been billed then small refund. Have had x - rays/ ct scans bulk billed but had a MRI and got billed..............thankfully we are a healthy family in general

That is because they are sending you to a private specialist, a lot of drs tend to do that, if you can’t afford to pay ask them to refer you to the public system.

Another idea for anyone else is if your Dr is concerned and wants to refer you consider going to a private specialist and if you need an operation they can usually bump you up the queue and if you are lucky it may even be that same specialist who does the op as most work for the public and private hospitals. 

‘Also don’t forget the safety net there are two, one for prescriptions and one for out of pocket medical expenses. There is an article about the prescription one in our directory here https://www.pomsinoz.com/articles.html/living-in-australia/

[Marisawright]

21 minutes ago, The Pom Queen said:

That is because they are sending you to a private specialist, a lot of drs tend to do that,

That's very true.   I've had my share of health issues and I've never, ever been referred to a specialist in the public system by a GP.  They all just assume you've got private health insurance!   If you want to use the public system, you've got to speak up.

I have seen a specialist on the public system once, and although I was warned it would be a long wait - it wasn't.  

Also, I had my double spinal fusion on the private system because I thought it would be quicker and a better surgeon.   A month later, my friend's father had exactly the same op on the public system - he'd been waiting six weeks.  My op cost $35,000 of which I got about $25,000 back.  His cost him nothing!

Edited March 18, 2018 by Marisawright

[ssiri]

I'm confused now.

Could we establish what exactly you pay for in Australia please?

Not under insurance, and not using some sort of health care card, and even if you get some back on Medicare.

I think it could be of interest to those migrating to know exactly what they are in for, and whether they should go private.

It would also be of interest to those migrating how much extra private people have to pay.

Also, prescriptions.

I'm confused as hell and I've lived there for thirty years.

 

 

I’ve been here for a year, in Aus and have had a plethora of tests via Medicare at my GPS request - I haven’t paid for any of them. This is X-rays, ultrasounds, CT scans, cancer tests, blood tests, eye tests etc. They were prescribed by my GP without hesitation, and I went to a pathologist and got them done, when it suited me. Results were turned around in a day or two and my appointment with my GP to review them was booked in very soon after, each time - around what suited me.

 

So far, I’ve not had the need to use any Medicare services, where I get some money paid back (for fronting up the initial cost, as other on here have advised as per their personal circumstances).

 

I’ve paid for medicines - prescription antacids for a bout of gastritis - that’s all.

 

Insurance - I use the optional extras. Dental, physio therapy etc. I can get physiotherapy via Medicare, too as a care plan, if I wanted, but it’s limited to five sessions, per issue. For my chosen plan 66% of the cost is covered by insurance (the extras).

 

As I understand it, migrants don’t have to get private insurance I they don’t want to, but the fed Govt encourages it for everyone. If a person is below 33 (I think is the age cap), and haven’t got a health fund/pvt insurance , they then get charged an offset or levy to make up for it. If as a migrant you arrive in Aus, and get private insurance within the first year of arriving, you are exempt from the levy. Otherwise, you are not. I haven’t looked into the levy that much, as I’m not affected (have pvt insurance) but first time migrants should look into it all, against their circumstances - to assess what they need.

 

Comparison websites or Bupa, would provide information on what is available and at what cost via insurance - it depends on what cover a person/family wants and needs based on their circumstances. I can’t advise on that aspect as it’s personal to individuals. So they need to do their research!

 

 

[ssiri]

You pay for everything.  Medicare has a schedule listing the approved price for all services (prescriptions, tests, GP and specialist visits etc).   You get that fee as a refund, either by claiming yourself, or by authorising the GP or pathology lab to claim on your behalf.  The only question is how much money you get back from Medicare.
It's confusing because nowadays, more service providers choose to "bulk bill".   So instead of you paying the service provider a high fee, and getting part of it back, the provider charges just the schedule fee, and bills it straight to Medicare.  So it might seem to you as if it's free, but in fact it's just that the price you paid matches your refund.
 

Well, that’s like the NHS then. No money comes out of my account (take home pay) or goes back in. Paid from taxes, is what you mean? Unless one also has pvt insurance, in which case their is a monthly premium, I pay out of my take home, and any excess.

[Marisawright]

6 minutes ago, ssiri said:

Well, that’s like the NHS then. No money comes out of my account (take home pay) or goes back in. Paid from taxes, is what you mean? Unless one also has pvt insurance, in which case their is a monthly premium, I pay out of my take home, and any excess.

 

 

No, I don't mean paid from taxes. Every time you attend the doctor, you are charged a fee.   When I first arrived in Australia, the norm (in Sydney at least) was that you paid that fee, then you took the invoice to Medicare and claimed it back.  Often, the doctor charged more than the fee approved by Medicare, so you didn't get the whole lot back.

Nowadays, many doctors (and pathology labs) bulk bill. What that means is that instead of you having to pay and claim it back, you sign a form authorising them to claim the fee directly from Medicare on your behalf.  If they're charging more than Medicare approves, you pay them the extra - if not, there's nothing to pay.

So yes, Medicare is funded by taxes but you are actually paying and claiming back each time.

[ssiri]

That just isn't our experience at all, my wife has an issue that is in the family if you like and she is sent for regular scans and also various other tests. My GP has bought me in for regular health checks. It took a year almost to the day for my GP to finally send me for a scan which led to me finally being treated for a double herniated disc. We can only talk about our own experiences and obviously those living in one country are going to say it's better in that country whereas there doesn't seem to be anything to back it up other than meaningless anecdotes. If you prefer to think a certain aspect is better that's fine but I can tell you judging by recent experience no-ne will convince me there is a better system somewhere else. 

The NHS is an outstanding system, but it is under pressure more and more, doing a lot with very little. If it is to survive and continue its work and be sustainable into the future for all the people it needs to treat, it needs to be allowed to evolve. It’s a matter of preserving the NHS, not for national pride, but because it is worth it. Not is it about convincing you of anything.

I have lived in Cambridge and various parts of the Home Counties and I have found the GP role, wanting. As I’ve said, once past then, care is exemplary. I’m not the only one - friends in their 50s and 60s have had to fight to get past the GPs, hip surgery, heart surgery, the lot. So have I (had to fight to get past the GPs).

I came to Aus not expecting great things from the Medicare service, but have been pleasantly surprised and impressed by the GP access and preventative care from them. There are things the UK could learn from this, to even better deliver what is already a great NHS service, albeit creaking and quite frankly vulnerable.

[ssiri]

However, previously you have conceded that your experience, in a lower-populated area where doctors are less under pressure, is different to the experience in large cities in the UK.

It also varies from region to region, not just urban/rural etc. It’s not called a postcode lottery for nothing.

[ssiri]

No, I don't mean paid from taxes. Every time you attend the doctor, you are charged a fee.   When I first arrived in Australia, the norm (in Sydney at least) was that you paid that fee, then you took the invoice to Medicare and claimed it back.  Often, the doctor charged more than the fee approved by Medicare, so you didn't get the whole lot back.
Nowadays, many doctors (and pathology labs) bulk bill. What that means is that instead of you having to pay and claim it back, you sign a form authorising them to claim the fee directly from Medicare on your behalf.  If they're charging more than Medicare approves, you pay them the extra - if not, there's nothing to pay.
So yes, Medicare is funded by taxes but you are actually paying and claiming back each time.

So yes, paid from (funded by) taxes then, as my GP doesn’t charge me up front for anything, nor do I claim anything back. I haven’t signed any forms authorising my GP or pathology labs for consultations or tests either. I’d have queried it otherwise. Are you in Sydney or Aus ATM?

[Marisawright]

3 minutes ago, ssiri said:

 I haven’t signed any forms authorising my GP or pathology labs for consultations or tests either. I’d have queried it otherwise. Are you in Sydney or Aus ATM?

 

 

Are you absolutely sure?  Isn't there a form that you sign when the consultation is finished?   When a test is ordered, doesn't your GP ask you to sign a form which you take with you to the lab?  Read it next time.

[bristolman]

15 minutes ago, ssiri said:

 

 

The NHS is an outstanding system, but it is under pressure more and more, doing a lot with very little. If it is to survive and continue its work and be sustainable into the future for all the people it needs to treat, it needs to be allowed to evolve. It’s a matter of preserving the NHS, not for national pride, but because it is worth it. Not is it about convincing you of anything.

I have lived in Cambridge and various parts of the Home Counties and I have found the GP role, wanting. As I’ve said, once past then, care is exemplary. I’m not the only one - friends in their 50s and 60s have had to fight to get past the GPs, hip surgery, heart surgery, the lot. So have I (had to fight to get past the GPs).

I came to Aus not expecting great things from the Medicare service, but have been pleasantly surprised and impressed by the GP access and preventative care from them. There are things the UK could learn from this, to even better deliver what is already a great NHS service, albeit creaking and quite frankly vulnerable.

 

 

As I say we van only speak about our own èxperiences, my GP in Brisbane took a year almost go the day to diagnose a herniated disc. Our GP here has been brilliant. It' our experience and the only one we can comment on. 

[newjez]

1 hour ago, ssiri said:

 

 

The NHS is an outstanding system, but it is under pressure more and more, doing a lot with very little. If it is to survive and continue its work and be sustainable into the future for all the people it needs to treat, it needs to be allowed to evolve. It’s a matter of preserving the NHS, not for national pride, but because it is worth it. Not is it about convincing you of anything.

I have lived in Cambridge and various parts of the Home Counties and I have found the GP role, wanting. As I’ve said, once past then, care is exemplary. I’m not the only one - friends in their 50s and 60s have had to fight to get past the GPs, hip surgery, heart surgery, the lot. So have I (had to fight to get past the GPs).

I came to Aus not expecting great things from the Medicare service, but have been pleasantly surprised and impressed by the GP access and preventative care from them. There are things the UK could learn from this, to even better deliver what is already a great NHS service, albeit creaking and quite frankly vulnerable.

 

 

I quite agree that the NHS needs to evolve. I'm not sure I like the way the Tories are evolving it. I would prefer it to move towards the Australian system where the wealthy pay rather than just become a failing system.

[ssiri]

Are you absolutely sure?  Isn't there a form that you sign when the consultation is finished?   When a test is ordered, doesn't your GP ask you to sign a form which you take with you to the lab?  Read it next time.

Yes, I take a form, to the pathology lab from my GP but I don’t sign it. Nor do I sign anything after I’m done with my GP - nothing. My point is I don’t pay anything up front at the moment, as I wouldn’t in the UK.

There may be an arrangement between the lab, my GPS surgery and the Government but Its not coming out of my take home pay. Taxes yes, (like in the UK), but not take home pay. Apart from for a prescription of antacids, I’ve not had to pay for anything so far. I can’t make it any clearer than that.,

[ssiri]

Are you absolutely sure?  Isn't there a form that you sign when the consultation is finished?   When a test is ordered, doesn't your GP ask you to sign a form which you take with you to the lab?  Read it next time.

Yes, I take a form, to the pathology lab from my GP but I don’t sign it. Nor do I sign anything after I’m done with my GP - nothing. My point is I don’t pay anything up front at the moment, as I wouldn’t in the UK.

There may be an arrangement between the lab, my GPS surgery and the Government but Its not coming out of my take home pay. Taxes yes, (like in the UK), but not take home pay. Apart from for a prescription of antacids, I’ve not had to pay for anything so far. I can’t make it any clearer than that.,

[Perthbum]

The NHS has been seen by other countries when they do these studies as the best in the world,  always comes at the top or near the top, but the tories are killing it with no investment....we need a government to raise taxes which the majority of the public agree with to fund the NHS with what it needs.

Edited March 18, 2018 by Perthbum

[Booma]

1 hour ago, Marisawright said:

Are you absolutely sure?  Isn't there a form that you sign when the consultation is finished?   When a test is ordered, doesn't your GP ask you to sign a form which you take with you to the lab?  Read it next time.

sometimes Im asked to sign a form & sometimes im not. same doctor & same or similar tests. never thought about it till now. it doesn't seem to make a difference one way or other that I can see.

[Wa7]

3 hours ago, Wa7 said:

I have never quite got my head around it.

Doctors have mostly been bulk billed but anytime we have seen a specialist for a child we have been billed then small refund. Have had x - rays/ ct scans bulk billed but had a MRI and got billed..............thankfully we are a healthy family in general

Yes it's all making sense now 

I have though got my head round the fact that ' I haven't quite got my head around it' and just expect no payments at the Drs but more specialist treatment there may be a charge but a rebate of some sort which I am ok with.

Edited March 18, 2018 by Wa7

[ssiri]

I quite agree that the NHS needs to evolve. I'm not sure I like the way the Tories are evolving it. I would prefer it to move towards the Australian system where the wealthy pay rather than just become a failing system.

That or even closer to home in (shock horror), Europe. Hear continental care and access is quite good too.

[ssiri]

Yes, I take a form, to the pathology lab from my GP but I don’t sign it. Nor do I sign anything after I’m done with my GP - nothing. My point is I don’t pay anything up front at the moment, as I wouldn’t in the UK.

There may be an arrangement between the lab, my GPS surgery and the Government but Its not coming out of my take home pay. Taxes yes, (like in the UK), but not take home pay. Apart from for a prescription of antacids, I’ve not had to pay for anything so far. I can’t make it any clearer than that.,

Sorry, not sure why the double post appeared. Slow internet where I am! Once was enough.

[Sandgroper]

4 hours ago, Wa7 said:

I have never quite got my head around it.

Doctors have mostly been bulk billed but anytime we have seen a specialist for a child we have been billed then small refund. Have had x - rays/ ct scans bulk billed but had a MRI and got billed..............thankfully we are a healthy family in general

I believe you are in Perth, you need to change your GP i’ve been through X-rays, ct scans mri’s with my knee and shoulder over the last 18 months and not paid a cent!

[Guest The Pom Queen]

2 hours ago, ssiri said:

 

 

So yes, paid from (funded by) taxes then, as my GP doesn’t charge me up front for anything, nor do I claim anything back. I haven’t signed any forms authorising my GP or pathology labs for consultations or tests either. I’d have queried it otherwise. Are you in Sydney or Aus ATM?

 

 

That’s because you are going to a bulk bill GP. Some GP’s only charge the schedule Medicare fee I think it’s $37.05 at the top of my head as Medicare give you $37.05 to see a GP then the Dr usually gets you to sign a form to say you allow them to claim on your behalf so that the $37.05 is paid directly to them. Some GP’s don’t even bother about you signing the form and it sounds like yours is one of those, you just walk in and walk out.

Another GP clinic down the road may charge a fee of $78, if this is the case you can either pay them in full at the time of consult and then submit a claim to Medicare, or most GP practices are now linked up to Medicare and can claim for you. So you would still pay the $78 but you would have $37.05 sent back to your bank account by Medicare usually within 48 hours, you would then be $40.95 out of pocket

[Wa7]

23 minutes ago, Sandgroper said:

I believe you are in Perth, you need to change your GP i’ve been through X-rays, ct scans mri’s with my knee and shoulder over the last 18 months and not paid a cent!

We were booked in for the mri on the request of the specialist and was billed for the mri by the hospital ( pmh) not the GP. I have no issue with the charge, but it goes to show how different it can be for everyone.

 

[Guest The Pom Queen]

20 minutes ago, Wa7 said:

We were booked in for the mri on the request of the specialist and was billed for the mri by the hospital ( pmh) not the GP. I have no issue with the charge, but it goes to show how different it can be for everyone.

 

You don’t pay the GP that’s correct. Sometimes you may find a GP or specialist refers you to a radiologist who doesn’t bulk bill, remember to ask as prices vary between them. When we lived in Cairns I was quoted $1,000 for a special test, I tried another branch of the same company Queensland Xray and it was Bulk Billed, so it really does pay to shop around. Also always remember to ask how much out of pocket you will be as the price may be $1,000. but you may get a huge percentage back

[Guest The Pom Queen]

3 hours ago, bristolman said:

As I say we van only speak about our own èxperiences, my GP in Brisbane took a year almost go the day to diagnose a herniated disc. Our GP here has been brilliant. It' our experience and the only one we can comment on. 

A GP diagnosed? That is one thing that doesn’t happen as they always refer you to specialists, or maybe it’s just me because I’m too complex. I’d love to know others experiences. Yes if you have a cold or something minor they treat, some GPS also do minor procedures like stitches. Cerberus as disc issues and he was sent for X-rays etc and then on to a specialist, same for his frozen shoulder. 

[Joji]

I don't have private healthcare and have benefited immensely through Medicare here in Australia , I've had numerous tests and procedures I.e ultrasounds , CT scans , X-rays , screening , biopsies , operations and haven't paid any expenses whatsoever . I have a GP practice 5 minutes down the road where I can see a doctor the same day , I have had  blood tests done at the same practice and diagnostic tests done 15 minutes drive away , results are always provided within a week or two at the latest . I am so impressed with the care I have received and during my short  stays I have had in the local university hospital It was faultless , I have also used the on call out of hours doctors for the kids and they have been out within an hour . The out patience side of things I also can't fault I have also seen the stretched side which was in accident and emergency which actually quite surprised me , my young son was sent in via ambulance for suspected appendicitis , the ambulance was quick to arrive but we were waiting with the ambulance staff  In the corridor at the hospital for well over an hour awaiting a bed and there was a queue of other patients there also and some in extreme pain awaiting beds , it was the week of schoolies so I asked if this was due to that and they said this was the norm , it's always busy here . Although my son was still on an ambulance trolley he was reviewed by a doctor and appendicitis was diagnosed as likely to be the problem we still had to wait there with the ambulance staff until a bed was found and a changeover could be provided , the ambulance and staff my son came in with and all the others also waiting really highlighted how stretched the a  and e were and how much waiting around the ambulance staff had to do before going back out . Once he was fully admitted and given a bed due to the influx of a and e for children's ward the care he received  was absoluutely faultless . Although initially some of his care was done in the corridor he was being continually observed by the ambulance staff and the on duty doctor. I was always kept updated and continialy reassured , I could see they were stretched and prioritising patients in need but could also feel the stress and hear their aplogies for the wait . They had the staff that was clear to see but they had nowhere to put my son  in the children's department so In the end they had to put him on the adults side temporarily .I cannot fault the care they gave my son and had the ambulance staff taken him to a different hospital that was less busy they said he would have been transferred here anyway because they didn't have the facilities to treat him there for appendicitis. I believe it is hard to make a  true relative comparison between two different counties of which is better or worse just of your own experience , my experience in one postcode in Australia although positive might not be the same in a different area , my experience in the a and e in the U.K. was faultless but the GP side in my postcode was not as positive as in Australia but my area was highly populated and there were less doctors surgeries available. 

[Johndoe]

It all worked out well for you Joji and sometimes, that is all we can hope for................the end result. As you say, sometimes it seems that staffing levels are ok and it is the beds that they are short of, but that's just a "managerial blind".

The "short of beds" statement doesn't mean that all beds are fully occupied, it means that they aren't staffed. "Short of beds" invariably means "short of staff" It's not an "OZ thing" it's one of the reasons we emigrated as my wife was a nurse and hated the use of the words, "short of beds". It's been an excuse for a long time in both countries for the inability to staff beds due to managerial decisions.....................notice I didn't say "cuts". Yes the budgets may be cut, but "short of beds" comes down to individual management of hospital resources and doesn't necessarily mean that the budget won't stretch to beds being opened up (more staff). It can be due, and in many cases is, due to managers allocating funds inappropriately eg allocating funds to the building of a staff/visitor cafeteria when the very same funds could have opened up 6 more beds for the year...........priorities.....we're all different, as are our priorities.