Why comparisons between British and Australian health systems are distorted

[Johndoe]

5 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. 

So your problem lies with the individual doctor not the health care system, despite what you will do your best to imply

[Johndoe]

5 hours 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.

I've never signed anything other than the receipt for the gap payment (years ago) and that doesn't even happen now. The GP hits "send" (I'm guessing) on his computer, as i leave his room, and by the time that I arrive at the receptionist's desk, she hands me a receipt as my bank details are already lodged with the surgery

[Johndoe]

2 hours ago, The Pom Queen said:

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

spot on! Should all be "mechanised" for want of a better word but some surgeries are behind the times. The doc charges whoppetty whop, the gov't pays him whippety whip, you dab your card at whoppetty whop and you automatically get credited with the difference between the two into your bank account.

It all started as a rebellion by GP's who said that whippety whip wasn't enough for a consultation so they upped their fees thinking the Gov't would meet their demands for whoppety wop..........they didn't so that is now "The Gap" which you get refunded.

GP's who still charge whippety whip (bulk bill) are often viewed with suspicion as just being "client gatherers" whose experience/skill/knowledge wouldn't afford them the client base if they charged more. Not necessarily the case as they may consist of a young knowledgeable (new generation) empathetic practitioner base averse to the establishment. That said, they could also consist of a practice who, albeit having Australian recognition, be comprised of migrant GP's with "less than ideal" qualifications or who have cultural differences. How many times have I heard, here and in the UK  "that Indian Doctor was really abrupt"? Sometimes they have to bulk bill to attract clients, whereas without bulk billing, they'd struggle.

[Joji]

Sentence structure has always been a weakness for me . I haven't got a phobia of paragraphs , I actually like paragraphs, I  simply struggle to know where to put full stops , commas and start new paragraphs. I managed to get by though and gain a degree at uni , but looking back at my last post it does scream paragraph phobia and I do wonder how I managed it ?

[Johndoe]

4 minutes ago, Joji said:

Sentence structure has always been a weakness for me . I haven't got a phobia of paragraphs , I actually like paragraphs, I  simply struggle to know where to put full stops , commas and start new paragraphs. I managed to get by though and gain a degree at uni , but looking back at my last post it does scream paragraph phobia and I do wonder how I managed it ?

You also need to hit the "quote" button so we know who you're replying t

Forget paragraph formatting if you struggle with it. Just hit..................when you feel you need to take a breath and the reader likely will too. I do it all the time, despite, (I'm told), scoring 95% in my only GCE sat, which was English Language in the Army. I'm a stickler for commas though :-)

[newjez]

24 minutes ago, Joji said:

Sentence structure has always been a weakness for me . I haven't got a phobia of paragraphs , I actually like paragraphs, I  simply struggle to know where to put full stops , commas and start new paragraphs. I managed to get by though and gain a degree at uni , but looking back at my last post it does scream paragraph phobia and I do wonder how I managed it ?

Sorry to be flippant, but my eyesight is not great and I can't read posts that don't have a fair bit of whitespace.

[Joji]

3 minutes ago, Johndoe said:

You also need to hit the "quote" button so we know who you're replying t

Forget paragraph formatting if you struggle with it. Just hit..................when you feel you need to take a breath and the reader likely will too. I do it all the time, despite, (I'm told), scoring 95% in my only GCE sat, which was English Language in the Army. I'm a stickler for commas though :-)

I'm so sorry Johndoe   I thought I  hit the quote for  Newjez , I'm rubbish at paragraphs  and also rubbish at sending quotes to the right person . As they say 'everyday is a school day '  I think I've worked it out now , the quote button that is , I'm never going to master paragraphs  lol 

[Joji]

5 minutes ago, newjez said:

Sorry to be flippant, but my eyesight is not great and I can't read posts that don't have a fair bit of whitespace.

I suggest you go to specsavers they are always more than willing to help . ?

[Johndoe]

13 minutes ago, Joji said:

I'm so sorry Johndoe   I thought I  hit the quote for  Newjez , I'm rubbish at paragraphs  and also rubbish at sending quotes to the right person . As they say 'everyday is a school day '  I think I've worked it out now , the quote button that is , I'm never going to master paragraphs  lol 

No need for apologies. Takes time to find your way around a forum and it's "buttons"

[Johndoe]

8 minutes ago, Joji said:

I suggest you go to specsavers they are always more than willing to help . ?

Wrong footed there Joji. Apologies from Newjez about white space, met with what seems like sarcasm, whilst you expect your apologies about paragraph formatting to be met with consideration?

[Toots]

6 hours ago, The Pom Queen said:

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. 

Our GPs wherever we have lived always referred us  to specialists - not that it's needed to happen that often but in my case with my dickie heart and a couple of other instances, an appointment was made with a specialist immediately.  I've always received very good care.  In Sydney the hospital and cardiologist was only 15 minutes from home.  Here I have to go to a cardiologist in Launceston which is a good hour away as there aren't any heart specialists at Latrobe or Burnie hospitals.  Touch wood, if it wasn't for my heart problems, I very rarely need to see a GP.

[newjez]

4 hours ago, Joji said:

I suggest you go to specsavers they are always more than willing to help . ?

My last pair of variable focus glasses cost £400. Not in a hurry to go back thanks.

[Marisawright]

11 hours ago, ssiri said:

 

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.,

 

Here is an article explaining how the system works. 

http://www.mydr.com.au/first-aid-self-care/australian-health-system-how-it-works

What I'm trying to explain is that the doctors, pathology labs, etc, charge for each individual service.  If a foreigner walks in off the street, he will have to pay that fee.  If you walk in, you hand over your Medicare card instead, so the practice can claim your rebate on your behalf.  So far, you have been visiting doctors and labs who bulk-bill, therefore you're not seeing the invoice, or having to pay anything - the surgery claims your rebate.

So you're right, at the moment you're not having to hand over money to the doctor - but one day, you might attend a specialist who doesn't bulk bill, and then you'll have to pay the difference.

It may sound like a fine distinction but if people understand how the system works, then it's less confusing.  It's not a case of "some things are free and some things are not".  It's the case that some doctors/labs/specialists charge more than the government-approved fee, and some do not. 

[ssiri]

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

Thanks, that’s good to know, that it can vary like that. I like the arrangement we have with our current GP (and can’t fault the service either). Wouldn’t want to go to GP who’d arguably charge over the odds.

I’d imagine however, the shortfall cost appears more pronounced, if specialist treatment and consultation is involved, (albeit maybe not always)?

[ssiri]

spot on! Should all be "mechanised" for want of a better word but some surgeries are behind the times. The doc charges whoppetty whop, the gov't pays him whippety whip, you dab your card at whoppetty whop and you automatically get credited with the difference between the two into your bank account.
It all started as a rebellion by GP's who said that whippety whip wasn't enough for a consultation so they upped their fees thinking the Gov't would meet their demands for whoppety wop..........they didn't so that is now "The Gap" which you get refunded.
GP's who still charge whippety whip (bulk bill) are often viewed with suspicion as just being "client gatherers" whose experience/skill/knowledge wouldn't afford them the client base if they charged more. Not necessarily the case as they may consist of a young knowledgeable (new generation) empathetic practitioner base averse to the establishment. That said, they could also consist of a practice who, albeit having Australian recognition, be comprised of migrant GP's with "less than ideal" qualifications or who have cultural differences. How many times have I heard, here and in the UK  "that Indian Doctor was really abrupt"? Sometimes they have to bulk bill to attract clients, whereas without bulk billing, they'd struggle.

Our doc does bulk bill, he is Australian, but second (Indian ancestry). My partner and I can’t fault his care and attention to detail. We recommend him to others (including the in-laws).

Once when he wasn’t around, I saw another GP and couldn’t fault her approach either - her bedside manner was more matter of fact/less empathic (Aus second gen Chinese), but by no means abrupt or rude. Just to the point - the outcome of the diagnosis and result were still the same - I was satisfied with the service and outcome.

[ssiri]

My last pair of variable focus glasses cost £400. Not in a hurry to go back thanks.

 

 

My pairs are for reading only and I got both for under £250 (yes you saw that right) at spec savers, too! I haven’t had to change the prescription since, so so far, so good.

 

[ssiri]

Here is an article explaining how the system works. 
http://www.mydr.com.au/first-aid-self-care/australian-health-system-how-it-works
What I'm trying to explain is that the doctors, pathology labs, etc, charge for each individual service.  If a foreigner walks in off the street, he will have to pay that fee.  If you walk in, you hand over your Medicare card instead, so the practice can claim your rebate on your behalf.  So far, you have been visiting doctors and labs who bulk-bill, therefore you're not seeing the invoice, or having to pay anything - the surgery claims your rebate.
So you're right, at the moment you're not having to hand over money to the doctor - but one day, you might attend a specialist who doesn't bulk bill, and then you'll have to pay the difference.
It may sound like a fine distinction but if people understand how the system works, then it's less confusing.  It's not a case of "some things are free and some things are not".  It's the case that some doctors/labs/specialists charge more than the government-approved fee, and some do not. 

Thanks for the clarification- it’s good to know the nuances - in terms of needing care. Yes you are right no specialists for me yet. Insurance may then come in handy to make up any gap/minimise out of pocket expense, in the event that I do need one. If I were to use anything other than the options cover that my insurance provides.

From a system perspective, is it possible to say you want to go public ( so even if not bulk billed, you only are out of pocket for the Government portion of the specialist appointment or procedure, till you claim back the rebate?).

[Marisawright]

11 hours 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.

 

It's nothing to do with whether it's ordered by the GP.   It depends on what the provider chooses to do.   

Each and every time you go to a doctor, path lab or x-ray provider, they charge a fee for that particular service.  

For each service, Medicare has set a fee which they think is fair (the schedule fee).  That's the maximum Medicare will pay for that service.  If the doctor/lab charges that exact fee, you don't have to pay a cent - by giving them your Medicare card, you authorise them to claim that fee from Medicare on your behalf.  

However, some doctors (and most specialists) charge more. If they charge more, you have to pay the difference.  That difference can be hundreds of dollars (for instance, I think the schedule fee for cataract surgery is less than $1,000 per eye, whereas most eye surgeons charge $2,000 to $3,000 per eye - so your "gap" could easily be over $1,000).

So where you're being asked to pay, it's because the doctor is charging more, not because the public system doesn't cover it.  

[Marisawright]

45 minutes ago, ssiri said:

From a system perspective, is it possible to say you want to go public ( so even if not bulk billed, you only are out of pocket for the Government portion of the specialist appointment or procedure, till you claim back the rebate?).

 

 

Yes, it certainly is.  

[Marisawright]

58 minutes ago, ssiri said:

My pairs are for reading only and I got both for under £250 (yes you saw that right) at spec savers, too! I haven’t had to change the prescription since, so so far, so good.

 

If they are for reading only, then you can just buy them at the chemist.   

There is no advantage in buying expensive reading glasses at the optician, except that the frames will be stronger.  The ones you get at the chemist work just as well and won't do your eyes any harm at all.   If you buy the more expensive ones (say, $15 to $20 instead of the $5 ones) they will last longer and have better quality glass, that's all.

This is the advice my husband got from his eye surgeon after cataract surgery.  He no longer needed distance glasses, he just needed reading glasses.

[ssiri]

If they are for reading only, then you can just buy them at the chemist.   
There is no advantage in buying expensive reading glasses at the optician, except that the frames will be stronger.  The ones you get at the chemist work just as well and won't do your eyes any harm at all.   If you buy the more expensive ones (say, $15 to $20 instead of the $5 ones) they will last longer and have better quality glass, that's all.
This is the advice my husband got from his eye surgeon after cataract surgery.  He no longer needed distance glasses, he just needed reading glasses.

I got mine whilst in the UK, and haven’t had the need to replace them yet. Good to know I can do so at a chemists, if I wanted, when the need arises.

[Guest The Pom Queen]

2 hours ago, ssiri said:

 

 

My pairs are for reading only and I got both for under £250 (yes you saw that right) at spec savers, too! I haven’t had to change the prescription since, so so far, so good.

 

I went to Specsavers got a pair of sunnies and a pair of glasses for $49, Hubby went to Bupa and paid $280 for one pair, the ironic thing is we are with Bupa yet they charge more

[Marisawright]

16 minutes ago, The Pom Queen said:

I went to Specsavers got a pair of sunnies and a pair of glasses for $49, Hubby went to Bupa and paid $280 for one pair, the ironic thing is we are with Bupa yet they charge more

Yes, those opticians and dentists run by the health funds are a trap for the unwary.   You assume that because they're run by the health fund, it will be cheaper - but they're not. I went to an HCF Eyecare Centre for glasses once, and they were the most expensive pair I've ever had!

[desreb]

We have a young disabled child, and have found the two systems to be night and day, with Australia winning hands down so far.

In Australia, she was diagnosed as being profoundly deaf soon after birth. After the diagnosis, we went into the hospital for a series of consultations, and I remember one with four professionals, including a paediatrician, audiologist, doctor, and a family counsellor. It was the last really struck me, but sure enough, the public health system recognises that this is a stressful time for a young family, and provide a counsellor to help the family cope. I don't think I've ever heard of such a thing on the UK NHS for a disability.

From there, she had implant surgery at 5.5 mos (vs 1 year old, typically, on the NHS), with early implantation being important to the outcome. After that, we went to a local early intervention centre for weekly sessions with our own dedicated speech therapist and audiologist, who follow and assist children's progress from 6mo to pretty much when they graduate from school. All this was funded by a $26k lump sum at our disposal for the EI centre sessions, and any other supportive measures - we used a bit to buy some more accessories for the implants, but also to take a sign language course at the TAFE. The EI centre was a bedrock of her treatment, and the staff became like family. All related treatment - the surgery itself, the ENT, other appointments, were all arranged by them; we went along with their advice. When we moved back to the UK, we still email and Skype them for advice from time to time, for free, and one of them even offered to 'drop by' while in the UK at a conference.

In the UK, we have so many healthcare professionals involved in her care, we need an org chart to keep track. She's seen around 16 in the year we've been here, and there are eight active at present. There are three different bodies - the local council sensory services, the local NHS trust, and the specialist implant centre at the local major hospital - and each have their own specialists in the same role, most of whom have only occasional communication with the others. Whereas in Australia the same audiologist has been working in the centre for 15 years, in the UK we've had four audiologists rotate through the centre in one year. Most specialists recommend speech therapy every week for someone her age, although the NHS will only provide one every quarter. We organise a 'team around the child' meeting every quarter to try to bring all these people together to introduce themselves and find some way of coordinating treatment, although really it seems more like an exercise to placate frustrated parents. Ironically, the best and most engaged people we've met in all these centres, are all ex-pat Australians on work experience in the UK.

Now - there is a postcode lottery effective here; In Oz, we were in Clovelly, where you'll get a lot of highly-paid medical professionals living and working nearby, versus South-East London, where you'll get...fewer of those. But that doesn't explain the bulk of the issue.

 

The fundamental problem appears to be this; whereas Australia has favoured early intervention centres that focus on the children, the UK offers a procession of different overlapping bodies and services, with little coordination and little emotional connection to the patient. Hence, more time appears to be filling forms and gaining familiarity, than actual treatment and therapy.

 

Because of this, I do get the occasional pleasant surprise from the NHS, such as when I went in for a joint injury, and they gave me a series of physio sessions only two weeks later. And A&E can be excellent, of course. But generally, it's pretty shocking.

 

D

 

[CaptainR]

My family have a history of glaucoma and I have shown some of the risk factors such as high interocular pressure that could mean I would develop glaucoma as well. In the UK other than the possibility of eye drops it is unlikely that any real treatment would take place until there was actual deterioration of the vision and glaucoma was diagnosed. Whereas, here in Australia within a few days of the optician referring me to my doctor I was in with my GP, then straight for an MRI of the optic nerve, results back the following day and on to a specialist. Two weeks later I had Selective Laser Trabeculoplasty surgery and the pressures are down. This was all bulk billed on medicare, none of this was rushed any more than normal.