[tri-med] Re: healthcare in Australia

----- Original Message ----- 
From: "Mark & Jayne Wright"
>I got this off a website, so correct it if you think it's wrong.
> In Australia, the health care system has two main parts, there is the 
> public health care system which is called Medicare and there is a private 
> system which consists of a network of privately owned and operated 
> hospitals, medical centres and health care providers, the cost of which 
> can be partly covered by private health insurance.

Thats all true. Everyone is covered by the public health system, Medicare. 
But folk who can afford it are encouraged to have private coverage. That 
encouragement is in the form of taxation. Premiums are rebated by age and 
continuous coverage (unless you have to go on welfare where it is stayed). 
So the younger you are when you start and the longer you have continuous 
coverage the less the premiums are (by up to 30%). Similarly if you are 
deemed to be able to afford to have private health and don't you pay a 
medicare levy on your tax - up to 3% of your gross income (I think its 3% - 
its a sliding scale).

> Medicare is owned and run by the Australian Government. It is designed to 
> provide essential care for eligible Australian residents, including new 
> migrants. Under Medicare, patients can be treated at a public hospital at 
> no charge, and also have access to subsidised treatment by doctors and 
> other health professionals.

True. The government also own and operate Medicare Private, the private arm 
of medicare. Its a non profit private insurance company. The government also 
limits the premiums private insurance companies can charge. If they want to 
raise premiums they have to get approval from the government.

> However, under Medicare, in a public hospital you won't be able to choose 
> your own doctor and for non emergency procedures you will be placed on a 
> public hospital 'waiting list'. The length of time you have to wait for 
> public hospital treatment will depend on the urgency of your condition. So 
> you may not be able to choose when you are treated in a public hospital.

Not so true. If you have a doctor that operates in a public hospital you can 
be put on his waiting list. If you go through a hospital clinic no you dont 
get to choose. Most doctors have two operating lists, a private list and a 
public list. Most of the time I have had my own doctor (meaning I have seen 
him in his rooms) and I get surgery based on urgency. If its not so urgent I 
may have to wait longer but if its not urgent does that matter?

> It is also important to know that Medicare does not generally provide 
> benefits for things like dental treatments, optical items and medically 
> necessary ambulance transport. But don't worry you can get cover for these 
> additional services with private health insurance.

No dental is not covered by medicare, that is a state system, and yes ours 
stinks. Even so if you are in pain or have an infection there is no wait. 
Optical visits are and arent. The doctor is the glasses arent. But then for 
low income earners we have Vision Care. You go to the optometrist of your 
choice and either choose the "free" glasses or choose what you want and pay 
the difference between the cost of the free ones. Ambulance travel is free 
to anyone who has a healthcare card and thats anyone with a low income or 
permanent disability. Some folk (like Jocelyn) have a health care card and 
private insurance. They didn't mention that hearing aids arent covered by 
Medicare either - thats a different program again for health care card 
holders and children to 21 and folk over 60.

Medicare also doesn't cover cosmetic surgery (except under certain 
circumstances) and some other surgeries deemed truly elective.

> With private health insurance, you can choose who treats you, where you 
> are treated and most importantly, how soon you are treated.

Providing that the doctor and hospital you chose have the time and beds 
available. Refer to my neighbours story. You also have to be able to afford 
the gap or co-pays.

> There are a number of privately run hospital facilities in Australia that 
> help to take the burden off the public health system. However you are 
> required to pay for using their services and like many places in the 
> world, health care costs can be expensive. Even a few days in hospital for 
> a routine operation can add up to thousands of dollars in hospital charges 
> and doctors fees.

Yep

> Private health insurance helps cover the cost of treatment in a private 
> hospital and because waiting lists in private hospitals are generally much 
> shorter than in the public system, you can expect to be treated sooner.

Depends, as I said some (most) private hospitals dont have the facilities 
and so people go to the public hospital as private patients. The government 
pays for all those things that are not profitable for the private sector.

> Also with private health insurance you can be covered for a range of other 
> everyday health services that are not covered by Medicare such as dental, 
> physiotherapy, optical items and medically necessary ambulance services.

These can be obtained publically so its a mistruth. Even if I were to go and 
get private insurance for say dental - I have to wait 12 months before I can 
use it, and then I am limited to X amount of work each year. I may wait 12 
months to get into the public dental system but there is no limit to the 
amount of work I can get done. They do what is needed. The facilities are 
more modern at my local dental clinic than at the dentist I used to use. 
Then again I can often end up with a very young dentist.

> Private health insurance is generally divided into hospital cover and 
> extras cover:
>
> Hospital cover
> Helps you with the cost of being treated in a private hospital and allows 
> you to choose your own doctor, as well as which hospital you would prefer 
> to attend. You can also use hospital cover benefits to help with costs of 
> being treated as a private patient in a public hospital.

Yes the key word is HELPS but the gap payment or co-pay can be hundreds of 
dollars a day and most private hospitals want it up front.

> Extras cover
> Helps you with the cost of services that are not usually provided by 
> hospitals such as dental, physiotherapy, optical items and more.

Yes but they have limits and exclusions, more than the state system and I 
still have to pay part.

> Medicare does not cover the cost of using an ambulance, so if you have an 
> accident and require an ambulance to get you to a hospital you will need 
> to pay for the service, and this can be very expensive.

Yes ambulance cover can be expensive, but as I said a lot of folk are 
already covered with health care cards.

The Australian system means that everyone is covered if necessary but if you 
can afford private cover then you are actively encouraged to take it.

Karen 

                  Building ___ooOOoo__ Rainbows
                       www.trisomyonline.org
                  Families Helping Families On-line

Other related posts: