We have it decent in Australia, but for the Americans reading on, the bar is so ridiculously low you can walk over it.
I hope one day Medicare can actually be universal, and not the private subsidy model we have currently.
I dunno about you, but finding bulk billing is a pain the arse now, and in certain areas it simply doesn’t exist. Not to mention my premium mouth bones which aren’t covered for some stupid reason.
I just wish we’d finally kill off private health. Private health is such a scam we only take out because we have a two tiered system and there’s a tax discount.
I really don’t like Australians talking about how good we have it, when it’s kinda meh, and actively getting worse.
That all being said, yeah, the PBS is pretty good and I’m glad insulin is affordable.
Thank Christ we didn’t get the Libs back (for American readers, that’s the conservative party), we could do SO much better given how wealthy we are per person.
But, anyone who doesn’t want to pay more in tax in order to get truly public healthcare doesn’t know how to do maths. We could just pay what we pay in private health premiums already, in tax, and we’d probably get way better care per person (because profit is inherently inefficient).
I also hate private health, and in fact, cop the additional medicare levy on the chin because id rather pay 2-5k in tax that funds medicare, than get some junk private health cover.
The problem with bulk billing is it’s so dependent on location. I have great GPs that can get an appointment within a day or two. More rurally you’re waiting 6-8 weeks and paying $90 a pop.
Despite their being flaws in Australia you can still at least get emergency life saving care that won’t bankrupt your family. I’m not as well versed but there’s also the safety net for medications which I believe stops the horrendous out of pocket expense across a year
Yep, safety net changes slightly each year but it’s usually based on the cost of a certain number of scripts.
This year it’s $1,694.00 for general patients and $277.20 for concession card holders.
When you hit it as a concession holder the cost becomes 0 and as general you get the concession card price for the rest of the year.
This will be the first year of my adult life where I won’t hit it which feels pretty amazing. One new drug lets me drop multiple existing ones and not get sick as often.
I don’t mind private health existing but it should only exist without all the bs policy to force you into it and without leeching off public funding through tax breaks and Medicare funding.
Bulk billing fortunately doesn’t impact me because I see a team at hospital outpatients for almost everything.
Fortunately PBS brings one of my speciality meds down to affordability from a few hundo K per year.
My big gripe at the moment is ndss funding for CGM sensors is non-existent if you aren’t type 1.
So it’s ~100 per fortnight if you want good glucose monitoring but have some non type 1 need for them.
Oh damn, that must suck (regarding the glucose monitoring)
Thanks for sharing your thoughts.
I do have one extra Response:
I don’t mind private health existing but it should only exist without all the bs policy to force you into it and without leeching off public funding through tax breaks and Medicare funding.
The problem is that the private health model in our country only works with tax breaks and Medicare funding.
If we made them ACTUALLY compete with Medicare (i.e., if you have private health cover, you’re no longer eligible for Medicare), the business model would collapse.
I for one, propose this as a method for killing it off.
After almost 20 years of big L Liberals in Aus, we should just consider ourselves lucky we still have Medicare. I want dental too, but I also want them to repair the basic model first
Do you mean the basic model? If so, it means everybody has access to free medical. Although, in order to include dental earlier, it would need to be restricted at first on need.
Yeah I was curious as to what reforms you would propose. We already have a system that purports to have universal medical care, but it’s only true in limited ways. There are many avenues to free medical care, but it’s still a for-profit system under the hood (for non-hospital care, which includes seeing specialists).
There are government run parts of the system, like emergency hospital which runs very well, but outside those, the gap fees are getting larger, and the “elective” surgery system where people on the public queue wait months for life altering surgery is an embarrassment.
I’m proposing we end the subsidy model, make all health care publically provided, not just some, everyone goes through the same system, not two tiers for those who can afford it. This is the only way there is extremely strong incentive for everyone to want healthcare to be extremely good.
Although, in order to include dental earlier, it would need to be restricted at first on need.
Why though? I’m guessing hospital care is vastly more expensive than getting a check up at the dentist. The peak body of dentists rail against dental into Medicare because it’ll dampen their profits. Preventative dental is cheaper than emergency dental.
We should pay medical employees actually doing the work more, and give practice owners nothing.
The “free market” is a stupid way to run an essential service. Thank god ours at least is regulated decently (but, not enough)
People need to look at the last 40-50 years and realise privatisation has not worked, it’s time to roll back the clock on government ownership and running of essential service.
We have a say over the government’s decisions, not private companies (outside regulation and legislation). Why are people so allergic to government ownership (it’s propaganda, if we’re being honest)
Profit motive needs to be taken out of healthcare and elder care yesterday.
Sure, universal health would be great, but, we are a very conservative country, the best we can hope for in reality is a subsidy model that doesn’t subsidise private. We need to unwind the changes of the past 2 decades while also expanding it.
Profit itself isn’t the issue imo, profit above all is. We have to get back to making people the priority, not profits.
I think the only way this would make sense in my view is making gap fees illegal. But because Medicare hasn’t been properly indexed, this also would likely mean we’d see even fewer bulk billing practices.
Even then, we shouldn’t incentivise medical coverage on how much money doctors can expect to make because of demographics in the area.
It makes vastly more sense (in my view) to simply provide the services where people are on an as-needed basis similar to so many other public services (like schools), and just pay the doctors and other medical staff a competitive salary.
we are a very conservative country
We’ll have to agree to disagree on this. It’s a miracle we have a centre government (Labor) with the right-wing media dominance in this country. But we do bring back centre left governments because the character of the country is about people receiving a “fair go” which is the opposite of conservative values.
We are a country founded in-part on the labour movement, we have just lost our way over the last couple of decades (on labour, other issues we’ve improved obviously) and while there are conservative areas, I don’t really think as a nation we’re terribly conservative compared to many other countries.
We have to get back to making people the priority, not profits.
I agree very much
Profit itself isn’t the issue imo, profit above all is.
I do not agree. Profit motive is the issue, to some degree, in practically all areas of our economy. Profit, in any form, is causing problems in our healthcare. Having practice owners who have the capital to own a practice, taking a percentage for all appointments from the doctors who work there, serves the community in no shape or form.
In the long run, it would be cheaper for us to just own the practice ourselves via the government and employ the staff directly. The profit we need to pay goes into the practice owner’s pocket and does nothing for actually providing the service. People may try to argue this is the return they deserve for putting in the investment of owning the practice, but this only holds true because we have relinquished the responsibility of investment. Either way, the investment needs to come from somewhere. It’s just way cheaper in the long run if it comes from our taxes, rather than in the form of markups for profit.
The profit motive means doctors are incentivised to charge as much as possible while still attracting enough patients. This is market forces and doesn’t lead to an optimal outcomes. The profit motive needs to be removed entirely, because what, we’re going to ask individuals to work against their own best interest?
Psychologists got way, way more expensive during COVID: because they could. This is the profit motive.
We need to make the public service larger and employee essential services directly.
Pay them well, and we’ll all be better off (well, except for the practice owners)
This is my opinion, but I think many of us can agree that over the last 40 years the personal economic situation of us all had become worse. And it’s not that we couldn’t afford, as a country, to go back to government provided services.
It just would make the powers that be less money. And we can’t have that, can we.
I have a relative that needs about 1800 a month for their Insulin. They’re disabled but if they applied for disability they wouldn’t be poor enough to qualify for public assistance and the disability payments wouldn’t be enough to cover the price of insulin so they’re forced to live in poverty until they old enough to retire.
In Portugal - which has a National Health Service - I’m getting 5 pens for €0 with a doctor’s prescription (and there are mechanisms for just getting new prescriptions regularly or on request without needing to go for a doctor’s appointment every time), as would anybody else that needs it, by the way, as it’s not means tested.
That said, without said prescription it would be about €70 for 5 pens.
Also the local politicians are slowly but surely destroying the National Health Service in order to privatise Healthcare bit by bit.
Yeah that’s what we’re doing in Australia too, our Medicare system used to be great free doctors everywhere etc.
Now they’re fewer and far between and private health companies got a boost from the government since the government said if you don’t have private health you will pay more in tax
For comparison…
In Aus I’m paying ~$32 for 25 pens
We have it decent in Australia, but for the Americans reading on, the bar is so ridiculously low you can walk over it.
I hope one day Medicare can actually be universal, and not the private subsidy model we have currently.
I dunno about you, but finding bulk billing is a pain the arse now, and in certain areas it simply doesn’t exist. Not to mention my premium mouth bones which aren’t covered for some stupid reason.
I just wish we’d finally kill off private health. Private health is such a scam we only take out because we have a two tiered system and there’s a tax discount.
I really don’t like Australians talking about how good we have it, when it’s kinda meh, and actively getting worse.
That all being said, yeah, the PBS is pretty good and I’m glad insulin is affordable.
Thank Christ we didn’t get the Libs back (for American readers, that’s the conservative party), we could do SO much better given how wealthy we are per person.
But, anyone who doesn’t want to pay more in tax in order to get truly public healthcare doesn’t know how to do maths. We could just pay what we pay in private health premiums already, in tax, and we’d probably get way better care per person (because profit is inherently inefficient).
Abolish private health.
Thanks for being accosted with my rant.
US user here: I REALLY appreciate the context. I hear surprisingly little about the Australian side of this kind of thing. Thank you!
No worries mate. All the best in improving your country’s situation!
the bar is at the bottom of the marianas trench.
No need for that. I feel informed by this. Thank you.
Thanks for this haha, I do often feel like I’m just projecting “things are bad” into the world. Appreciate you saying this.
I also hate private health, and in fact, cop the additional medicare levy on the chin because id rather pay 2-5k in tax that funds medicare, than get some junk private health cover. The problem with bulk billing is it’s so dependent on location. I have great GPs that can get an appointment within a day or two. More rurally you’re waiting 6-8 weeks and paying $90 a pop. Despite their being flaws in Australia you can still at least get emergency life saving care that won’t bankrupt your family. I’m not as well versed but there’s also the safety net for medications which I believe stops the horrendous out of pocket expense across a year
Yep, safety net changes slightly each year but it’s usually based on the cost of a certain number of scripts.
This year it’s $1,694.00 for general patients and $277.20 for concession card holders.
When you hit it as a concession holder the cost becomes 0 and as general you get the concession card price for the rest of the year.
This will be the first year of my adult life where I won’t hit it which feels pretty amazing. One new drug lets me drop multiple existing ones and not get sick as often.
Heck yeah!
100% agree. Dental should be covered.
I don’t mind private health existing but it should only exist without all the bs policy to force you into it and without leeching off public funding through tax breaks and Medicare funding.
Bulk billing fortunately doesn’t impact me because I see a team at hospital outpatients for almost everything.
Fortunately PBS brings one of my speciality meds down to affordability from a few hundo K per year.
My big gripe at the moment is ndss funding for CGM sensors is non-existent if you aren’t type 1. So it’s ~100 per fortnight if you want good glucose monitoring but have some non type 1 need for them.
Oh damn, that must suck (regarding the glucose monitoring)
Thanks for sharing your thoughts.
I do have one extra Response:
The problem is that the private health model in our country only works with tax breaks and Medicare funding.
If we made them ACTUALLY compete with Medicare (i.e., if you have private health cover, you’re no longer eligible for Medicare), the business model would collapse.
I for one, propose this as a method for killing it off.
By making them compete, hehe
I stopped going to the dentist, it is simply way beyond what my budget can handle. That sucks.
I must be preaching to the choir, but remember this when they don’t tax large corps, or propose another tax cut for workers (you and me).
We don’t need tax cuts, we need to stop wasting money on subsidising the already wealthy so we can afford to finally abolish private health for good!
(Dentists don’t like the sound of this, because they won’t be able to charge whatever they like anymore. But tough, my mouth bones aren’t a luxury)
After almost 20 years of big L Liberals in Aus, we should just consider ourselves lucky we still have Medicare. I want dental too, but I also want them to repair the basic model first
Our of curiosity, what does this look like in your view?
Do you mean the basic model? If so, it means everybody has access to free medical. Although, in order to include dental earlier, it would need to be restricted at first on need.
Yeah I was curious as to what reforms you would propose. We already have a system that purports to have universal medical care, but it’s only true in limited ways. There are many avenues to free medical care, but it’s still a for-profit system under the hood (for non-hospital care, which includes seeing specialists).
There are government run parts of the system, like emergency hospital which runs very well, but outside those, the gap fees are getting larger, and the “elective” surgery system where people on the public queue wait months for life altering surgery is an embarrassment.
I’m proposing we end the subsidy model, make all health care publically provided, not just some, everyone goes through the same system, not two tiers for those who can afford it. This is the only way there is extremely strong incentive for everyone to want healthcare to be extremely good.
Why though? I’m guessing hospital care is vastly more expensive than getting a check up at the dentist. The peak body of dentists rail against dental into Medicare because it’ll dampen their profits. Preventative dental is cheaper than emergency dental.
We should pay medical employees actually doing the work more, and give practice owners nothing.
The “free market” is a stupid way to run an essential service. Thank god ours at least is regulated decently (but, not enough)
People need to look at the last 40-50 years and realise privatisation has not worked, it’s time to roll back the clock on government ownership and running of essential service.
We have a say over the government’s decisions, not private companies (outside regulation and legislation). Why are people so allergic to government ownership (it’s propaganda, if we’re being honest)
Profit motive needs to be taken out of healthcare and elder care yesterday.
Sure, universal health would be great, but, we are a very conservative country, the best we can hope for in reality is a subsidy model that doesn’t subsidise private. We need to unwind the changes of the past 2 decades while also expanding it.
Profit itself isn’t the issue imo, profit above all is. We have to get back to making people the priority, not profits.
I think the only way this would make sense in my view is making gap fees illegal. But because Medicare hasn’t been properly indexed, this also would likely mean we’d see even fewer bulk billing practices. Even then, we shouldn’t incentivise medical coverage on how much money doctors can expect to make because of demographics in the area.
It makes vastly more sense (in my view) to simply provide the services where people are on an as-needed basis similar to so many other public services (like schools), and just pay the doctors and other medical staff a competitive salary.
We’ll have to agree to disagree on this. It’s a miracle we have a centre government (Labor) with the right-wing media dominance in this country. But we do bring back centre left governments because the character of the country is about people receiving a “fair go” which is the opposite of conservative values.
We are a country founded in-part on the labour movement, we have just lost our way over the last couple of decades (on labour, other issues we’ve improved obviously) and while there are conservative areas, I don’t really think as a nation we’re terribly conservative compared to many other countries.
I agree very much
I do not agree. Profit motive is the issue, to some degree, in practically all areas of our economy. Profit, in any form, is causing problems in our healthcare. Having practice owners who have the capital to own a practice, taking a percentage for all appointments from the doctors who work there, serves the community in no shape or form.
In the long run, it would be cheaper for us to just own the practice ourselves via the government and employ the staff directly. The profit we need to pay goes into the practice owner’s pocket and does nothing for actually providing the service. People may try to argue this is the return they deserve for putting in the investment of owning the practice, but this only holds true because we have relinquished the responsibility of investment. Either way, the investment needs to come from somewhere. It’s just way cheaper in the long run if it comes from our taxes, rather than in the form of markups for profit.
The profit motive means doctors are incentivised to charge as much as possible while still attracting enough patients. This is market forces and doesn’t lead to an optimal outcomes. The profit motive needs to be removed entirely, because what, we’re going to ask individuals to work against their own best interest?
Psychologists got way, way more expensive during COVID: because they could. This is the profit motive.
We need to make the public service larger and employee essential services directly.
Pay them well, and we’ll all be better off (well, except for the practice owners)
This is my opinion, but I think many of us can agree that over the last 40 years the personal economic situation of us all had become worse. And it’s not that we couldn’t afford, as a country, to go back to government provided services.
It just would make the powers that be less money. And we can’t have that, can we.
I have a relative that needs about 1800 a month for their Insulin. They’re disabled but if they applied for disability they wouldn’t be poor enough to qualify for public assistance and the disability payments wouldn’t be enough to cover the price of insulin so they’re forced to live in poverty until they old enough to retire.
That’s like covering rent for two extra people. That’s insane.
In Portugal - which has a National Health Service - I’m getting 5 pens for €0 with a doctor’s prescription (and there are mechanisms for just getting new prescriptions regularly or on request without needing to go for a doctor’s appointment every time), as would anybody else that needs it, by the way, as it’s not means tested.
That said, without said prescription it would be about €70 for 5 pens.
Also the local politicians are slowly but surely destroying the National Health Service in order to privatise Healthcare bit by bit.
Yeah that’s what we’re doing in Australia too, our Medicare system used to be great free doctors everywhere etc.
Now they’re fewer and far between and private health companies got a boost from the government since the government said if you don’t have private health you will pay more in tax