In the last year I have had medical treatments, including surgery, in both Australia and England, and I've been covered by private health insurance in both countries. The comparisons are interesting to me.
The "public" system in Australia, for non-hospital treatment, is far superior to England, in my experience. The Australian government is in the business of managing the registration of doctors, and funding medications, it is not in the business of employing doctors.
In Australia you have a medicare card issued by the government, and you can go to any GP you feel like (there is no need for registration, you just attend whatever surgery is convenient for where you are on that day), and there is a standard schedule fee for all types of GP appointment. Some GPs bulk-bill, meaning they only charge the medicare fee, and you will pay nothing. Some GPs charge more than the medicare fee, and you pay the difference. It's entirely down to which GP surgery you decide to attend.
What that means in practice is that my usual GP was the one near where I worked (50kms away from my home), and I could make appointments online at a time that suited me, duck out of work for an hour, see a doctor, and go back to work. Much more convenient. Plus I never had an issue getting an appointment on the same day, and never had to miss work to see a doctor.
In addition, when GPs in Australia prescribe drugs they are covered by the PBS system, so you will never hear from an Australian GP that you can't have a particular drug because their surgery or region doesn't cover it, it is all federally controlled and funded in Australia. In the UK I was told I couldn't have Bricanyl inhalers because they were too expensive for the surgery to cover. That would NEVER happen in Australia.
The other difference, particularly relevant for people with chronic conditions like asthma, is repeat prescriptions. In Australia a repeat prescription is issued, with the number of repeats listed on it, and an expiry date of a year. You can then walk into any pharmacy anywhere in Australia, hand over the prescription, and walk out 10 minutes later with the medication, as often as there are repeats listed on the prescription. Neither you nor the pharmacy ever need to consult the doctor again until either the year or the repeat count expires.
England claims to have repeats, but in reality it is just a system where the GP *may* be willing to write a new prescription and send it to a pharmacy without having to see the patient again - you still have to request it, and in my experience, it only worked 1 out of 5 times. The other 4 times they insisted I had to come in, usually for something completely unrelated (one time they withheld asthma medication because they had forgotten to write down my blood pressure last time, so I had to try and make an appointment to get that done before they would allow me to breathe. After 5 days of staying home and attempting to get an appointment, I decided breathing was more important and went to a private GP).
So far, so good for Australia. And why I don't even bother registering with an NHS doctor in the UK. I go to a private doctor, get a private prescription, and pay for it myself. Still works out a lot cheaper than taking multiple days off work in an attempt to see a local NHS doctor, and also means I get the medication most appropriate to my condition, not the one that the local NHS decides it can afford.
The private health system for non-GP related costs was a surprise to me though.
In Australia when I had surgery at a private hospital the health fund covered the hospital stay, and drugs administered in hospital, theatre fees etc. However, the surgeon's and anaesthetist's fee were only covered up to the medicare scheduled cost of the procedure. So once again medicare covered a portion of the surgery fee, the health fund covered the remainder ("gap") between the schedule fee and the medicare covered portion. My surgeon however charged 7000AUD for the procedure, where the medicare schedule fee was only 995AUD. So I paid over 6000AUD, and another 2000AUD for the anaesthetist. That was expensive, and I did wonder what the point of health insurance was at that point.
In the UK, Bupa covered absolutely everything - the private hospital, the scans and x-rays required, the surgeon's fee, the anaesthetist's fee, the physio required, theatre fees, drug fees, the followup consultations etc. The only things they wouldn't cover were the ugly hand splint, and the even uglier white Teds I had to wear for surgery. So Bupa appear to have an aesthetic clause where they wouldn't cover things that are really ugly :-). All up I was only out of pocket 14 pounds to cover those items.
Also, the private hospital and consultant I had were exceptional. I had multiple appointments, scans and x-rays, and was given options all the way through. The day unit at the hospital had a private room for me, with ensuite. I was allocated a nurse who was with me throughout, took me to theatre, brought me back from recovery, monitored me until I was able to leave, and walked me out. Both the surgeon and anaesthetist visited before and after the surgery.
In my experience, the hospital private system and private health cover in the UK appears to be quite superior to Australia then, and I was barely out of pocket for anything. And the monthly cost of a health fund is also far cheaper than it was in Australia. But for GP care and prescription medication, Australia wins without question. I have no real experience of the public hospital system in either country, but from what I gather in the media, they seem to be pretty much the same (great medical treatment hampered by bureaucracy and long waiting lists. And at Princess Alexandra, some extraordinarily unpleasant staff).
The "public" system in Australia, for non-hospital treatment, is far superior to England, in my experience. The Australian government is in the business of managing the registration of doctors, and funding medications, it is not in the business of employing doctors.
In Australia you have a medicare card issued by the government, and you can go to any GP you feel like (there is no need for registration, you just attend whatever surgery is convenient for where you are on that day), and there is a standard schedule fee for all types of GP appointment. Some GPs bulk-bill, meaning they only charge the medicare fee, and you will pay nothing. Some GPs charge more than the medicare fee, and you pay the difference. It's entirely down to which GP surgery you decide to attend.
What that means in practice is that my usual GP was the one near where I worked (50kms away from my home), and I could make appointments online at a time that suited me, duck out of work for an hour, see a doctor, and go back to work. Much more convenient. Plus I never had an issue getting an appointment on the same day, and never had to miss work to see a doctor.
In addition, when GPs in Australia prescribe drugs they are covered by the PBS system, so you will never hear from an Australian GP that you can't have a particular drug because their surgery or region doesn't cover it, it is all federally controlled and funded in Australia. In the UK I was told I couldn't have Bricanyl inhalers because they were too expensive for the surgery to cover. That would NEVER happen in Australia.
The other difference, particularly relevant for people with chronic conditions like asthma, is repeat prescriptions. In Australia a repeat prescription is issued, with the number of repeats listed on it, and an expiry date of a year. You can then walk into any pharmacy anywhere in Australia, hand over the prescription, and walk out 10 minutes later with the medication, as often as there are repeats listed on the prescription. Neither you nor the pharmacy ever need to consult the doctor again until either the year or the repeat count expires.
England claims to have repeats, but in reality it is just a system where the GP *may* be willing to write a new prescription and send it to a pharmacy without having to see the patient again - you still have to request it, and in my experience, it only worked 1 out of 5 times. The other 4 times they insisted I had to come in, usually for something completely unrelated (one time they withheld asthma medication because they had forgotten to write down my blood pressure last time, so I had to try and make an appointment to get that done before they would allow me to breathe. After 5 days of staying home and attempting to get an appointment, I decided breathing was more important and went to a private GP).
So far, so good for Australia. And why I don't even bother registering with an NHS doctor in the UK. I go to a private doctor, get a private prescription, and pay for it myself. Still works out a lot cheaper than taking multiple days off work in an attempt to see a local NHS doctor, and also means I get the medication most appropriate to my condition, not the one that the local NHS decides it can afford.
The private health system for non-GP related costs was a surprise to me though.
In Australia when I had surgery at a private hospital the health fund covered the hospital stay, and drugs administered in hospital, theatre fees etc. However, the surgeon's and anaesthetist's fee were only covered up to the medicare scheduled cost of the procedure. So once again medicare covered a portion of the surgery fee, the health fund covered the remainder ("gap") between the schedule fee and the medicare covered portion. My surgeon however charged 7000AUD for the procedure, where the medicare schedule fee was only 995AUD. So I paid over 6000AUD, and another 2000AUD for the anaesthetist. That was expensive, and I did wonder what the point of health insurance was at that point.
In the UK, Bupa covered absolutely everything - the private hospital, the scans and x-rays required, the surgeon's fee, the anaesthetist's fee, the physio required, theatre fees, drug fees, the followup consultations etc. The only things they wouldn't cover were the ugly hand splint, and the even uglier white Teds I had to wear for surgery. So Bupa appear to have an aesthetic clause where they wouldn't cover things that are really ugly :-). All up I was only out of pocket 14 pounds to cover those items.
Also, the private hospital and consultant I had were exceptional. I had multiple appointments, scans and x-rays, and was given options all the way through. The day unit at the hospital had a private room for me, with ensuite. I was allocated a nurse who was with me throughout, took me to theatre, brought me back from recovery, monitored me until I was able to leave, and walked me out. Both the surgeon and anaesthetist visited before and after the surgery.
In my experience, the hospital private system and private health cover in the UK appears to be quite superior to Australia then, and I was barely out of pocket for anything. And the monthly cost of a health fund is also far cheaper than it was in Australia. But for GP care and prescription medication, Australia wins without question. I have no real experience of the public hospital system in either country, but from what I gather in the media, they seem to be pretty much the same (great medical treatment hampered by bureaucracy and long waiting lists. And at Princess Alexandra, some extraordinarily unpleasant staff).
Comments
Post a Comment