In a message dated 11/25/02 2:22:46 AM, PilotRob@webtv.net writes:
<< How do you handle medical care down under? Is it working pretty
well? We are in deep trouble on this issue in this country. It is going
"unaffordable" very, very quickly. Part of the reason is liability
issues in terms of amounts awarded though in some cases it seems
warranted. Reply off list if you wish...I am really interested in this.
>>
I am too. Can I get in on the response/discussion if off-list?
Annice & Bob
-------------------------------------------------------------------------
Funnily enough, this was a topic of conversation at dinner last night
at Birk's in Santa Clara - nice place - (guns was another topic of
conversation - there is no escape!! aaarggghhh)
I was dining with an old friend (originally Chicago, now Bay Area) and
his relatively new Canadian wife.
It seems that a) the US system (predominantly private, crippled public)
is busted, and has artificially high charges because employers pay most
medical insurance, not individuals who would shop around and introduce
more price competition. b) the Canadian system (totally public, private
*banned*) is woefully inadequate and results in those that can afford
it travelling to the US while everyone else waits *forever* for
mediocre care. I've heard 2nd or 3rd hand that the UK system is similar
but that could be unfair.
The Australian system is a balanced mix of private and public.
The public system is well funded, and (mostly) provides very high
quality and timely care. This is especially true for non-elective
procedures - e.g. emergency care, etc. Medical treatment in the public
system is *mostly* free. Each procedure has a scheduled fee (i.e. visit
to you local GP might be say $25, a hip replacement might be $5000 --
I'm making up numbers but you get what I mean) but doctors have the
right to charge greater than the scheduled fee. Most GP visits (71% in
the past 12 months apparently) result in no "co-payment" by the
patient. Obviously 29% of patient visits incur out of pocket expenses
by the patient. As an example, we have the choice of a 3 local
clinics - 2 would be free to us, one costs about A$7.50/visit. We chose
the latter because we value the extra time and effort that the doctor
spends on us -- it is great value in our minds, but if circumstances
were different and we were scrimping for money we could still get
unlimited excellent free care just down the road.
Competition means that co-payments are never too large, but the fact
you can have them means some doctors/patients will do a $/time/quality
tradeoff.
Most hospital episodes cost $0
As an example, we chose to have our 3rd child in the public system --
the quality of maternity care and the level of staffing/expertise were
better than the private competition. My wife had eclampsia in our
previous 2 pregnancies and spent 6 weeks in hospital under careful
watch for all 3 children. Despite that, we incurred *no costs*, for the
best care in the country and equal to the best anywhere.
OK, so how does the private system survive?
In fact, it is government policy to provide sufficient
assistance/subsidy to private health insurance funds so as to maintain
a competitive private sector.
They also use a "big stick" to encourage high-income earners to be in a
private fund. This is in the form of a penalty tax for high income
earners who are not in a private fund.
The private funds also offer a more timely service for elective
surgery, and offer some rebates for things like dental and even
cosmetic surgery.
What else, well the cost of drugs is subsidised under a national
pharmaceutical benefits scheme. So if some really expensive drug costs
say $500/week, if the panel deems it to be a) proven, b) effective, c)
the only choice for a particular situation, then it may only cost the
patient $25/week in that situation.
Not all drugs are covered, sometimes there are arguments and delays but
*most* of the time it works out well.
I'm not saying it is perfect, but it seems a lot better than the US and
Canadian systems, and it seems to me that promoting both healthly
public and private systems is the differentiator here. Both systems
need to deliver quality and value
Mike
/// unsubscribe/change address requests to majordomo@autox.team.net or try
/// http://www.team.net/mailman/listinfo
/// Archives at http://www.team.net/archive/spridgets
|