In wondering why UK can't adopt the Australian Healthcare system?

[chopc]

I was talking to some friends abroad and in Australia about frustrations with our wonderful
NHS for both patient and doctor. One of them wondered why we can't adopt the Australian Healthcare system. I thought the same and checked with those using it in Australia, and I can't see any downsides to it ........

What is stopping the UK adopting the same system?

*So it’s like first, second and third class care as opposed to first class and economy like we have in the uk?

I’d rather everyone pay higher taxes so that the poorest still get quality care*

This is a reality in every country in the developed world. Doesn't matter if you are in Finland, Australia or the UK, if money is not a problem you will always have the best health care.

What I like about the system in Australia is that it's a mixture of private and public where the majority can access good health care free or for very little money.

Australia has a huge land mass with many outback communities where providing health care is very expensive. It's not the same to live in a city like Sydney or Melbourne or live in Brewarrina. We also have the Flying Doctor Service that provides primary health care to those outback communities that don't have a doctor in hundreds of kms. It's hugely expensive to run but a necessity for many of those communities.

My experience is that Australia has seriously good health system. Not perfect by any means, but then health is hugely expensive in every country and there are no perfect systems to provide good health care to the majority of the population where people can easily chose doctors, specialists, pathology and hospitals either free or with minimal costs.

I think I’d still rather a better managed and funded NHS system. We should work towards improving what we have rather than importing the Australian system.

@Billynina

Bad parts of the Australian system.

Rural people are disadvantaged. No bulk billing for gps in my experience, not even for kids. Add to that having to travel for specialists and surgery means health costs were why we moved to a large city.

Also all therapies are expensive. I’m not even sure that private health would cover them in full, you would still have to pay a gap. The only time I saw a physio was when I was still under the care of the public hospital after giving birth. They discharge you at around 6 weeks and then you’d have to find your own and pay yourself. Things like speech therapy and occupational therapy and psychology and dieticians are out of the budget of most people.

If you have a diagnosed disabled child (or you are disabled) you get a funding plan to cover therapies and support workers etc

Medicines are also expensive. People of welfare pay the same price per item regardless of the item. However everyone else pays what it costs - items my family buy range from $15- $60 per month. In total our family pays a minimum of $200 a month on medicine. And we are not high income.

The NDIS scheme is not just about having a disabled child. Anyone who has not reached 65 and has a recognised disability can apply for funding for services like speech therapy, occupational therapies, psychology, exercise physiologists etc. Obviously if you've broken your arm and need a physiotherapist you can't apply to NDIS but if you go to your GP they can make up a health plan where the first 5 visits to the therapist of your choice will be at 50%.

The only bad aspect that I see with the Australian health care is that it doesn't cover dental or have any kind of dental plan to minimise costs. Kids are covered but not adults. Adults either go to dental hospitals (and the waiting lists are horrendous) or have to fund fully their dental work.

Things like speech therapy and occupational therapy and psychology and dieticians are out of the budget of most people.

Everyone can get a GP care plan for 5 sessions per calendar year through Medicare with these therapists with a rebate. Yes there’s a out of pocket fee, but it’s better than the UK.

Medicines are also expensive. People of welfare pay the same price per item regardless of the item. However everyone else pays what it costs - items my family buy range from $15- $60 per month. In total our family pays a minimum of $200 a month on medicine. And we are not high income.

This is true, but remember it’s capped per year with the PBS threshold (around 1500 per patient per year) and if you’re paying 200 a month you will reach that threshold usually by this time per calendar year and then should only be paying 6.60 per script.

And the NHS has the ridiculous scenario of paying for prescriptions for paracetamol which cost 2 cents per tablet in the supermarket.

I've a feeling that a lot of people who are all for private healthcare are young or don't have chronic health conditions both of which drive insurance premiums up and introduce exclusions.

People don't choose to get old, have things gradually go wrong and generally at that point alternative options are non existent.

I've been told that maternity/neo-natal insurance and care in the US is extornionate.

And the NHS has the ridiculous scenario of paying for prescriptions for paracetamol which cost 2 cents per tablet in the supermarket

I was at the pharmacy earlier today and you can get a pack of 500 for two dollars fifty

@AllTheUsernamesAreAlreadyTaken

I think I’d still rather a better managed and funded NHS system. We should work towards improving what we have rather than importing the Australian system.

I do agree with you in this. Same as in Australia.

I have never heard of the pbs threshold so will ask my pharmacist about that, thank you!

Yes you can get Medicare health plans but they only reduce psychology down to $100 per session last time I asked for my dc. So not accessible for many people.

Psychologist services are mixed. Yes it costs to see a psychologist privately. But there are bulk billing psychologists in many areas. And there are schemes to help with this, such as ATAPS. Depends where you live. But overall access to psychology for kids where I am is much better than the awfulness I’ve read on threads about the UK.

Definitely ask your pharmacist. They normally notify you! It would depend on whether an individual has reached that threshold.

It’s the same for Medicare. There’s a threshold, so if you’re accessing private services frequently, after a certificate point the gap you pay drops significantly.

but they only reduce psychology down to $100 per session last time I asked for my dc

For under 12s, if they or their parents have a HCC the state I work in has a scheme where you get 6 fully funded sessions that don’t cost extra. There’s provision for more under specif circumstances. Technically it can’t just be for behaviour but it’s easy to turn issues into anxiety, mood issues, learning etc.

Do you have a Headspace where you live? They are accessible from 12 years plus. They have clinical psychologists and you don’t need to pay extra.

And the NHS has the ridiculous scenario of paying for prescriptions for paracetamol which cost 2 cents per tablet in the supermarket

Nobody does that here, you can buy a pack of paracetamol in the supermarket for 45p!

Some low income people with free prescriptions might be prescribed paracetamol in specific cases, but otherwise GPs really don’t do this.

I worked in Australian health care system and although some good aspects overall for whole population would not say it is superior. I think they spend much more on administrative costs too.
There is a lot of private work and money swings decisions.
You can go private here /get private cover here. I think that + NHS much better Australian system.
If you can’t afford private cover here, I don’t think the Australian system would be better for you.

@PearlclutchersInc

I've a feeling that a lot of people who are all for private healthcare are young or don't have chronic health conditions both of which drive insurance premiums up and introduce exclusions.

People don't choose to get old, have things gradually go wrong and generally at that point alternative options are non existent.

I've been told that maternity/neo-natal insurance and care in the US is extornionate.

Don’t compare the Australian insurance system to the US.

@irresistibleoverwhelm

And the NHS has the ridiculous scenario of paying for prescriptions for paracetamol which cost 2 cents per tablet in the supermarket

Nobody does that here, you can buy a pack of paracetamol in the supermarket for 45p!

Some low income people with free prescriptions might be prescribed paracetamol in specific cases, but otherwise GPs really don’t do this.

pharmaceutical-journal.com/article/news/nhs-bill-for-paracetamol-in-england-tops-70m

Only because a concerted effort had to be made to clamp down on it because of huge costs.

Just popping in to say that I have just finished paying $33,000 for my three kids braces. Their dental is on top of that. We pay towards every single medicine (if it is subsidized by our Pharmaceutical Benefits Scheme.) Can be anything from $3.00 - several hundred. If it’s not in the subsidized list, or it’s a private script, you pay for the lot. I had to pay $420 per kid to see a heart consultant, plus about the same in ECG’s and ultrasounds to rule out a potentially fatal genetic issue that I have recently been diagnosed with. (The public wait list where I live is approx 3.5 years.) Physio’s, podiatrists, etc, hundreds - then we pay more for orthotics, crutches, etc. Our health insurance allows us to have surgery in a private hospital (sooner than public) and we pay about $500 per admission, and it also gives us a little bit of money back for each kid’s dental appointments (about $700 per kid per lifetime) and other services like Physio, etc…. We have no bulk-billing doctors near us.

I had to pay $420 per kid to see a heart consultant

Why don’t you have medicare? There would have been a Medicare rebate on that fee

@Billynina

I have never heard of the pbs threshold so will ask my pharmacist about that, thank you!

Yes you can get Medicare health plans but they only reduce psychology down to $100 per session last time I asked for my dc. So not accessible for many people.

The threshold is even lower ($316.80per annum) if you have a concession card.

You can get a concession card if you get an Age pension and meet the income requirement or if you get ABSTUDY, Austudy, carer allowance, family tax benefit part B, jobseeker, parenting payment, partner allowance or a variety of other things. There is also a low income health care card.

The info is available on servicesaustralia.gov.au

What happens if you have long term health issues?

To develop a new system that applies across the board means that for some people insurance won't be possible without being extremely expensive, due to pre existing conditions. Also I assume insurance goes up every time you need to renew.

I didn't choose to develop psoriasis as a teen and hen the related arthritis in my 30s. But I need a lot of medication and regular appointments and blood tests as a result. I didn't choose to have SVT and need treatment for it. I didn't choose to,get covid and develop hypertension as a result needing life long medication.

I've seen what these things have done to my travel insurance, and I'm now priced out of life insurance.

So, what happens to medical insurance in such situations?

I wasn’t aware that in Australia there is a children’s hospital with a waiting list to see a paediatric cardiologist that is 3.5 years. That would be completely unacceptable at my local children’s hospital and would be major news.

@PicsInRed

In NZ you pay an amount towards GP appointments (however these are still free if you are low income and also for children).

This "copay" system reduced wasted/unneeded appointments and meant less waiting for those in need, and appointments within days (or same day if urgent). Unlike here, I never found myself having to negotiate, beg or push to see a GP when really sick.

It's one NZ practice I'd strongly encourage the UK to adopt.

You have to pay for ambulances, though, and home visits. And the range of drugs that can be prescribed is tightly controlled and much smaller than here.

OTOH the NZ no-fault compensation for medical accidents is excellent.

So, what happens to medical insurance in such situations?

You either pay high premiums or don’t take out insurance and have your treatment for free in the public system.

Or if you’re developing a new system, the law enacted caps premiums for people with pre-existing conditions like yours. Which would a battle between legislators, like the Affordable Care Act in the US (“Obamacare”).

Otherwise insurance companies will do what insurance companies do: make a risk assessment. Just like if people keep driving into you at no fault of your own you’ll pay more for car insurance.

@nolongersurprised - I got $140 back per kid. You don’t get it all back. None of the specialists around here offer No-Gap services.

@NotBadConsidering - the heart condition that I just discovered I have is considered to be a symptom of a genetic rhumatological/soft tissue syndrome. My children have other symptoms of this syndrome. Unfortunately it is not considered to be a “cardiac” condition until it is diagnosed, and that doesn’t happen until they have cardiac symptoms. I wasn’t willing to risk that happening in the middle of a football game, or at school, etc. (One is also anxious/on the spectrum and I didn’t think she could handle waiting - she’s 17 and old enough to understand and has also found me unconscious on the floor, so there was a lot of psychological reasoning behind the decision to do this as well.)

So you didn’t pay 420 per child, you paid 280. Worth being accurate so people get an idea about what costs actually are.

If you’re talking about Marfan Syndrome or Loeys Dietz or similar, if there’s a known cardiac risk then it still wouldn’t take 3.5 years for a child to be seen at the children’s hospital.

If there’s a known cardiac association with any syndrome, the paediatric cardiologists here will see, and much sooner than 3.5 years. There must be a problem at your local children’s hospital for this. Or it may be 3.5 years for a 17 year old to be seen in the adult service. Even then it’s a ridiculously long time. It’s important people reading the thread appreciate that what you’re describing isn’t the norm for children’s healthcare in Australia.

My experience is that Australia has seriously good health system.

This is also my experience.