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?

My uncle lived in Australia and lost their house paying for cancer treatment for my aunt who sadly died

Or they could have gone public and paid nothing out of pocket.

I am in no way suggesting that the NHS is perfect or that change isn’t needed.

But personally I wouldn’t want a two tier system, or a system whereby an insurance company decide what tests/treatment you get rather than the medical team.

It’s sad enough their are people here who can’t afford prescription costs so don’t get their medication even when it is very much subsidised for most medications. I wouldn’t want more people unable to access medication due to cost.

Every system has pros and cons, amazing stories and massive failures, and I think whatever changes come to the NHS, we can't just take another country's model. The needs here need to be considered along with evidence from a range of ideas.

I've no idea about the Aussie systems, I've heard the whole range of positive and negatives as partially shown in this thread.

Personally, my concerns are around access - especially around kids without an adult who holds the insurance details having had terrible experiences with that in the US - and chronic illnesses which have a tendency to get a raw deal in most system & may in some ways be one litmus test.

[quote echt]In a public emergency department they don’t ask if you have private, it wouldn’t even come up

Yes it does. I've been asked every time.

Should you doubt my word, here's some other evidence:

www.smh.com.au/business/consumer-affairs/have-you-got-insurance-the-us-style-question-finding-its-way-to-australian-hospitals-20190314-p5149v.html

theconversation.com/if-youve-got-private-health-insurance-the-choice-to-use-it-in-a-public-hospital-is-your-own-113367[/quote]
Sure, you can be asked if you’d like to use your private insurance in a public hospital once you’re admitted to a ward, which is completely optional because really all it’s going to get you is a parking voucher and a newspaper but in 17 years in the public system and certainly in the tertiary hospital I work in, it’s definitely not practice to ask in the emergency department if you have private health insurance.

Not sure I see the relevance to this discussion though. Hospitals are a business, they don’t shy away from this fact. As you say, they ask you if you’d like to use it, you’re not required to just because you have it. You get the exact same care, same doctors and nurses if you stay public in a public hospital.

My original statement was simply that anyone, anywhere can walk into an emergency department and be seen and treated for free, but that I didn’t think that was any different to the UK system in this respect.

@echt, not every state charges for ambulances

You're right.

Tasmania and Queensland don't charge for residents.
Tasmania has reciprocal agreements with all states and territories except Queensland and South Australia.
Queensland residents are covered everywhere.

It's one country, FFS.

Sure, you can be asked if you’d like to use your private insurance in a public hospital once you’re admitted to a ward

Not so. I was asked at check-in.

As soon as you implement any form of charging then you start excluding some people from accessing healthcare.

Mostly those on lower and lower middle income.

Evidenced in this country by people not accessing dental health and eye care because they can't pay for it or are fearful of charges or put off regular checks until an emergency arises.

Evidenced in this country by people not accessing dental health and eye care because they can't pay for it or are fearful of charges or put off regular checks until an emergency arises

Quite. And more heading this way.

www.theguardian.com/society/2021/sep/02/scrapping-free-prescriptions-for-over-60s-could-have-devastating-impact

@A2M4 thank you

@echt I’m sorry about the issues you’ve faced

[quote Oceanbliss]@echt I’m sorry about the issues you’ve faced [/quote]
Thank you, but I think you may have meant another poster.

@echt

Sure, you can be asked if you’d like to use your private insurance in a public hospital once you’re admitted to a ward

Not so. I was asked at check-in.

That’s interesting to know. I don’t see it as a bad thing though. You’re not required to use it if you don’t want to (I work in ICU and I advise all my patients families not to use it as a lot of people’s private health won’t cover all ICU treatments) and it gives people an opportunity to use the insurance they’ve been paying premiums for god knows how long for.

As I said, neither system is perfect but we could do a whole lot worse that many other countries.

Reading these comments it becomes apparent that no matter where you live people have differing opinions on healthcare. Some rave because they have been fortunate enough to experience the positives. Equally there are those who don’t necessarily like it because of their own experiences. I don’t think there is auch a thing as a perfect system. Money will always come into it because it must. It’s no good blowing millions of £‘S on a treatment for 5 people for the year, if it means 100 people won’t get their treatment. It’s a hard thing to determine particularity when our population increases and our medical personnel are working part time (for females this is amazing and something many of us demand but not great in all jobs), or leaving in droves. Social care impacts it too so it’s not as simple as we think. Insurance might well be an idea but it will end up with some people not able to afford certain care because of their wage, additionally there will be multiple things not covered or will force up the price.

I liked what I've seen of the German system. German ex could get up to 3 GP appointments a year - after that, he had to pay €30, but if it was seen as a needed appointment, he'd get the money back from his insurance. German GPs don't seem to do much other than refer you to specialists - for gastric, for mental health, for cardiology, neurology, whatever. I think GPs in the UK do a lot more work and would refer you at after stage in the process. Germany also seems to have more preventative medicine, and post care. Ex went to Kur - like a convalescent home/wellness hotel - after he had a stroke, and we there for 3 or 4 weeks doing physio and speech therapy and so on. There was a woman staying there who was doing physio before her hip op, as that's shown to improve outcomes. I was able to stay in a guest room, and it was like a spa hotel. I ate in the canteen (varied menu, though all healthy,
and easy to cater for special diets; you might have a prescribed menu, depending on why you're there) and swam in the pool (outdoor heated pool, fab!) A colleague's wife has just been in for about 5 weeks for depression.

This obviously costs more, and just what you get may vary according to your health insurance (I don't know,) but everyone is covered. Countries like Germany and France pay a higher percentage of GDP on healthcare, and the NHS would be better if we paid similar levels.

@echt Oops sorry I must have made an assumption. I thought when you wrote: Like you suddenly didn't have cancer in 2002 and the specialist needs reminding.
That you had cancer.

The NHS is still the envy of the world.

What makes you think that? It rather sounds like brainwashing to me. I live in "the world" and I've never heard anyone say that.

Countries like Germany and France pay a higher percentage of GDP on healthcare, and the NHS would be better if we paid similar levels.

I would like the UK to spend a comparable amount per head on healthcare. Good quality healthcare and short wait times cost money.

For those who are talking of insurance based systems, what is the advantage for the average person of putting an insurance company into the equation? Surely that is just adding in cost for the end users as the insurance company needs their profit? Or are some insurers not for profit, in which case, what is the advantage of the insurance component? As an end user of healthcare, an insurance system is an extra layer of admin / paperwork to navigate and potentially leads to an inferior service for people on low incomes.

@gofg

The NHS is still the envy of the world.

What makes you think that? It rather sounds like brainwashing to me. I live in "the world" and I've never heard anyone say that.

Lol if Australia and NZ had a system like the UK NHS, or Canada or even the flawed ones in India they would have been able to vaccinate their relatively tiny populations.

[quote A2M4]@echt. I have never been asked if I have private health, except by the dentist. Is this a public hospital you have visited or a Private Emergency Dept?[/quote]
Public hospital.

Lol if Australia and NZ had a system like the UK NHS, or Canada or even the flawed ones in India they would have been able to vaccinate their relatively tiny populations

The vaccination debacle in Australia has nothing to do with the health systems.

No thanks would I want Australian system. They completely botched their Covid vaccination program. It is more expensive per capita than the NHS for no better outcomes.

[quote Oceanbliss]@echt Oops sorry I must have made an assumption. I thought when you wrote: Like you suddenly didn't have cancer in 2002 and the specialist needs reminding.
That you had cancer.[/quote]
My apologies. I see your point. I was just using it as an example.

Still thanks for your kind wishes.

@PlanDeRaccordement

No thanks would I want Australian system. They completely botched their Covid vaccination program. It is more expensive per capita than the NHS for no better outcomes.

The fucked up vaccine roll-out has nothing to do with health systems.