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?

Anyone from the UK who could be teleported to Australia would be bowled over by the access to GPs.

“Are you saying I can see someone the same day? I don’t have to call at 0800 only to be told at 0801 that all the appointments have been filled for the next 3 weeks? And it’s free, except I might have to wait an hour or so? And if I want to pay a small fee I can see who I want at a scheduled appointment time? I don’t believe you.”

Not all cities in Australia have the same level of health care and rural have a lot less. There is a lot of politics involved that affects health care in both state and federal level.

Health care is inconsistent across Australia. While some places have lots of bulk billing doctors there are other places where it is near on impossible to find it.

@echt you can take out ambulance cover here. Ots about $100 a year for the whole family. Otherwise even a trip with no emergency treatment is $$ thousands.
If you have a health care card (not sure what the equivalent UK benefit would be called these days)ambulance is free.
Healthcare card holders also get free treatment from GPs.
If I see my GP it might be about $120 for a basic appointment. I'll get about 80 back under Medicare. Goes straight into your bank account these days.
Bad news is that in the 15 odd years I've been here, I'm seeing public hospital surgery lists getting longer and longer. So if you can, you pay to skip the queue.
Private healthcare is pretty much compulsory if you earn over a certain amount or you get taxed more highly.
It's hugely expensive and a con in my view. All the funds have "exclusions" in the small print.(a PP mentioned cataracts for example)
And when they do pay out, it's only ever a percentage of the cost.
Having said that, you can rock up at any emergency dept, free of charge no matter what you end up having done, from tests to surgery.
I've taken various family members to emergency. Triage system is excellent and so is the care. Even when they're mega busy

@Eyesofdisarray

It might make people appreciate it more if it wasn't 'free'. It's so unwieldy it's easy to use and abuse. And so much money is wasted

Not true, the NHS consistently comes top of all international healthcare metrics in efficiency and value for money. We spend less on healthcare than most Westernised countries in terms of promotion of GDP yet come top of efficiency tables. Our spend is around 8% of GDP compared to most EU countries’ between 9 and 15% - the US is around 29% as huge proportions are creamed off in inefficiencies and profit in the US.

Look at statistics and facts - not just what you’d like to be true.

*proportion of GDP

My friends who live in Australia sold their house to fund IVF treatment (not covered by insurance.) Also, hadn’t seen a dentist in 3 years, as couldn’t afford it ; and they both have decent enough jobs. They obviously pay for anything the kids need, but when she broke her hip (terrible fall - in her 30s), got a neighbour to take her to hospital, as an ambulance was an additional payment they could do without.
I’ve spent a lot of time over there, and lived there for a few years in my 20s. A broken ankle, couple of bad infections, and an anaphylactic reaction were covered to some extent by my insurance and Medicare, but I had to put a whack of it on a credit card.

All systems have their pros and cons.

I live in australia and what has shocked me about the nhs is the way that you make appointments.
I can make an appointment with my GP online. The website shows all the gps in the practice, plus times available for the next few weeks. I choose one and book it in. Otherwise I can ring at any time of day to request an appointment. I will be offered a range of days and times
If I need a hospital or specialist appointment I ring, they tell me what is available and we agree on a time and date that suits
I think if the nhs had a similar system then there would be far less complaints on mumsnet and it would be much more fit for purpose.

@echt

Bulk billing. You do not have to pay to see a GP

I was responding to the poster who saw a virtue in being able to see a GP on the day. Bulk billing practices entail a wait for most, though not as bad as in the UK.

Also while anyone can go to bulk billing, anyone earning $90, 000 gets stung with a tax hit if they ^don't* have private provision.

It definitely varies depending on the area you live in but in major cities, you can get same day appointments with bulk billing GPS.

Also, I’d like to clarify that private health insurance is not relevant to GP appointments. Health insurance doesn’t cover GP appointments.

After Medicare, I usually pay about $30 for my private GP appointments. That is £16. To put that in perspective, minimum wage in Australia is about $20 per hour.

The average full time salary in Australia is less than $90,000 and the median is much lower. However, about 50% of the population have private health insurance. That suggests that people do see value in it beyond minimizing tax.

@WhoNeedsaManOfTheWorld

Loads of countries have systems where people pay something towards their treatment, some good systems in Europe Our government is only interested in capitalism and there is a conflict of interest as some have interests in US health companies. They have just gone down privatisation by the back door route

There are plenty of posters on here who pipe up when the NHS is discussed that they would welcome a privatised service. I can't understand why you would want the person who is advising that you require/don't require surgery to benefit financially from that surgery. I prefer financial benefit/medical decision making to be totally separate

But by the same token if I needed surgery or a medication or something I would want it to be available now, with no wait lists and not be told “but that’s not available in this country” and have to resort to going overseas for the treatment I need.

No system is perfect. Having lived in the UK and used the NHS and now living in the US, I prefer the system here.

You could see a dentist routinely for years before the cumulative cost became greater than a cycle of IVF. And IVF isn’t massively funded on the NHS so I don’t see how having to borrow money to do it in Australia is any different to people having to self fund to do it in the UK.

I’ve spent a lot of time over there, and lived there for a few years in my 20s. A broken ankle, couple of bad infections, and an anaphylactic reaction were covered to some extent by my insurance and Medicare, but I had to put a whack of it on a credit card.

If you were only a temporary resident but from the UK, then all these treatments for acute problems or emergency issues would have been free with the reciprocal health care arrangement if you had gone to any public hospital.

The only reason people from overseas are made to use there credit cards at emergency departments is because they will claim to be from a country that is part of the reciprocal health care arrangement or claim to have insurance but won’t actually be covered and the hospitals will need to chase a bill.

Again, this is no different to people who aren’t UK residents not being eligible for treatment under the NHS and having to pay. Your experience as a temporary resident aren’t indicative of the function of the health system.

[quote Weatherwax13]@echt you can take out ambulance cover here. Ots about $100 a year for the whole family. Otherwise even a trip with no emergency treatment is $$ thousands.
If you have a health care card (not sure what the equivalent UK benefit would be called these days)ambulance is free.
Healthcare card holders also get free treatment from GPs.
If I see my GP it might be about $120 for a basic appointment. I'll get about 80 back under Medicare. Goes straight into your bank account these days.
Bad news is that in the 15 odd years I've been here, I'm seeing public hospital surgery lists getting longer and longer. So if you can, you pay to skip the queue.
Private healthcare is pretty much compulsory if you earn over a certain amount or you get taxed more highly.
It's hugely expensive and a con in my view. All the funds have "exclusions" in the small print.(a PP mentioned cataracts for example)
And when they do pay out, it's only ever a percentage of the cost.
Having said that, you can rock up at any emergency dept, free of charge no matter what you end up having done, from tests to surgery.
I've taken various family members to emergency. Triage system is excellent and so is the care. Even when they're mega busy[/quote]
@echt you can take out ambulance cover here.

I know. I live in Australia.

The point I've been making is that costs to the patient have not been addressed, or ignored in posts praising the Australian system. Such as the tax hit for those over $90,000 pa.

Having said that, you can rock up at any emergency dept, free of charge no matter what you end up having done, from tests to surgery

And you will be asked if you have private insurance. To say yes is not always a good idea as you may well end up with out of pocket expenses.

My friends who live in Australia sold their house to fund IVF treatment (not covered by insurance.)

There are BB IVF clinics though. IVF is super expensive, though selling the house to pay for it suggests multiple attempts. Are unlimited attempts finding through the NHS?

@HollaHolla

My friends who live in Australia sold their house to fund IVF treatment (not covered by insurance.) Also, hadn’t seen a dentist in 3 years, as couldn’t afford it ; and they both have decent enough jobs. They obviously pay for anything the kids need, but when she broke her hip (terrible fall - in her 30s), got a neighbour to take her to hospital, as an ambulance was an additional payment they could do without. I’ve spent a lot of time over there, and lived there for a few years in my 20s. A broken ankle, couple of bad infections, and an anaphylactic reaction were covered to some extent by my insurance and Medicare, but I had to put a whack of it on a credit card.

Medicare rebates are available for IVF but it doesn’t cover the entire cost.

From personal experience, one round of IVF last year cost approximately $8000 out of pocket with the remainder (approx $5000, I think) paid for by Medicare. That includes blood tests and ultrasounds etc.

Subsequent rounds in the same year are cheaper because of the Medicare safety net threshold.

Also, some health insurance plans do cover IVF.

Such as the tax hit for those over $90,000 pa.

Most people would view taxing those who earn well to help fund health care to be a good thing. Anyone who earns over $90,000 pa can make a choice. Is the extra tax they will pay per annum via the Medicare surcharge greater or less than an annual premium for private healthcare (payments to which are tax deductible). The answer is nearly always that it’s more economical to take out private cover for tax benefits.

And you will be asked if you have private insurance. To say yes is not always a good idea as you may well end up with out of pocket expenses.

This is usually a rort by public hospitals that allows them to bill a person’s health fund rather than it come out of their state funding budget. The patients usually don’t pay any excesses in these scenarios.

The standard of health care is good but the funding model is a shitshow.

Private insurance companies make obscene profits thanks to government policy.

Much of the population is blackmailed into having insurance through taxation penalties, even if they don't earn enough to use it (there are huge gaps on cover) and still rely on the public health system.

The government approves annual insurance premium hikes well in excess of cost of living increases.

The government throws yet more money at insurers by subsiding premiums, allegedly to help with the cost but every time the subsidy goes up, the insurers just increase their premiums to match.

Coming from the Spanish system, I find the Australian one very poor and I agree 100% with @Mrbob .

Specialist visit are extremely expensive, several hundreds of $, and Medicare will reimburse 75$, and compared to other countries' private insurance, specialist visits are not covered by private insurance. You can be seen in a hospital but it will take a year or more unless urgent.

X-rays might be bulk billed but most scans are not, and I had to pay several times for MRI prescribed by specialist and I was out of pockets , Same thing with blood test, not everything is bulk billed. My experience is very different from @Rainbowqueeen when it comes to seeing a specialist at the hospital. Unless it is in the private suits they have in there and you are seen as a private patient.

Dentists are atrociously expensive and will be covered by private insurance. I have a tumour inducing disorder with a risk of 59.6 % of lifetime cancer and a 26 years reduced lifespan. I am seen once a year by a geneticist and oncologist at the public hospital for free (well last two years was a phone call....) , but they constantly send me to have private visits and tests in the private system.

Spanish system was amazing. Great for public system, I had great surgeons and care, and BUPA (called Sanitas in Spain) had their own network of doctors and hospital.

I think you need to look pre nhs when people couldn’t afford to see a doctor, we already have families who can’t afford to eat. The nhs needs a shake up true but needs to remain free at the point of entry.

Really OP?
You seriously think The Australian medical system is better than the NHS?

Honestly?

@HollaHolla I have basic health insurance and it costs me $25 to see a dentist for a check up and clean. The full cost is about $200. If your friends are on a good wage they might choose not to go to the dentist but it really isn’t that expensive over here.

I had a spine fusion a few years ago and was on an international forum for support. There were several people in Australia having the same operation. All of them took out insurance to have the operation done and then I think they tried to get money back from workman's comp? Does that sound right? The situation they described sounded similar to the NHS. They said the public system was fantastic for emergencies. But for general surgery and elective operations, the waiting lists were long. They did not talk as if it were a system to aspire to. Of course this is purely anecdotal but all of them said the same thing and they were from all over Oz.

Of course there are other systems that function better than the NHS, but it requires people to do co-pay and so it costs more to individuals.

@EccentricaGalumbits

The standard of health care is good but the funding model is a shitshow.

Private insurance companies make obscene profits thanks to government policy.

Much of the population is blackmailed into having insurance through taxation penalties, even if they don't earn enough to use it (there are huge gaps on cover) and still rely on the public health system.

The government approves annual insurance premium hikes well in excess of cost of living increases.

The government throws yet more money at insurers by subsiding premiums, allegedly to help with the cost but every time the subsidy goes up, the insurers just increase their premiums to match.

There are also not-for-profit insurers. I know because I am with one.

Blackmailed into having insurance? That kind of hyperbole doesn’t help your argument, it hinders it. To the point that I wonder why you are so invested in this and I can’t trust what you write without carrying out my own research.

@Rainbowqueeen

All systems have their pros and cons. I live in australia and what has shocked me about the nhs is the way that you make appointments. I can make an appointment with my GP online. The website shows all the gps in the practice, plus times available for the next few weeks. I choose one and book it in. Otherwise I can ring at any time of day to request an appointment. I will be offered a range of days and times If I need a hospital or specialist appointment I ring, they tell me what is available and we agree on a time and date that suits I think if the nhs had a similar system then there would be far less complaints on mumsnet and it would be much more fit for purpose.

My GP and many other practices have exactly this!

I cannot ever complain about my practice as they are excellent. You can ring or go online to book an appointment with a specific doctor; or you can for urgent appointments ring at either 8am or 12 noon and get an appointment within the next four hours. They see babies and small children for emergencies at any time and they have arranged for a GP to see my DD on numerous occasions within a couple of hours. They do phone appointments, in person appointments, Saturdays, the works.

Our local out of hours GP service is an excellent triage based at the hospital and for out of hours you can ring 111 and be booked into an appointment within a couple of hours. It’s efficient and quick with hardly any waiting.

Like every system, the NHS often depends on good local organisation and local practice/Trust management. Some surgeries are more efficient and others less so. Some catchments have more sick people and fewer GPs. But so far when healthcare trusts in the U.K. have been running privatised models - like Circle Healthcare at Hinchingbrooke - they often collapse or walk away from contracts when it becomes clear the profits aren’t enough.

Improving local management sounds a lot better a way to improve NHS services than to introduce a whole set of profit-seeking, top-slicing private healthcare and insurance providers. Those only increase inefficiency and wastage rather than decrease it. It’s a fallacy best left in the last century that “competition” increases efficiency in healthcare provision - it doesn’t.

People really don’t understand the Australian healthcare system .

It IS free at point of entry. It’s exactly like the NHS in terms of access for everyone in the entire country. No one has to pay at hospitals. The only difference is there is a more affordable private system that gives people options.

The Australian system is basically a better functioning version of the NHS and American system combined.

To repeat, no one has to pay for healthcare at the point of care in Australia. Some people chose private cover.

The NHS equivalent part of the Australian health system is generally better or at least comparable. Even if people write about how they have to wait or have long gaps between specialist appointments in Australia, it’s certainly no worse than the NHS.

Oh dear. This thread is descending into people being hurt over imagined slights about their countries health systems and then going on the attack. I should imagine whatever system a country had, some citizens will complain about it. It's the way of the world.

Ultimately it might be that the Australian system has advantages over the NHS. But as a Britsh person, if we reform the NHS, I want the best possible system to replace it, not one which is just slightly incrementally better. I mean if the best system turned out to be the Australian one, great. But from my experience that is probably unlikely.

@TheWeatherWitch

Yeah! Best of luck to any political party that wants to do away with our NHS. It would be political suicide for them.

The NHS is still the envy of the world.

Unfortunately, I just don't think it is anymore. Maybe from poorer countries that don't have healthcare. But not from advanced countries.