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?

@NotBadConsidering

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.

Yes. This is worth repeating.

I live in Aus i love the healthcare system but it's very expensive - on top of taxes, I pay $200 monthly in healthcare.

Recently had a routine surgery and paid $5,000 for out of pocket costs.

Every time I crack a tooth its $3,500 for the dentist. There are no free dentists in Aus.

@NotBadConsidering

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.

I had temporary residency for almost 4 years. I am from the UK, and had both medical insurance and was covered by Medicare reciprocal agreement. I was still charged what I couldn’t claim back, to the tune of over £100 each time, as I remember it clearly. It was about 20 years ago, but I remember it clearly, as I was temping at the time, and it was proportionately a lot of money for me. Two of those were when I was living rurally, and there was only one healthcare provider/hospital.

Did you go to a public hospital? Do you have a UK passport? No UK citizen would be asked to pay money for an acute presentation to the emergency department with anaphylaxis. If it was rural, it may have been a private hospital which would have charged an emergency attendance fee, which they do for everyone.

NotBadCOnsidering@ so it’s basically a 2 tier system surely people can get private health care in the Uk, so what’s the difference?

And it doesn’t change the point that your treatment as a temporary resident doesn’t describe the healthcare system for those who live in Australia. Non-UK residents have to pay for treatment on the NHS.

For the anaphylaxis it was a city hospital in Melbourne. I couldn’t tell you if it was public or private; it was nearest as I was struggling to breathe. The other two were rural NSW. I am a British passport holder. I was absolutely charged. I had to call my parents to help me out with charges, as I was temping on minimum wage, so it’s stuck with me.
I can only share my experiences. I did receive excellent care though - although I did discharge myself early to avoid paying additional for an overnight stay. 24 year old me thought that was a good plan. 🤣

@Pixxie7

NotBadCOnsidering@ so it’s basically a 2 tier system surely people can get private health care in the Uk, so what’s the difference?

Because the private system is a lot more accessible to middle income earners and private healthcare providers are a lot more ubiquitous, making treatment options more available. From memory only about 5% of healthcare in the UK is private, it’s closer to 50% in Australia off the top of my head (would need to check), but that’s the general difference. Got a worrying mole? Wait months to get it seen in the UK, or get it removed this week in Australia if you’re willing to pay a bit.

@Pixxie7

NotBadCOnsidering@ so it’s basically a 2 tier system surely people can get private health care in the Uk, so what’s the difference?

The difference is that the public system isn’t regarded as a sacred cow and the private system isn’t considered to be the root of all evil.

I’d like to point out that the Medicare provision available to temporary residents under the reciprocal healthcare system isn’t the same as the Medicare provision available to permanent residents and citizens of Australia. Reciprocal means that if it is publicly available in both the U.K. and Australia, then you (the patient) don’t have to pay as the Australian government will claim it from the U.k. (possibly from the NHS, not sure). If it is treatment that wouldn’t be available on the NHS or available in a public hospital to Aussies, then you have to pay.

@HollaHolla

For the anaphylaxis it was a city hospital in Melbourne. I couldn’t tell you if it was public or private; it was nearest as I was struggling to breathe. The other two were rural NSW. I am a British passport holder. I was absolutely charged. I had to call my parents to help me out with charges, as I was temping on minimum wage, so it’s stuck with me. I can only share my experiences. I did receive excellent care though - although I did discharge myself early to avoid paying additional for an overnight stay. 24 year old me thought that was a good plan. 🤣

Is it possible that you were expected to pay upfront and then could have claimed it back from Medicare ? When I first moved here, I struggled to know what I could and couldn’t claim and the fact that some doctors would process Medicare claims for me and others would expect me to make the claim myself was so confusing!

You can also use private services without private cover. For example, say you are a healthy family on a mid level income. You decide there’s no need for private cover - you won’t need recurrent medical procedures, you have no chronic dental issues and obviously, like everyone in Australia, you have access to a fully functioning public system.

Except your 2 year old has recurrent ear infections and persistent middle ear issues. A hearing test confirms fluid in the middle ear and there is some hearing loss. His speech is moderately delayed. There’s a long wait for ENT in public (I’m sure this happens in the UK as well).

You look into private cover and decide it’s still not worth it and decide to go privately for a day stay procedure for grommets. You are lucky in that you have some savings and you work out that, factoring in time off work it’s worth it for your family.

Your otherwise healthy child never needs any private input ever again, with broken arms, admission for cellulitis and review after head injury all catered for in the public system.

@NotBadConsidering
I don't think people are overwhelmingly praising the NHS on here. I think all British people recognise it does a good job but it desperately needs improvement. But I don't understand why you're going out all guns blazing to defend a system which is far from perfect. Can't you just recognise that both systems have their deficiencies but we're lucky to live in the UK and Australia and receive the care we do?

I’m not at all saying that the Australian system is without faults. I’m pointing out the major misunderstandings and the fact that, on the whole despite its faults, healthcare is better in Australia.

I have worked in the health systems of three countries, including the UK and Australia, and if I was being forced to chose a country to live in based on its health system, the UK would be third.

The UK will never adopt an Australian system because it would mean a tax on the wealthy being introduced, which never gets through parliament, and the conduct and regulation of private companies would be too closely aligned to the USA than Australia and would be even worse than the conduct of Australian insurance companies.

But it still doesn’t change the fact it’s a much better system in Australia.

And as an employer? I wouldn’t go back to work for the NHS for all the money in the world. I was shocked how well looked after junior doctors are in Australia compared to the UK. Hours capped at 76 hours per fortnight, and that’s actual hours, not averaged out over a 6 month period to get around the rules . But that’s a whole other topic.

Holla if you were about to be charged for an overnight stay you somehow ended up in a private hospital.

For the billionth time, public hospitals do not charge for treatment or hospitalisation.

So if the NHS was going to be overhauled, would you say the Australian Health system was the best one to model itself on? Or are there better? Because that's really what the thread is about.

My back operation took me 20 months from gp to operation, with treatments in between. That's a long time. Australians I communicated with on the forum I was using, said the wait for them could be longer than that (in that it was impossible to predict) so they took out private payment. They hoped that might get some of their out of pocket expenses back but they had to pay before they made a claim so couldn't be sure. It was stressful because they were not only in pain and then recovering but they had financial worries too. But, they did get it quicker than my 20 months. In the uk I couldn't get health insurance because it was a pre-existing condition, and I couldn't afford to fund it all. So I really had no choice but to wait. But I didn't have financial concerns. So two systems, but neither ideal.

Not RTFT

Aus is totally different country to UK. Population 25 million. Different demographics culture health issues etc etc

IIRC there is more onus on employers to chip in and they have big schemes. Pensions. Very different. Healthcare? Maybe? Probably?

Just googled and 2% levy on everyone for healthcare.

System funded by a mix of govt, healthcare insurance and other stuff.

It works for aus would it work here? Prob individuals are paying more towards it?

They do in France Germany etc I think where healthcare is often seen as better.

In the end I'm not sure where to go with the NHS. Difficult.

But comparing apples and oranges is not useful.

Well, it’s hard to apply a decision about healthcare systems when discussing back surgery, because back surgery is hugely controversial. The evidence for it actually working in many circumstances is poor, and as such many people are waiting years for operations they don’t actually need. That’s a problem everywhere, and the best healthcare system would keep back surgeons in check and as such, waiting times for those who actually need surgery would be better everywhere. Private back surgery is a big problem in Australia, because surgeons promise they can fix what others can’t if you’re willing to pay. Regulation of this, or lack of, is definitely a problem.

But to answer your question, there are other systems around the world but the Australian system applied to the UK would work better if there was an independent regulator of insurance companies, full transparency on fee increases, better laws around waiting periods and exclusions etc. All insurance companies need better regulation, regardless of the area covered, so they’re generally resistant.

@nolongersurprised

You can also use private services without private cover. For example, say you are a healthy family on a mid level income. You decide there’s no need for private cover - you won’t need recurrent medical procedures, you have no chronic dental issues and obviously, like everyone in Australia, you have access to a fully functioning public system.

Except your 2 year old has recurrent ear infections and persistent middle ear issues. A hearing test confirms fluid in the middle ear and there is some hearing loss. His speech is moderately delayed. There’s a long wait for ENT in public (I’m sure this happens in the UK as well).

You look into private cover and decide it’s still not worth it and decide to go privately for a day stay procedure for grommets. You are lucky in that you have some savings and you work out that, factoring in time off work it’s worth it for your family.

Your otherwise healthy child never needs any private input ever again, with broken arms, admission for cellulitis and review after head injury all catered for in the public system.

My DD2 had pretty much what you describe!

Anyway.

You can pay to go private one off in UK .

Hearing tests etc are given to all children at certain ages.

Grommits aren't really a thing any more are they? I would hesitate personally to intervene surgically on a 2 yo for that.

And that's an issue when private gets involved. More treatment= more cash. Not saying they do unnecessary stuff etc. But. In their interests to provide things and then follow up appts etc.

In your example where is the follow up with the kid?

Grommets are definitely still a thing. The follow up in that example would be with the surgeon in their rooms for the small cost of an appointment fee.

They're definitely not so common in the UK now.

Had a look NHS. It's way down the things that happen with glue ear.

Usually resolves itself in 3 months so wait and see first.

Is it a GA? Personally I wouldn't be putting a child esp a 2yo in for surgery except if definitely needed

Just my opinion.

Thing about NHS is it was amazing groundbreaking when it came in.

And for years.

Now though things have changed. Many more treatments for lots of stuff, plenty of it expensive. MH and back etc. 1 in 7i think it is on ADs. Many more older and elderly people.

The NHS is/ was brilliant. But the landscape has changed.

I don't know what the answer is.

France Germany aus etc more expensive per head. Will people go for that?

I've had NHS and private and imo NHS was miles and miles better in terms of continuity etc. Just my experience.

USA system is appalling so whatever. Not that.

Grommets are definitely still a thing! In this scenario they would be offered both in the public and private systems.

Follow up with the ENT who did the operation, then the GP.

Restoration of normal hearing and resolution of chronic glue ear in a 2 year old isn’t particularly controversial. If a 2 year old has hearing and speech affected by glue ear what happens on the NHS? The hearing won’t come right until the Eustachian tube is about to drain. True, eventually the anatomy will change but it’ll take years to do so.

You can see the rapid improvement in well being and expressive language in these children.

It’s true you are relying on the integrity of medics re tests and follow up but doctors don’t get remunerated for the tests. On the other hand, a new appointment, that you pay for, will get you one hour with a specialist (not a junior doctor) to discuss your concerns. There’s no gate keeping for gynaecology referrals etc and if you have a private procedure you can choose your surgeon and know that it will be he/she who is doing it.

@NotBadConsidering. I think that's a very fair comment about backs. A nightmare for patients and a cash cow for doctors (especially in US). I had spondylolisthesis and my operation gave me a 100% recovery but I recognise other conditions are not so clear cut. However, back conditions here and with you are probably not so different and I also read that lots of updated advice for what could be operated on her and there was the same so the situation for waiting times shouldn't be so different. I'm not in any way disrespecting the Aus system, although I did have some dealings on the behalf of other people for work and I would say doctors attitudes here and there are quite similar - and that's not necessarily a compliment. I just think if we're going to spend money to try and sort out the NHS here - and I don't believe voting Labour will be some great fix - I don't think the Australian model is the worlds gold standard. But I love Oz and think you're all great so not wanting you to think I'm being disrespectful. 🙂

The system isn’t broken, it’s the money going in that is. We are paying too little in taxes. We are currently paying not very much as a country for an ok ish service. There has to be the public and political will to pay more for a better service. Fiddling around with the system structure will make bugger all difference if the amount of money (whether from tax or private sources) stays the same.