Socialised health care, Australia style

Miscellaneous and Personal Stuff I Must Share
21

I really didn’t want this to get into a pissing match between the Aus and the US system of health funding. It was just a FYI, about my recent experience in the Australian health system, and how marvellous I found it. Yeah, there’s always shortcomings, but at the end of the day, I came out alive, breathing, healthy and with no debits on my cc.

Now Beck might find this an affront to her experience. All good, I don’t give a fuck, because I know I live in the better system (as do my Canuck, Brit and Euro friends) and when I see/hear the US Becks of this world defending their health insurance system, I just know that they have no strands left on their rope.

22

As an American who relocated to Europe many years ago and thus has extensive experience with both approaches to healthcare, I can confirm firsthand that there is our civilized system, and there is America’s giant pile of festering shit.

23

Speaking as someone who has been on both sides of the US system (provider side and patient side), I wholeheartedly agree with Cervaise & Wolfpup.

My husband is a doc. At one point we owned a small health clinic, and I did some of the medical billing. The only reason I could is because of the kind of facility we had - very small, attached to a college, we did not take Medicare/Medicaid. Even so, it was a NIGHTmare. It is not easy, and it is costing us (people in the USA) Jillions of dollars. I hear his stories of trying to get his patients appropriate care and the insurance wrangles all the time. It’s no easier in a big hospital practice, in fact it might be worse.

About 8 years ago now my husband had a serious accident that had him in ICU and specialized care for over 2 months, and then another year of PT. (I wrote about it here, actually - he took a small plane propeller to the head). We only paid off the bills for that incident LAST YEAR. And that’s with really good insurance, and on a family practice physician’s salary.

I utterly do not understand how the poor and those with minimal education can navigate our healthcare system. I am not a stupid person, and we are fortunate enough to be reasonably well off, but those years damned near broke me.

@kambuckta, I’m so glad you are well and your country’s care system works so well for you. Someday I hope the US wises up …

24

You don’t have to get nasty.

I expressed happiness you’re better. I wished you the best.

Medical care is a personal yet public concern. We all need it, eventually.
I’m happy to hear you’ve all had great experience, where you are.

But its really funny to me people come from allover the world to America to get to some of the smartest doctors and best minds and the best equipped hospitals for specialized care. For cures. Surgeries and remedy.

Why are more than half our health care workers from foreign countries. Doctors and Surgeons on down?
Oh it must be they want the best jobs or the highest pay. Or maybe they want an impressive chance to work for the best.

Folks are beating our borders down for a chance to live in America. Now you know the rest of the story. This is why a certain faction of our country have notions we have an immigration problem that is not sustainable.

@kambuckta , I am truly over joyed you are feeling better and you got the treatments you needed.

I never said Americas healthcare was perfect. It’s not. But its worked successfully for me. Many many years. Many many Doctors. Many many procedures.
I have a right to own that and be happy about it, just as you do, yours.

Good luck to you and keep feeling good.

25

I’ll rise to Beck’s defense here a bit.

It’s sorta off-topic for this thread, but the truth is US healthcare works great. For WAG half of us. Maybe it’s 40%, maybe it’s 60%, maybe it’s 30%. I don’t want to quibble about the number.

It certainly contains more end-user administrative irritations than it seems the UK, Aus, and Canadian systems do. But not significantly more for the people for whom the system works. It is certainly more costly for the people it serves well.

Does it mis-serve millions of people? You bet. Does it also serve well millions of people? You bet.

For round numbers, the UK, Canada, & Australia have a combined population of 140M people. I’ll suggest that the number of well-served medical customers in the USA is larger than that. Not by a lot, but by a little.

Admittedly the number of ill-served US customers is probably larger yet. Which an enlightened society might want to fix. We don’t have an enlightened society in our country. We are a capitalist economic machine thinly disguised as a human society. And lately we’re in the process of ripping off the disguise.

26

(In the UK) I did some rough numbers, on the assumption that the health budget takes roughly 19% of central government expenditure. Applying that and current tax rates showed that people in employment could be said to pay between 4% and 6% of their gross salaries to fund the NHS, from the average household income up to £150k (?$200k) p.a.. It’s less for people not in employment, of course. Plus there are around 4% of indirect taxes, like VAT and duties on alcohol, flight departures and so on.

Which is not to say that’s enough. All public services have been squeezed for years.

27

It’s great you can afford private health insurance.
What about Americans who can’t?

Yes rich people do travel to the USA to get special treatment (private rooms, no waiting, top-class surgical teams; full after-care.)

Rich peole also travel around Europe to get to specialised hospitals.

Sadly this has nothing to do with your average American getting healthcare.
If you’re not well off in America, you have to decide whether to spend money getting a worrying symptom investigated.
In the USA, lawyers, doctors, pharmaceutical companies, ambulance companies etc all compete to make a profit out of healthcare. And the patients pay for it.

28

Does not preclude universal health care as many other nations demonstrate. It’s a choice.

29

Indeed, the U.S. continues to lag behind in terms of healthcare affordability—millions remain shut out from the care they need.

Programs like Medicare and Medicaid do a decent job for those who qualify, and private insurance can work well enough for people who can pay for it. Still, the overall system leaves far too many on the outside looking in. A universal healthcare model could help close these gaps, making access more equitable across the board.

But where America truly shines is in the sheer quality of its medical care. It boasts more top-ranked hospitals than the rest of the world combined, with heavyweights like Mayo Clinic, Cleveland Clinic, Johns Hopkins, and Mass General consistently setting global standards. The country is home to Nobel-winning researchers, pioneering specialists, and remains the global epicenter for medical innovation.

Highest-Rated Countries by Medical Specialty:

Cardiology & Heart Surgery
1. United States – Cleveland Clinic sets the bar worldwide, followed closely by Mayo Clinic and Mount Sinai.
2. Germany – University Heart Center Hamburg offers elite cardiovascular care and surgical precision.

Neurosurgery & Neurology
1. United States – Johns Hopkins, Mayo Clinic, and Barrow Neurological Institute are considered among the best.
2. France – Paris’s Pitié-Salpêtrière Hospital merges top-tier neurology with cutting-edge science.

Oncology (Cancer Treatment)
1. United States – MD Anderson, Memorial Sloan Kettering, and Dana-Farber are global powerhouses in cancer care.
2. United Kingdom – London’s Royal Marsden Hospital leads in chemo, radiotherapy, and cancer research.

Orthopedics & Joint Replacement
1. United States – Hospital for Special Surgery in NYC sets the global benchmark.
2. Germany – Offers high-volume orthopedic centers with strong outcomes.

Ophthalmology
1. United States – Bascom Palmer in Miami and Wills Eye in Philly are at the top of the field.
2. Israel – Hadassah Eye Clinic stands out for innovations in corneal transplants and ocular treatment.

Genetics & Rare Diseases
1. United States – NIH and Boston Children’s Hospital lead the charge in gene therapy and rare disease care.
2. Switzerland – Known for its precision diagnostics and pioneering research.

Innovation, Trials & Experimental Medicine
1. United States – No competition—still the undisputed leader in experimental treatments and breakthrough trials.
2. Denmark – Emerging as a serious player in biotech and medtech development.

Bottom line: if you can afford it, U.S. healthcare offers unmatched quality. But that’s a big, expensive “if.” Universal healthcare would ensure that world-class medicine is a right—not just a luxury.

30

@LSLGuy , as usual, I think you have a reasonable take on the situation. I’m not disagreeing with any of it, but I’d like to offer a further perspective.

One thing to remember is that the millions of Americans who are happy with their health care are inevitably those with the financial means to afford good health insurance and the other associated out-of-pocket costs like deductibles, co-pays, and the cost of claims denials. And part of the reason they can enjoy great health care with little or no wait times is that millions of their fellow citizens get no health care at all. All of which is just to say that there’s a moral aspect to the question.

But aside from the moral aspect, there are other good reasons for those privileged to have good health insurance to support the basic principle of universal health care. When my older brother moved from Canada to the US to take a high-paying job with excellent benefits, he had no complaints about the quality of his health care – but by God did he have complaints about the paperwork and bureaucracy of dealing with insurance companies, something that’s completely unknown anywhere in Canada.

And thing is that everyone is paying for this freaking bureaucracy – a bureaucracy that explicitly intervenes between a patient and their physician, and totally undermines the physician’s autonomy by second-guessing their decisions for reasons of cost, and may deny essential treatment because something else is cheaper. And you’re paying for this! Through the nose! The per-capita cost of health care in the US is about twice what it is in Canada. Administrative costs are only part of the reason. Another is the lack of any kind of centralized cost control over provider fees.

No argument there.

My brother’s wife was diagnosed with lung cancer some years ago, and it appeared that it was incurable. After doing a lot of research, he took her to Sloan Kettering. They performed some really advanced robotic surgery and literally saved her life. She’s doing fine today.

31

America has the best doctors because Americans pay doctors a LOT of money. It’s as simple as that. It’s also part of the reason why healthcare is so expensive.

I live in a UHC country, and medicine is considered a respectable middle-class profession, but not something that will make you rich. Lots of doctors from around here travel to the U.S., temporarily or permanently, and make three, four, five times as much as they would at home. Of course American healthcare is great - you’re paying for the best.

32

The argument from @Tibby in my estimation isn’t about “the best doctors”, it’s more about “the best medical institutions”. The latter has less to do with what individual doctors are paid than with the huge amount of medical research that is funded by the richest country in the world – something that one might note is currently being drastically cut by an Orange Doofus hell-bent on destroying the research community as much as possible. But there’s naturally a close association between the research community and medical specialists that leads to the potential for the best care for those lucky enough to have access to it.

The higher incomes of American doctors compared to the rest of the world has to be judged from the perspective of their costs in dealing with insurance companies and being stiffed by them and by deadbeat patients. They have to pay staff solely to deal with accounts payable, something that doesn’t exist in countries with UHC. Here in Canada, the GPs and specialists I know make a very good living indeed, with guaranteed payment from the government for the services they provide.

33

We do at least have this in America. I spent most of 2023 tending to my father, mother and boyfriend in hospitals and the staff - from the people who wheel you around to the nurses to the surgeons - were all wonderful. Those places are full of very, very hardworking and caring people.

34

Absolutely. I can say firsthand that what doctors bill—and what we actually bring home—are worlds apart. On paper, the numbers might look sky-high, but once insurance billing adjustments, high overhead, and everything else come into play, the take-home is much more modest. Your points hit home, and then some.

My youngest daughter was born with a rare congenital condition called moyamoya—Japanese for “puff of smoke”—which causes strokes due to narrowing arteries in the brain. We only found out after she had a major stroke at just 15 months old, which left her completely paralyzed on the left side of her body (hemiparesis). Later scans showed she’d actually suffered her first stroke in utero, along with multiple TIAs leading up to the big one. It’s a progressive and potentially fatal disease, and the only real shot at a normal life involves complex brain revascularization surgery.

We brought her to Dr. R. Michael Scott at Boston Children’s Hospital—widely considered one of the best neurosurgeons at the top institution for treating moyamoya. He’d actually pioneered the surgery himself. She underwent two high-risk operations, spaced just a week apart.

Long story short: the surgeries were a complete success. Incredibly, she started regaining movement on the left side of her body on the train ride home. Today, more than 20 years later, she’s back to almost full strength—and giving me grief like any daughter her age should. But I wouldn’t trade that for anything. Dr. Scott and Boston Children’s gave her that chance.

35

That question simply astonishes me. “Is it perfect?”
Since when is that a necessary question in this world of imperfection?
Nothing is perfect.
NOTHING.

36

I totally agree.

I was responding to the OP.

Said this many times: I get great care here in this US of A.
Yes I pay some things out-of-pocket for little upgrades(in my mind, yours would be different, I’m sure) for my comfort.
Not one person in my pod at dialysis has private insurance, besides me. Its all government paid.
They get the exact same care I get.

The alternative is death or the dreaded state hospital dialysis. No one wants to go there. Trust me.

My private insurance is not as expensive as you’d think.
What is expensive is my in-home care. Ivy- the bane of my existence.
The slave driver.
The takes-no-shit, crossed arms, tapping toes Witch(on a good day).
And, I gotta pay her for this privilege :saluting_face:

Actually we love the heck outta her.
Part of the family, at this point.

I feel pride that the awful awful Healthcare in America has kept and continues to keep me alive.
Alive!

That is my endorsement.

I truly believe we can fix the situation for needier Americans. With the right PTB.
I’m not sure UHC is right for America.
I’ll leave that to people who know better.
I would like to see all children covered automatically at birth.
Of course disabled and elders should get the care they need.
We gotta get the prescription costs down.
I see no problem with Docs and nurses making a good wage. They will have school debts.
Frivolous malpractice and class action suits should be limited.
Malpractice insurance is killing doctors bottom line.

37

The situation described in the OP is supposed to be the same here. Sadly it isn’t. Everything was great until our GP retired during the pandemic. Four years later, I have been assigned a primary care physician that I like, but he is only a resident and he finishes his residency and has a military obligation, so I will be changed to a new resident who will replace him. I liked him and was hoping he could keep me when he finished, but that is not to be. Also, the clinic is downtown and there is no nearby parking. So a taxi or a bus and the latter is getting increasingly hard for me.

But my wife’s situation is worse. She was originally assigned a doctor, but a year later he left the public serviice. He expalined that he was a single parent and the proviince was running his life, assigining him to do this, do that,… and he had no life. She was then assigned to a clinic, not a doctor. And to get an appointment with the clinic, you have to call a special medical phone number (811) and ask them to make an appointment for you. Which she did successfully once, but never got a callback the second time she tried. Meantime, she had a small lump in her breast. Ultrasounds at public hospitals had a long waiting time and you don’t screw around with breast cancer. (Her mother died of breast cancer.) So she went to a private clinic that did a mammogram for nearly $1000. It was determined to be likely malignant. Two days later she had an appointment with a surgeon who took it out and determined that it was confined to a duct (ductal carcinoma in situ). $3000 for outpatient surgery. But then, they made an appointment for her with a public radiation oncologist who arranged for her to have 5 radiation treatments, all free. She (the radiation oncologist) then arranged an appointment with a chemo oncologist in the same hospital who prescribed tamoxiphan, but told her that her cancer was a type that didn’t spread.

Meantime she still needed a primary care doctor and that assigned clinic just wasn’t working, so she finally made an appointment with the guy who had left the public service. $250. She will turn 87 next month and cannot find a doctor. By the way, doctors cannot adopt patients; then can take only patients that the province assigns them.

38

Sorry to hear this. It goes to show that even in socialized medicine countries the treatment you get between provinces like Ontario and Quebec is very different.

39

Medicaid is for low-income people, and some people on disability. Children do not automatically get it, although it’s somewhat easier to get for pregnant and post-partum women.

And it DOES NOT cover everything. Trust me on that. Like Medicare, much of the time it doesn’t even cover the facility’s own cost for giving care; in other words, hospitals, pharmacies, nursing homes, physical therapists, optometrists, etc. lose money on these patients.

All Americans on dialysis, even children from high-income families, are eligible to have their dialysis paid for by Medicare; this was signed into law by Richard Nixon in 1972. At the time, dialysis was fairly new and health insurance was not the ubiquitous thing it is now, and there were a lot of people who needed dialysis but couldn’t get it because they had no way to pay for it. As it turns out, most people on dialysis are 65 or over anyway so they would be covered regardless. p.s. In many cases in people under 65, it ONLY pays for the dialysis, unless the person is declared to be fully disabled.

I’ll never forget when Medicare Part D(isaster), which allegedly covers prescription drugs, was announced around 2000 and there was a LOT of publicity about how pharmacists were almost universally opposed to it. I was working at the grocery store, and a colleague who had 20 years on me summed it up this way: “When that goes online, you will very quickly find out just how free it is.” Almost 20 years after it was launched, that’s STILL true.

40

I’ve also heard of wealthy, or even not-wealthy, Canadians going to the U.S. to get health care, because they didn’t want to be put on a waiting list, or they knew they would likely die, or their illness would become untreatable, before their name came up on the list.