Friday, January 11, 2008

Going to the Doctor

Although we have taken our son to the doctor twice since we arrived in Australia last June, I hadn't been a patient here until this morning.  We are currently covered only by the government's Medicare program, to which every Australian resident is entitled.  This provides basic coverage for nearly everything medically necessary, as well as hospital expenses, as long as you can put up with longer wait times for some sorts of surgeries and a more limited choice of medical care.  We plan to enrol in a private supplemental plan as well, but our total health care costs will still be much lower than what we paid back in the States. 

Anyway, seeing a doctor here for something routine is much easier than what we faced back in Atlanta.  I needed a general check-up, and a particular prescription refilled, so we called on Wednesday to the clinic where my son has been to schedule an appointment.  It turned out that all sorts of appointments were available that afternoon, the next day, and today, so we picked one that was easy for me this morning.  Back in the States, I might have waited 4-6 weeks before I could see my physician for a similar visit.  When I showed up to the clinic, I filled out a brief health history and showed the receptionist my Medicare card.  I was charged $62 for the visit because that clinic charges "private" fees, but we will get about half of that reimbursed from the local Medicare office.  While I waited in the reception, I noticed that an assistant was putting a sign outside on the sidewalk announcing "Doctor Open." I can't remember a time when I saw a physician trying to snag passers-by in the U.S.

The doctor, who also sees my son because pediatricians are more of a speciality here, was quite nice and generally thorough. He asked me a few questions, took my blood pressure, and gave me a referral sheet so that I can get lab tests done and a new prescription for my old complaint.  I didn't have to wait in a tiny room before seeing him, and he wasn't more than 5 minutes late for the appointment.  He told me that I didn't need a prostate exam until I was 50 (they start at 40 y.o. back in the States), but I had one just over a year ago anyway.  There was no other physical exam.  I didn't feel rushed, but the appointment was over in about 10 minutes.

I immediately crossed the street to a chemist at the corner and got my prescription filled in five minutes (again, at heavily subsided price because of the Medicare coverage).  I can get my lab tests done any morning without an appointment at a place near our home--again, paid for by Medicare.

In sum, it feels so much easier to get proper medical treatment here.  My comparison, of course, is to what we had in Atlanta, so it could be just as easy in other parts of America or the rest of the world.  V. has remarked that the doctors here aren't as thorough as their counterparts in the States, but she thinks that's because they aren't as concerned about medico-legal liability here.  If the U.S. is looking for some new ideas about how to get universal health coverage, I recommend that the next administration consider what Australia is providing with Medicare.  There are some definite problems here, but they mostly have to do with a critical shortage of doctors and nurses as a result of overly restrictive university admissions about a decade ago.  I, for one, am a happy, healthy camper.


Anonymous said...

I believe the Australian govt of the time did invite Hillary Clinton to study the Australian system when she planned to overhaul US health coverage (and the lack thereof for so many citizens). But I don't think she took the offer up and her attempt at reform ended in tears, as we know.

Dobbs said...

I have found health care here for routine things very good as well. I like the mixture of national coverage and private coverage. It works well. It still amazes me though that it seems like by talking to Aussies and watching the news they always think their health care system is broken.

I think as far as the US the problem is that the Democrats want complete socialized medicine while the Republicans want complete private coverage instead of working together and creating a hybrid system like Australia has.

Tors said...

Yeah... health care is an often-debated topic on YDU, and if any consensus can be made it's that a) YMMV, and b) it's a lot better than having nothing at all back in the States. :)

Personally, my experience has been overall good. I agree that routine stuff is totally easy!

Most of the problems we've had are to do with the "gap" between Medicare and private coverage, which is wider than I think a lot of people realise. Did you know that by law, private insurance cannot cover any procedure not done in hospital, for which a Medicare benefit is payable? That means that if you see a specialist, if the specialist performs an "in-office" procedure rather than putting you in hospital, you'll be paying most of it out of pocket. And specialists are not cheap! We paid close to $200 for our first son's visits to a paediatrician to determine what to do about his hydrocele, out of that we got less than 1/2 back. Another fun fact is that Medicare only reimburses 80% of the schedule fee for specialist care (as opposed to 100% for your normal GP visit), and of course specialists can charge whatever they like above and beyond (and do). Not that I'm complaining, but it can really broadside you if you're not prepared.

I don't know what the solution for the US is... in addition to the pure cost, there are some social attitudes that will need to be overcome to make it work. Hope they find a solution soon.

Audra said...

Treatment here seems to be much more evidence based. That is, with the exception of skin cancer, they don't spend a lot of time looking for conditions that aren't causing you an actual problem. There is certainly some logic to that approach. It makes it painfully obvious how much of America's medical practices are influenced by the pressures of the drug companies, particularly for those that treat non-disease 'conditions' that might someday increase your chance of dying 5 years earlier. (Sorry, I'm still bitter from my time in the pharmaceutical industry.)

One thing I don't like is the limited access to specialists - it's too much like an HMO. If I know I have a problem with my feet, why can't I just go see a podiatrist without first paying to see a GP? Why, to keep costs down, of course...and because the general public cannot be truusted to know what is best for them, which may be true now thhat I think of it!

The Prof said...

Maybe when the next President Clinton (or President Obama?) takes office, she/he can fly us ex-pats back for consultation! I agree with you all that there are problems with the system here, and I am thankful that I haven't had to deal with the more serious problems that Tors has had to deal with. I wish I knew more about what I should be looking for private health insurance coverage. Audra, one of the main reasons for my going to the doctor was to get a referral to a specialist. It did feel oddly similar when I was covered by an HMO a few years back. But they do seem to be containing the health care costs from the government's perspective.

Mummy B said...

As always its terribly interesting to read your take on something we here take completely for granted :)

Out of interest have you seen the Michael Moore documentary, "Sicko"?

Regardless of political views here in Australia, you'd be hard pressed finding anyone who hasn't noticed a dramatic change in the cost of health care here in Australia since the Howard government was elected.

Once upon a time bulk billing was common place. There were certain doctors who had a "gap" fee but they were far less common place then they are today. Prescriptions were significantly more affordable. They have certainly never been as costly as in the U.S so I can completely understand your surprise at our grumblings and complaints! However the price of your average prescription has been creeping up and up and UP. Pensioners and those on a "Health Care Card" were paying less then $4.00 per prescription...this has continued to increase also.

As the cost of medical fees have increased the congestion in our hospital emergency rooms has sky rocketed. Obviously if a person can't afford to see a doctor they may end up in the emergency room: a) for a problem that should really have been taken to a GP or b) a problem that began small, but due to insufficient funds to see a doctor has escalated to a more serious problem.

Whilst I completely understand how much better we have it then those in the U.S (if even a small percentage of the stories and "facts" presented in "Sicko" are accurate then I am horrified that a person living in a first world country's healthcare could be at such an abysmal state!)...I would still argue that our healthcare system needs some serious fixing.

The NHS in England is an example of the way I believe our healthcare should be. For a working adult to fill a prescription the cost will not exceed 6 pounds. For a pensioner or child a prescription is filled for free.

Regardless of how you feel about Michael Moore I would highly recommend watching his documentary if only to give yourself some material to research for yourself.

After watching Sicko Mitch and I decided France would be a lovely place to live...and not just for their pastries ;)