Healthcare – how it is misunderstood

This post is meant for a wide ranging audience because Australia has “healthcare” which is more or less different from the U.K.  I am writing this post because I noticed the ignorance of the letter writers being published in the Daily Telegraph on a subject that the letter writer does not fully understand.

First of all let me start with what I consider the most insidious of what has been included in what I have termed Abominablecare. This is the tax on medical appliances. The question to be asked: what is a medical appliance as classified by the various medical Acts etc. etc.? The answer is somewhat complex and I am likely to leave out a number of appliances if I try to list them. These appliances are not cheap. For example: orthotics required for foot problems such as plantar fasciitis cost more than $500. In Australia this cost is not covered under the general health insurance called Medicare. It is covered by private health insurance at 85% of the total cost but the total you get back is $500.  Another appliance is the CPAP machine, which is also not cheap, ranging from about $1500 to at least $2800. This is not covered by the general health fund but by the private health fund, up to $500.  As you can see from the Australian system there are significant out of post expenses just for these two appliances. The medical appliances also include artificial limbs. However, I do not have a list of everything that comes under the definition. With these appliances already costing a lot of money with significant out of pocket expenses when they are required, one can see how a tax on top of the appliance cost is insidious and can put the required item out of reach for the ordinary taxpayer, householder etc.  (FYI – I need orthotics because of issues with my feet, and I have been wearing the same since the 1980s; I am now using a CPAP machine for sleep apnea, as is my husband; my daughter in law has an artificial leg, but that cost is covered by the New Zealand government).

I have laid out the above for one purpose only and that is to show that even with “universal coverage” the consumer is left with massive out of pocket expenses when it comes to requiring such life saving equipment as a CPAP machine. It is also to point out that a new tax on these items is burdensome to the general public and it will hurt not just the supplier but also those in need of such items.

The issue as stated by the ignorant has been framed around the notion that somehow people who are not insured do not have access to medical services but of course we know that is not true. In Australia we have the right to go to any doctor we want. Medicare covers 85% of the recommended fee for that service. Now if I attended a lung specialist where the charge for the appointment is more than $100, this does not mean that I get back 85% of the actual cost of the bill. It means that I get back 85% of the scheduled fee. It means a gap of up to $60 that I must cover out of what is available for grocery money. This is the same for attending a rheumatologist where the gap would be of a similar amount.  It is because of the structure of the legislation that I cannot get a full refund because the health funds are not allowed to offer gap insurance.

I mention this because in the period before Medibank was introduced and then prior to the introduction of Medicare, we could get 100% coverage for our doctor fees. It is the scheduled fee that remains unrealistic.

Not everything is covered by Medicare in Australia. In fact there are professional medical consultants not covered under Medicare legislation such as podiatrists, pyschologists, dieticians, physiotherapists. They are however covered in very limited circumstances. Dental is not covered under Medicare and once again in each of these cases private health insurance covers some, but not all of the costs up to a limited dollar amount each year. Optometry is now covered by Medicare, but the cost of getting new lenses is not covered.

The cost of prescriptions is another matter that is vastly different from the U.K experience as well as the U.S. experience. In those countries there are prescription drugs that cost far less than in Australia. Lyrica is one of those drugs. When it was not covered by the NHS scheme and first introduced into Australia it had a cost of more than $100. In other words it was cost prohibitive for those on a lower income (myself included and I had to limit when I took the drug). There are plenty of examples where the cost of a drug in the UK is minimal but in Australia we are paying more than $30 for a prescription. The current cost of a script is more than $37 which applies where the drugs cost more than that amount, but if it costs lower then we pay the lower amount, yet that lower amount is still more than the cost in the UK or the USA for a lot of drugs. There are a lot of out of pocket expenses if one requires prescription drugs on a regular basis.

It is worth noting that Australians have never paid for others to have the pill. All drugs are in fact a private expense. The only thing that is regulated is how much is charged and if the drug is on the NHS list it means that a component above the the level of the co-payment is then paid by the government. A drug being on the NHS list also means that it counts towards what is known as the safety net. Once that is reached then one pays a smaller amount, that is $5 per script until the end of the year. It is still not totally free.

The word healthcare is misused in my opinion. It is only about insurance and nothing to do with attending doctors. The fact is that we all need health insurance to help pay for the costs of medical proceedures. However, what it does not do is rein in the massive costs for anyone who goes to Emergency for treatment when suddenly struck with an illness or whatever.

Here in Australia, if one goes to a Public Hospital Emergency Department there is no additional charge. If one went to a Private Hospital then there are big charges for any treatment. The real issue is actually the inflated charges for minor treatments. I think that this is the real issue in the USA.

Instead of Abominablecare, I think what was at first required was doing something about limiting the remedies available under litigation for things going wrong and poor doctor services. Yes, I do think that there should be remedies available, but I think that such remedies should have an upper limit, and there should be nothing for what is termed “suffering” because that is the part that is a real lurk. The cost of litigation in the USA has caused things such as doctor medical insurance to surge. It has caused a jump in the cost to the patient, and this has flowed into the cost of insurance.

A universal health scheme is normally one where the scheme is paid for out of taxes. In Australia we pay a levy of 1.5% for the universal health insurance. This is the money that is available to pay for our doctor costs. Some, but not all GPs bulk bill for the doctor visits. When the doctor does not bulk bill we are looking at paying more than $85 per visit to the doctor up front. This is a huge chunk out of the grocery bill.  It is fortunate that in this new location I found a doctor’s surgery where they bulk bill for the patient visit.

Basically, what I am trying to say is that one should not believe the hype coming out of any Marxist letter writer to any paper for the simple reason they are the ones who do not understand all of the issues that are involved. From what I have been reading most people will be forced to pay even higher premiums because of the introduction of Abominablecare, and that is not fair or reasonable.

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