Tell an Aussie about Healthcare in the US.

[Burkey]

I’m curious about a range of topics where the US and Australia differ greatly.
In this instance, I’m looking for opinions re: private vs govt funded Healthcare.
I’ll probably inject some of the Australia’s outcomes as we go.
Dig in. Tell me how it works/doesn’t work, what should happen etc etc.

Sponsored

 

[Hack]

I’m curious about a range of topics where the US and Australia differ greatly.
In this instance, I’m looking for opinions re: private vs govt funded Healthcare.
I’ll probably inject some of the Australia’s outcomes as we go.
Dig in. Tell me how it works/doesn’t work, what should happen etc etc.

It still works great, but due to malpractice law suits the costs can be high. Most people have insurance through their work and the cost isn't a huge deal. You can get anything you need fixed no problem by some of the best physicians in the world. And service is quick. I recently wanted a check up - I got in the next day at the time of day I preferred. Emergency stuff you are seen immediately.

I'd like to see torte reform to reduce lawsuits and help reduce the costs. Other than that, it's really good. I hope nobody messes with it too much. IMO it's much more likely to get worse than to get better.

 

[watisthis]

I’m curious about a range of topics where the US and Australia differ greatly.
In this instance, I’m looking for opinions re: private vs govt funded Healthcare.
I’ll probably inject some of the Australia’s outcomes as we go.
Dig in. Tell me how it works/doesn’t work, what should happen etc etc.

Honestly, you'd be better off asking this question on reddit. Far more constructive comments and healthy debate, plus, you get a wide range of locations in and outside of the US discussing their own experiences.

 

[kluke15]

im an ER nurse. i think costs of everything are too high. however i think the reason costs are high are due to a lot of different issues. i think everyone is sue happy and are looking for any reason to sue someone for money. i think insurance costs are ridiculous and i think insurance is a total scam. you pay into something that you never use and then when you need to use it they charge you even more. and lastly i think costs are high because you have part of society who doesnt pay taxes (homeless) but they use a lot of health care resources especially where i live. they come into the ER constantly rack up these large bills and then the hospital has to eat the cost because we cant turn anyone away in turn raising costs for everyone else. its a hard situation tho because i do believe health care at least to some extent should be a human right not a privilege but it is also not free so its gotta get paid somehow. with all that said it does seem like even homeless people can get some pretty badass health care including procedures referrals medications etc.

 

[lacanteen]

Here's an example of our problem:

 

[watisthis]

I'll chime in on the economics of our insurance problem, but like I said before I'd also ask this question on '/r/Ask_Politics/' as you'll get an extremely in-depth conversation.

Firstly, the problem with our insurance industry isn't all just X amounts of profit. It's really free market inflation in a closed loop.

Look at it this way, drug company X raises the price of medications because insurance Y must cover the cost. Drug company X gives cash rebates to insurance companies who use drug Z.

Person with insurance Y gets prescribed Z, costing lets say 2000, the insurance covers that 2000 but gets 1900 back from X. Ensuring Y covers drug Z not A. All this does is screw people without insurance because they still see the 2000 bill. This is done because every time someone raises up the price slightly they make a small profit before all the other costs adjust. While bureaucracy is turning they have 6 months of profit on drug Z.

Lastly, this works in reverse at hospitals. Insurance companies charge multi million dollar coverage costs for doctors. Those doctors have to charge tens of thousands of dollars for simple procedures which the insurance companies cover. That money only really moves on paper and screws the little guy.

This is out of control because the US has a massively litigious culture for many reasons most of which is because people are just plain poor, and when someone who gets hurt in a hospital can't work or at anytime might not be able to work they lose their insurance. So they must pay medical expenses out of pocket which in turn means millions of settlements by insurers. It really is a great scheme when you have a whole bunch of people who think this is ok until it happens to them or someone they know.

 

[Hack]

I’m curious about a range of topics where the US and Australia differ greatly.
In this instance, I’m looking for opinions re: private vs govt funded Healthcare.
I’ll probably inject some of the Australia’s outcomes as we go.
Dig in. Tell me how it works/doesn’t work, what should happen etc etc.

So, are you going to post about your experience in Australia?

 

[Burkey]

im an ER nurse. i think costs of everything are too high. however i think the reason costs are high are due to a lot of different issues. i think everyone is sue happy and are looking for any reason to sue someone for money. i think insurance costs are ridiculous and i think insurance is a total scam. you pay into something that you never use and then when you need to use it they charge you even more. and lastly i think costs are high because you have part of society who doesnt pay taxes (homeless) but they use a lot of health care resources especially where i live. they come into the ER constantly rack up these large bills and then the hospital has to eat the cost because we cant turn anyone away in turn raising costs for everyone else. its a hard situation tho because i do believe health care at least to some extent should be a human right not a privilege but it is also not free so its gotta get paid somehow. with all that said it does seem like even homeless people can get some pretty badass health care including procedures referrals medications etc.

Litigation in the US is quite possibly one of the reasons for the high cost of services
Over here in Australia, the doctor needs to be quite negligent before you have any hope of winning a legal battle.
As an example, many years ago I severed all the tendons (bar the big toe) on the underside of my foot. The treating doctor failed dismally, stitching the skin back up but not attending to the tendons. Weeks later it was obvious that I had no movement in the four toes. Back in for microsurgery to repair the tendons.
The toes now don’t work quite as well as they should, and the second surgery introduced other complications. I won’t go into it. In short, 11 weeks off work, not covered by any insurance policy, and to go to court would require that the “disability” would need to meet a range of criteria that it couldn’t even come close to.
However, ALL the treatment I received was completely free of charge. As has been all of the treatment I’ve received over the course of my life, the vast majority of which has been a positive experience with the only exception being this particular case, which isn’t really THAT bad in the scheme of things.

 

[Burkey]

I'll chime in on the economics of our insurance problem, but like I said before I'd also ask this question on '/r/Ask_Politics/' as you'll get an extremely in-depth conversation.

Firstly, the problem with our insurance industry isn't all just X amounts of profit. It's really free market inflation in a closed loop.

Look at it this way, drug company X raises the price of medications because insurance Y must cover the cost. Drug company X gives cash rebates to insurance companies who use drug Z.

Person with insurance Y gets prescribed Z, costing lets say 2000, the insurance covers that 2000 but gets 1900 back from X. Ensuring Y covers drug Z not A. All this does is screw people without insurance because they still see the 2000 bill. This is done because every time someone raises up the price slightly they make a small profit before all the other costs adjust. While bureaucracy is turning they have 6 months of profit on drug Z.

Lastly, this works in reverse at hospitals. Insurance companies charge multi million dollar coverage costs for doctors. Those doctors have to charge tens of thousands of dollars for simple procedures which the insurance companies cover. That money only really moves on paper and screws the little guy.

This is out of control because the US has a massively litigious culture for many reasons most of which is because people are just plain poor, and when someone who gets hurt in a hospital can't work or at anytime might not be able to work they lose their insurance. So they must pay medical expenses out of pocket which in turn means millions of settlements by insurers. It really is a great scheme when you have a whole bunch of people who think this is ok until it happens to them or someone they know.

The final point you raise is something I agree with entirely.
To determine if your system is equal you need to build it not knowing at which end of the spectrum you might reside.
Claiming that “insurance is covered by your employer” assumes firstly that you’re employed and secondly that this money wouldn’t go into your pocket if the employer wasn’t paying it to the insurer. Essentially the argument is that taxes would surely cost more than private enterprise.
All well and good until you don’t have a job.

 

[Burkey]

So, are you going to post about your experience in Australia?

Indeed I will.
Firstly though, I’ll have state up-front that in some of the examples I’ll provide, I’m using my experience, from my region, rather than more broadly speaking across Australia.
I’m sure the US has similar state by state variations etc.
Medicare was established in 1984.
Private health cover co-exists with Medicare. You are either treated as a private patient or public.
Public patients pay nothing, private patients pay for services.
Whether public or private, your taxes pay for Medicare, taken from each pay-cheque you receive.
More recently, the government has introduced a scheme where there’s an extra 2% levy that is to be paid by those who elect to remain public. This is paid at the end of the year.

Here’s the tricky bit.
The end of year levy is still usually cheaper than any level of private cover.
So, if you live in a regional area, you can either pay the (cheaper) 2% levy and see the same doctor in the same hospital as the private patient, OR, pay the taxes throughout the year, the cost of insurance, then pay for treatment on top of that....
Works fine in capital cities/larger towns etc where there may be a choice of hospital and doctors who don’t frequent both systems, possibly giving you a better doctor/facility, not so well in areas where the options are limited.
Private cover does give preference to some extent in terms of wait times, but triage still remains in place of course.

Now, to the issue of state vs public funding at a more localised level.
My township (Mildura) has enjoyed a dubious privilege. Our traditionally government funded hospital was run by a private company for quite some time. The less it cost to run, the more likely the provider would keep the contract.
Given that everything became about budget rather than outcome (no competition) it all turned to shit quite rapidly. Doctors and nurses placed under too much pressure, not enough beds, no investment in equipment etc etc.
The local community was forced to raise funds just to get basic items that are taken for granted in every other hospital across the state.

Now, I don’t oppose private enterprise on a basic level, in fact, I think it’s great in most instances, just not the area of health-care. Allowing companies to take control of health-care in a situation where they have a monopoly is just ludicrous. Dollars and cents will rule over quality of outcome every single time.

 

[Hack]

Now, to the issue of state vs public funding at a more localised level.
My township (Mildura) has enjoyed a dubious privilege. Our traditionally government funded hospital was run by a private company for quite some time. The less it cost to run, the more likely the provider would keep the contract.
Given that everything became about budget rather than outcome (no competition) it all turned to shit quite rapidly. Doctors and nurses placed under too much pressure, not enough beds, no investment in equipment etc etc.
The local community was forced to raise funds just to get basic items that are taken for granted in every other hospital across the state.

Now, I don’t oppose private enterprise on a basic level, in fact, I think it’s great in most instances, just not the area of health-care. Allowing companies to take control of health-care in a situation where they have a monopoly is just ludicrous. Dollars and cents will rule over quality of outcome every single time.

I'm not sure why you are blaming private enterprise for the issue. Unless I misunderstood, it was the government that was pushing the hospital to lower costs. And I expect the reason you have a monopoly in your area is because the government doesn't allow the companies to make a profit. So why would they want to start another hospital there?

In a capitalist situation, the lone hospital would charge enough to make profits. And then if they charged too much, it would be likely that a competitor would come in and undercut their prices.

Sponsored