OK, I'm beginning my post before I've read everybody's, I'll go bck and read (and add to this) as I go.
Janet, Tony's "boss" - talk to your taxation department about this, because it now is going to have a bigger impact on Tony's expenses. Maybe all you want to know from your tax office is - how does this new scheme affect Tony's tax? What can he claim? And then just mention/describe the boss. If your tax office is anything like ours, this will prick up their ears if boss is doing anything underhand, and they will be watching for him and may even decide to do an audit.
With the Aussie tax office (ATO) - they have a consult line, we can ring and pick their brains about all sorts of things. The person you talk to is an ATO employee of course, but also a tax payer who also wants to beat the system, but legally. They are very helpful but also very down on people knowingly trying to rort the system.
The 80% cover in some cases and 100% in others - we have something similar, I wouldn't mindbetting your incoming system has been modelled at least in part on ours.
Your private insurance companies - they will need to be regulated, supervised, watched, hounded and made to toe the line and not rip people off. I did hear tat they will no longer be allowed to drop people who "make too many claims" - after all, that is why people take out insurance, to cover them in the event of them NEEDING to make claims. In Australia, we can't be dropped unless we are claiming fraudulently. I know there have been frequent periods when our own personal health insurance company (yes, husband & I also carry private health insurance on top of the state-based public cover) would have loved to have dropped me, we hd claimed more tan we'd paid into it, over a number of years.
Another point you may not have realised - insurance premiums should go down, when there is a state-based health scheme. Our private health insurance used to cover GP visits, specialist visits as well as hospitalisations. Now it no longer has to cover any doctor visits and we only have to pay for hospital (which our insurance mostly covers) if we choose to go to a private hospital, or be admitted as a private patient. If we are admitted as public patients (which we can always choose) we get the same level of care, guaranteed. But the waiting list is often a lot longer. However, if it's an emergency such as a burst appendix or car accident, you have the choice on admission and generally people go public - you're going to get admitted anyway, going private just gives you the chance of a private room instead of having to share. Personally, I like the company.
I haven't had a chance to go digging into the new US plans, I know they can't be all like the Aussie scheme because of cultural differences. Our scheme is very much more Big Brother in what they can do to check up on you; if you do the right thing you have nothing to fear, but in Australia it's very hard to do the wrong thing and get away with it for long.
When our public health system first came in, it was ripe for exploitation by unscrupulous service providers and insurance companies. But a lot has been learned and I strongly suspect your people have been talking to our people about just how to avoid these problems.
It won't be perfect. But it's got to be better. Also, they will need to keep tweaking it to make it work better. There will be problems. It will take time. But hopefully once it's in place, you will see benefits fairly soon.
Our scheme is funded through an increase in taxation - above a certain (poverty line) level of income, there is about 1% levy (I think it might be 1.5% now). When you're already paying 40c in the dollar, what's another cent or two? Above a certain (rich) level I think the percentage is higher, unless you take out private health insurance (which pays for the fun stuff like specs, dental, physiotherapy, etc). Mental health - not a problem, psychiatrists are doctors too. But only recently were we able to claim for psychologist and only under certain conditions. Otherwise we had to have private insurance, or fork out (and then claim it back on tax).
Trinity, in Australia we always have the option of getting the job done privately if we can't accept the waiting time for the public scheme. But we always need a doctor's referral, and part of the Big Broter in our system monitors doctors who order too many "unnecessary" tests. So if a panel of doctors would not agree that your MRI is needed, your doctor would be in trouble (if he routinely over-prescribes or over-orders). But if it's genuinely needed - no problem.
With my breast cancer, I could have chosen to go public (and not pay a cent) but there was an unknown waiting time before I could have had my surgery. I am privately insured so I chose the private hospital route which got me my surgery within a fortnight. My brother, on the other hand, is stuck with the Queensland public health system and it's HUGE waiting times at public hospitals, and had to wait 18 months for urgent prostate surgery. Mind you, he could have complained louder and got attention sooner. Queensland is bad for this, mainly because their hospitals are not able to cope. Our national government is on the point of taking over all the states who until now have jurisdiction over actually providing the health services, even though the federal government foots the bill.
My breast cancer surgery - if I'd waited for the public hospital, I probably would have had my surgery in about 8 weeks instead of 2. NSW is not so bad as Queensland.
So for the US - administration is going to take time to set up and get it right. It won't happen overnight because you're a bigger country with more states and a previously different system which needs help to transition.
I wish you all well and hope that this is going to work out better overall for you. When you experience problems, you need to do two things:
1) Let the authorities know, loudly, so they can take the problems into account with their necessary tweaking; and
2) Never forget the alternative.
Marg