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<blockquote data-quote="Marguerite" data-source="post: 81217" data-attributes="member: 1991"><p>Heather, you said, "It also doesn't seem to occur to anyone that we don't have to have the exact same system as Canada or Britain or New Zealand or France, etc. We can learn from their mistakes, take what works and create our own. There is more than one way to set this up."</p><p></p><p>We have had what some people call "socialised medicine" in Australia since the 1970s. Back then it was totally free to all, and it quickly became a financial nightmare. The biggest problem was doctors making a fortune by double-dipping, filling in false claims, etc. Now technology has closed a lot of the loopholes, plus a lot of mistakes have been fixed. What we have now works.</p><p></p><p>We still have gaps - no publicly funded dental care, for example. But it's on the agenda.</p><p></p><p>How ours works currently - every member of the population has a Medicare number. This is not only all Aussie citizens, but also all permanent residents. Those with refugee status or similar have varying degrees of cover, for varying periods of time.</p><p></p><p>The Medicare number is like a social security number, only much more tightly controlled. Each family has one number, but a card with all family members' names on it. So it's not just the Medicare number, it's also your position on the card. difficult child 3 is no 6 on our card.</p><p>As the kids get older and independent, they apply to get a Medicare card (and number) in their own right. Both our girls have now done this.</p><p>If/when easy child and BF1 get married, they can either keep their own separate numbers or get a combined one. When they have their first child, a family card will be issued, if they want it.</p><p></p><p>With every change of Medicare number, the old number becomes inactive for that person. This cannot be abused. And our social security system links the Medicare numbers with tax file numbers with a vast amount of other personal detail.</p><p></p><p>Who pays for it? We all do.</p><p>NOW - we are all taxed about 1% (the Medicare levy). Below a certain income level, there is no levy. but clearly, as you get richer, you pay more.</p><p>If your income is above a certain level, you are encouraged (by a higher Medicare levy percentage if you don't) to buy private health insurance. This pays for extras like dental, optical, private hospital, etc. There are a lot of advantages to private cover, but it is ALWAYS as an add-on to everyone's basic automatic health cover.</p><p></p><p>Doctors are not permitted to refuse a Medicare patient - we are ALL Medicare patients anyway. Doctors used to bulk-bill - this means you didn't hand over any money at the doctor's, you just sign a chit and you're done. This is called bulk billing. But our current stingy government tried to cut their expenditure by cutting back on bulk-billing and discouraging people from going to the doctor - they stopped paying bulk-billing doctors the full amount and cut it back to 85%.</p><p></p><p>The fees are set by the AMA. The government then decides what THEY think is a fair thing and sometimes there are disputes. Some doctor specialists say they aren't being paid enough to cover their expenses and so none of them bulk bill (example - anaesthetists). Very few specialists bulk bill but most of them still charge schedule fee (100%). A number charge more than schedule fee.</p><p></p><p>Where a doctor requires payment, it is generally at the time of the appointment. WE DO NOT PAY TO WAIT AND SEE A DOCTOR as I know some of you do (that is appalling). But when we pay on the day, we can then go round to a Medicare office (most pharmacies double as Medicare offices also) and get reimbursed immediately to our bank accounts. We get reimbursed 100% of schedule fee.</p><p></p><p>Hospital - public hospital is free. For everyone. But it is also overcrowded. Still, we do fare better than a lot of you in the US in this example.</p><p>Private hospital - to avoid the long waiting lists or for elective surgery - you pay a lot. It costs, but you get a lot of it back with private health cover. Some health funds have hospitals "on their books" so if you go there, it's all taken care of and you're not out of pocket.</p><p></p><p>We have private cover as well as (of course) Medicare. We don't HAVE to use our private cover if we don't want to - when difficult child 3 was admitted with croup when he was 2, we chose to go public. This mean we had to take whichever doctor got assigned to him, but we didn't care, we just wanted him treated. and we walked out on discharge with not a cent to pay.</p><p></p><p>The drawbacks of our system - the government is constantly cutting it back to barer bones. Plus, we have no dental cover and I think we should. Cost-wise (to the country) you need to have really good paperwork and scrutiny in place to avoid blowing the budget, but it is working for us.</p><p></p><p>The positive side - we have a lot of programs in place designed to keep people healthy (and thereby cut government budget costs). And it's good to know that when you get sick and you're already facing loss of income, you don't have to also face huge medical bills, if you can't afford them. You can get a heart transplant (or anything else non-elective)on Medicare. You can't get a facelift on Medicare though. That's private health insurance and even THEY won't cover that sort of elective surgery, without a good reason.</p><p></p><p>Our system is similar to New Zealand's. It's almost identical. Because of our larger population, ours is more regulated and more carefully scrutinised. A lot of past problems with it (mostly to do with the system being exploited and costing more than it should) have been fixed.</p><p></p><p>They probably won't show "Sicko" in Australia, although we did get to see "Bowling for Columbine". I think we SHOULD see it - Aussies need to know how good we DO have it, so we will stop whining.</p><p></p><p>I really hope something positive comes out of this for you all.</p><p></p><p>Marg</p></blockquote><p></p>
[QUOTE="Marguerite, post: 81217, member: 1991"] Heather, you said, "It also doesn't seem to occur to anyone that we don't have to have the exact same system as Canada or Britain or New Zealand or France, etc. We can learn from their mistakes, take what works and create our own. There is more than one way to set this up." We have had what some people call "socialised medicine" in Australia since the 1970s. Back then it was totally free to all, and it quickly became a financial nightmare. The biggest problem was doctors making a fortune by double-dipping, filling in false claims, etc. Now technology has closed a lot of the loopholes, plus a lot of mistakes have been fixed. What we have now works. We still have gaps - no publicly funded dental care, for example. But it's on the agenda. How ours works currently - every member of the population has a Medicare number. This is not only all Aussie citizens, but also all permanent residents. Those with refugee status or similar have varying degrees of cover, for varying periods of time. The Medicare number is like a social security number, only much more tightly controlled. Each family has one number, but a card with all family members' names on it. So it's not just the Medicare number, it's also your position on the card. difficult child 3 is no 6 on our card. As the kids get older and independent, they apply to get a Medicare card (and number) in their own right. Both our girls have now done this. If/when easy child and BF1 get married, they can either keep their own separate numbers or get a combined one. When they have their first child, a family card will be issued, if they want it. With every change of Medicare number, the old number becomes inactive for that person. This cannot be abused. And our social security system links the Medicare numbers with tax file numbers with a vast amount of other personal detail. Who pays for it? We all do. NOW - we are all taxed about 1% (the Medicare levy). Below a certain income level, there is no levy. but clearly, as you get richer, you pay more. If your income is above a certain level, you are encouraged (by a higher Medicare levy percentage if you don't) to buy private health insurance. This pays for extras like dental, optical, private hospital, etc. There are a lot of advantages to private cover, but it is ALWAYS as an add-on to everyone's basic automatic health cover. Doctors are not permitted to refuse a Medicare patient - we are ALL Medicare patients anyway. Doctors used to bulk-bill - this means you didn't hand over any money at the doctor's, you just sign a chit and you're done. This is called bulk billing. But our current stingy government tried to cut their expenditure by cutting back on bulk-billing and discouraging people from going to the doctor - they stopped paying bulk-billing doctors the full amount and cut it back to 85%. The fees are set by the AMA. The government then decides what THEY think is a fair thing and sometimes there are disputes. Some doctor specialists say they aren't being paid enough to cover their expenses and so none of them bulk bill (example - anaesthetists). Very few specialists bulk bill but most of them still charge schedule fee (100%). A number charge more than schedule fee. Where a doctor requires payment, it is generally at the time of the appointment. WE DO NOT PAY TO WAIT AND SEE A DOCTOR as I know some of you do (that is appalling). But when we pay on the day, we can then go round to a Medicare office (most pharmacies double as Medicare offices also) and get reimbursed immediately to our bank accounts. We get reimbursed 100% of schedule fee. Hospital - public hospital is free. For everyone. But it is also overcrowded. Still, we do fare better than a lot of you in the US in this example. Private hospital - to avoid the long waiting lists or for elective surgery - you pay a lot. It costs, but you get a lot of it back with private health cover. Some health funds have hospitals "on their books" so if you go there, it's all taken care of and you're not out of pocket. We have private cover as well as (of course) Medicare. We don't HAVE to use our private cover if we don't want to - when difficult child 3 was admitted with croup when he was 2, we chose to go public. This mean we had to take whichever doctor got assigned to him, but we didn't care, we just wanted him treated. and we walked out on discharge with not a cent to pay. The drawbacks of our system - the government is constantly cutting it back to barer bones. Plus, we have no dental cover and I think we should. Cost-wise (to the country) you need to have really good paperwork and scrutiny in place to avoid blowing the budget, but it is working for us. The positive side - we have a lot of programs in place designed to keep people healthy (and thereby cut government budget costs). And it's good to know that when you get sick and you're already facing loss of income, you don't have to also face huge medical bills, if you can't afford them. You can get a heart transplant (or anything else non-elective)on Medicare. You can't get a facelift on Medicare though. That's private health insurance and even THEY won't cover that sort of elective surgery, without a good reason. Our system is similar to New Zealand's. It's almost identical. Because of our larger population, ours is more regulated and more carefully scrutinised. A lot of past problems with it (mostly to do with the system being exploited and costing more than it should) have been fixed. They probably won't show "Sicko" in Australia, although we did get to see "Bowling for Columbine". I think we SHOULD see it - Aussies need to know how good we DO have it, so we will stop whining. I really hope something positive comes out of this for you all. Marg [/QUOTE]
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