Tuesday, May 28, 2013

Free Healthcare!

As I very excitedly mentioned in my previous blog, I am now entitled to Medicare.  Woohoo!!!

Medicare is Australia’s universal health care system.  America:  take notes.  Medicare was implemented nearly 40 years ago, and after some fluctuations and political maneuvering, was finally left intact as a permanent feature about 10 years after that.  Of course, just like in America today, there was political debate, and the bill to implement Medicare faced an uphill fight.  The two chambers of Parliament were controlled by different parties, and the Medicare bill was one of the major ones they were squabbling over at the time, though apparently there were a few other controversial bills too.  The fight was so fierce that it led the Queen’s representative here to actually dissolve Australia’s Parliament.  To date, that was the only time Australia’s Parliament has been dissolved by the monarch.

So, what does it entail?  First, let me run a disclaimer:  I’m new to this system, so not entirely sure yet, but I think the below is pretty accurate.  Also, it’s actually quite complicated, so this is a very simplified version.  I think.

So, going to the hospital is free as long as you go to a public hospital.  Going to the doctor is free as long as you go to a doctor that “bulk bills” patients (basically, a doctor who agrees to charge the minimum Medicare rate).  And apparently eye exams are also free but I have yet to explore this fully.  So, what don’t you get?  Well, you don’t get to go to a private hospital.  And you won’t get a private room even in a public hospital.  And no, you can’t choose your doctor.  And yes, you may have to wait a few months to have your tonsils out because it’s not life-threatening.  But rest assured that if you have a heart attack or stroke or are diagnosed with cancer, that you’ll be treated quickly and efficiently at no cost to you.

Let me repeat:  something that would cost tens of thousands of dollars or more – even with insurance – in the US, is absolutely free in Australia.  And this is probably reason # 1 why I moved here.  Cancer doesn’t automatically mean you have to take out a second mortgage.

Also, prescriptions are subsidized by the government as well, so you won’t pay more than $35-ish for any necessary medications.  Not too shabby.

Now, of course, you may pay other out-of-pocket expenses for things aside from pharmaceuticals.  Some doctors charge a higher rate, and the difference between the higher rate and the Medicare approved rate is called the “gap”.  If you really want to go to a certain doctor that costs more and you end up spending a lot of money on gap payments, or have a lot of prescriptions and have to pay quite bit out of pocket, you’ll probably get a rebate or a tax break from the government.  Again, not too shabby.

Also, you have to pay extra out of pocket if you want your own room in a hospital, or if you want to go to a private hospital (though, I’ve heard that public hospitals have more funding and therefore better equipment).  Dental is not included in Medicare.  Neither are glasses nor contacts.  Neither are physiotherapy nor chiropractic.

So, what do you do in those situations?

That’s where private health insurance comes in.  And it conveniently works that it’s often times cheaper than Medicare.  “But Medicare is free, right?”  Yes, but higher income earners pay an additional Medicare levy surcharge of 1.5% of their annual income.  But, if you take out an acceptable level of private health insurance, the levy gets waived.  Also, unless you’re super rich, the government provides a subsidy for private health insurance, and the level depends on your age and income.  I only get a 10% discount because I’m young and single, but I think some people can get up to 40% off if they’re older or have children.  Also, unlike in America, private health insurance here is cheap.  Super cheap.  “Cheap as chips” as the Aussies would say, though they always complain about how expensive it is.  They have no idea.

To get my discount on taxes, I purchased a plan which gives me some basic private hospital cover as well as “extras cover”.  The hospital cover allows me to go to a private hospital, get my own room, and avoid most waiting periods.  As an example, you may have to put your name down on a year-long wait list for something like tonsils when using Medicare, but it may be only a week or two if using private health insurance.  It also provides ambulance cover, which is not a part of Medicare and would normally cost several hundred dollars.  I’d just call a taxi.

The “extras cover” also provides a bunch of other stuff that’s not included in Medicare.  This includes dental, physiotherapy, chiropractic, podiatry, and a bunch of natural therapies such as acupuncture, Chinese herbalism, homeopathy, aromatherapy, remedial massage, and more.

Let me just repeat that:  my health insurance covers acupuncture, aromatherapy, massage, and drugs dispensed by an old Chinese man.  I’m not even shitting you.  And this stuff is considered pretty standard for private health insurance in Australia.  Wow.

Now, it doesn’t always cover the full cost of these things – I’m likely to pay 20% - 40% out of pocket for most “extra” services, especially those provided by a dentist, doctor, or old Chinese man outside my insurance company’s preferred provider network.  But really, that’s not a big deal because most doctors and medical-ish services are pretty cheap in Australia.  Also, my entire plan cost less than $850… for an entire year… That’s like a monthly premium in the US.  The best part:  that is actually less than the Medicare levy surcharge for me, so I’m actually saving money by purchasing private health insurance.  Now, I could go out and buy the Mercedes of insurance plans which pays for everything and the kitchen sink, but I don’t think I’ll need the pregnancy cover anytime soon.  So I’ll stick with my Hyundai type plan.  It’s not very classy but it’s fairly reliable for now.  I’ll consider upgrading to a Honda type plan one day.

But wait!  There’s more!  Just as getting permanent residency in Australia came with the added bonus of full rights to live, work, and/or study in New Zealand, it also comes with a reciprocal health agreement!  So, if I get sick when travelling to New Zealand, I can just flash my Medicare card and “Bam!” I get treated!  Ok, so there may be a bit more paperwork involved, but I’d fill out a few forms for free healthcare.  And just when I thought it couldn’t get any better, not only does Australia have a reciprocal healthcare agreement with New Zealand, it also has similar agreements with the United Kingdom, Ireland, Netherlands, Belgium, Finland, Sweden, Norway, Italy, Slovenia, and Malta.  So, if I’m sick in Stockholm – “Bam!” Covered.  Diseased in Dublin?  “Bam!” Covered.  Ailing in Antwerp?  “Bam!”  That’s covered too!  I love alliteration.

Do you know who Australia does not have a reciprocal healthcare agreement with?


Because the US doesn’t have a healthcare system to reciprocate with.

Ain’t that some shit?

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