Australia Great Health Plans - Friends recent heart attack and open heart surgery

[wakeme2008]

Please nom so others can see this for a couple days

A female cruising friend of mine just was on a 8 month car and trailer trip around Oz when on the other side of Oz she had a heart attack that required open heart surgery. I asked her about the costs and she sent me a very long reply. I will cut and paste from it. She is waiting until the doctor clears her on the 20th so that she can fly home. Note they have an SUV and a 27' trailer on the west side of Oz and they live on the east side.

We hope to be flying out of here next `Saturday.......flight just has to be
confirmed by the insurance company on Monday. We were lucky to have an
insurance that covered us for illness and accident in our car and
caravan. We take the vehicles to a trucking company next Friday and
they will be sent home as soon as they can fit them on a
truck....could be a few weeks....but we have my car at home so doesn't
matter.

..cut..

We have access to two medical systems here. The first one is one that
every Australian is entitled to FREE medial treatment. It doesn't
matter if you live under a bridge or are a billionaire.....everyone
can have it free. Then there is also Private health insurance....those
who can afford it are encouraged to cover themselves but it is not
compulsory.

..cut..

When I first had the heart attack, I went to a remote country hospital
for 2 days....then the Royal Flying Doctor to Perth and 2 ambulance
rides...then about 3 days in the Royal Perth Hospital (where I had all
the tests, angiograms, echos x rays etc etc etc done)and I was never
asked if I had any medical insurance......the whole thing cost nothing
up to that point. Then the surgeon asked me if I had private
insurance, if I did he could transfer me to a private hospital and
would be able to do the operation quicker..

..cut..

I went to a more up market, comfortable hospital
(even with good food). In a private hospital though, you are not
completely covered for everything, where in a public hospital you are.
I have to pay extra for drugs, x rays, physiotherapy and some
tests........my private insurance will give me some of that money back
but not all.......I would guess that we will be out of pocket about
$800 all up. If I had stayed in the public system I wouldn't be out of
pocket at all. Most of our drugs are also subsidised by the
Government....usually only pay about $20 per prescription......but
when a family reaches a cost of $1000 for prescribed drugs in a year,
the cost then drops to $2.50 per script for the rest of the
year.....between John and I, we will probably reach the $1000 limit
around the middle of the year, so will get about 6 months worth almost
free each year.

..cut then she sums it up...

The system could be better but its the people who ruin things.....it
is certainly a lot better than you have. In any type of emergency, you
will be taken straight to the nearest public hospital, which always
have the best facilities anyway....and you wont be asked for a
cent......the worst part of the public system is when you get to our
age and might need some joint replacements etc......that is not
considered urgent or life threatening....so you will be on a waiting
list....could be for a couple of years....if you have private
insurance you can get a new hip next week.......all in all I think we
have a pretty good system......
Hope that explains it all

[Schema Thing]

1. Damn, it's becoming readily apparent:

If I was a hip replacement surgeon, I could write my own ticket anywhere in the world.

This is obviously THE most understaffed niche in healthcare the whole world o'er.


:mild sarcasm:

[napi21]

2. Did she happen to tell you what she has to pay for the Private Ins?

I'm just curious. I've been suggesting a system similar to what she described for a long time. It seems to me it would be wonderful for everybody to have "basic" coverage, but the availability of the Private Ins. should shut up the cmplainers who scream that they want what they have NOW!

As far as her outof pocket costs go, it's a heck of a lot better than here! I broke my leg last Sept. and my OP costs were finally capped at $2,500 and that didn't include the cost of any drugs!

[wakeme2008]

9. A lot :grr: she thinks $100 per month for her and her husband

:grr:

[elfin]

3. Related info on US emergency rooms via a trial lawyer

who visited recently.

Most ER's are so understaffed that you have to wait and wait and wait -- even with chest pains etc. UNLESS you arrive in an ambulance - they get in first. He knows due to several suits from delayed care resluting in either death or severe repercussions.

So don't have anyone drive you to the ER if you suspect it may be serious - pop for the ambulance - or have a feared trial lawyer as your advocate.

[Robson]

5. Good point

That's a good point about the ambulance.

I haven't seen the movie yet, but I'm looking forward to it (I think). I would suspect that it could be detrimental to one's health as it will raise blood pressure and the fight or flight response. My take is that the desire for more profits and big CEO pay in health care has been a big part of increasing our costs, not reducing them.

Every US citizen should receive a guarantee of quality health care. But there should also be options available for citizens to buy better insurance that would offer physician and hospital selection, private rooms, etc. I can remember paying for health care insurance years ago while some less responsible friends were spending their money on new cars. They didn't worry because they knew that they'd be covered if necessary. That was part of the problem too.

[rainbow4321]

6. You may get wheeled past the waiting room but....

once you get seen by the triage nurse, you will get put in line behind people in need of real emergent care.
A nurse at the hospital I work at told me recently how people are pulling the "call an ambulance then we won't have to wait" stuff. Including a guy with a cough. Not a bringing up blood-severe respiratory distress cough but a nagging cough. He gets to the ER via ambulance, gets triaged and put behind the chest pain people and then bitches about having to wait because, after all, he came via ambulance. The ER nurse told him "yes, you came via ambulance, but you came to an EMERGENCY department and there are people here having emergencies, like chest pain".

So word to the wise to those thinking that taking an ambulance will get you to the front of the line...think again..there is a triage nurse at the other end of that ambulance ride and he/she will put you back at the end of the line if you really don't need that emergent care. All you will end up with is a huge bill for an ambulance ride that you didn't really need.

[mcscajun]

4. Kicked and Recommended.

:kick:

Pretty damned good system they've got in Oz. :)

[fencesitter]

7. So, is insurance a supplement down under?

Or just a way of getting overall better care? We sort of have the same system in the US. Everyonse can go to the emergency room and get care. If you can afford it, and the more you can afford, your care is better and best. Except (w/o insurance) when you leave the emergency room, a huge bill will arrive in a week or so, followed by bill collectors, court judgements and trashed credit reports.

[wakeme2008]

8. Supplement basically $100 per month per my Oz friend for her and her DH

:)