By Gregg Brain
Let me say at the outset that I think that the Australian public health system is the second-best in the world – certainly in my experience. You can be kept from dying, without having to put your hand in your pocket, and that’s a whole lot more than can be said in most other countries I’ve experienced.
But – and it’s a big but – Australia has a two-tier health system. Public, as described above, and private. Private gets you what you want, when you want – but you have to pay, and pay big. For the purposes of this article, I went online to an Australian private health insurer, and got a quote for cover such as Kathryn and I had when we were living there. The annual premium is over $4,700 – that’s almost £2,700.00, to get on a shorter queue.
And that’s what it’s all about – shortening that queue, and I’ll explain why.
Imagine your knee cartilage has given up the ghost, and you need a knee replacement. Pretty straightforward stuff, nowadays, but you don’t have to fork out £3k for private medical insurance (PMI). As a result you run into the swamp of politically-driven ‘treatment queue management’.
You go to your GP, because that’s where you have to start any treatment. Without a significantly urgent need (or PMI) your appointment will be a week or two away. The GP says, “Yep, your knee’s crunchier than a bag of crisps”, and refers you for an ultrasound/X-ray/MRI. No PMI? Well, that’ll take about ten months or so to get to the head of that queue.
Now, ten months later you have your ultrasound report that says that your knee cartilage is cactus, and your GP phones a consultant orthopaedic surgeon to get you an appointment TO SEE IF YOU CAN GET ON THE QUEUE FOR SURGERY. Waiting list? 22 months. Tick, tock. Limp.
You turn up to your appointment with the consultant surgeon. The entire appointment takes less than 10 minutes, and they might not even examine you; just read the report, and ask you a question or two. After all, Mondays are set aside to push through a couple of hundred of these ‘quicky’ consults, if they can, public system workload being what it is. Good news – the consultant says that you need a knee replacement (who knew?) and you can now, after almost three years, start your journey on the eight-month waiting list for surgery. Meanwhile the politicians crow that they’ve reduced surgery ‘waiting lists’ to under a year. Limp, limp.
After a little under four years, your surgery is done, and rehab can commence.
But it is free, and as I said, in my experience it’s easily the second-best system in the world.
Or you can go private, and the whole process might be six months or so. If you can afford £3k. Not many can. Private GP visit? £30. Prescription for hayfever/asthma? £20. Private knee surgery? £10,000.
And PMI does not pay for all your medical costs– just a predetermined fraction. When Kathy was pregnant with Lachlan, we had PMI, including obstetrics, and it still cost us many thousands to go private. But that did mean that when important (but not immediately life-threatening) complications occurred late in the pregnancy, we got help straight away.
The Scottish NHS is completely different, and I can give an example.
Last year, Kathy found a lump in her breast. It was a Tuesday. For context, all the females in her family have died of soft-tissue cancers, including her own mother. If something’s wrong, she doesn’t sleep until it’s sorted.
So, Tuesday. She finds a lump. Rings the GP. Appointment same day. Referred to consultant surgeon for ultrasound the following week. Ultrasound is done, and it is determined that a biopsy is needed, which is done on the spot. The surgeon says he thinks it’s probably a benign, but invasive tumour, and recommends surgery. This is booked in for two weeks later. Within a month of discovery, the tumour is out, and is confirmed to be a phyllodes tumour, in a benign state. We can all sleep again. I’ll say that again – less than a month, from start to finish, and not a penny out of my pocket(well, apart from my N.I., and the Immigration Health Surcharge that we forn-types pay on top of that).
But I still, every time, go up to the counter at the end of a medical visit, asking if there’s anything to sign/pay, and I still can’t get over it when every time, they say, “No, that’s you sorted”.
Most locals have no appreciation of this, which is understandable, as they’ve never known anything different. By the same token, most of my Aussie friends don’t believe me when I tell them about our experiences with the Scottish NHS – which is far better than the private health care for which we paid thousands in Australia.
But you can be bankrupted by a simple fracture in the US, with the just ambulance ride easily costing over £5,000. You can wait years for surgery in Oz, limping and in excruciating pain. And in the majority of other countries, the nearest doc might be hours away, and out of your financial reach anyway. Sick? Get well, or die.
For God’s sake, fight for your Scottish NHS. I know it’s not perfect. But nobody, anywhere else in the world, has it this good.
