The Australian healthcare system

Now for the Australian healthcare system. I've only been working in the Australian healthcare system for 9 weeks, so I don't know everything about it, but I'll try to represent it as accurately as I can.

Who is eligible? Medicare is the name of the government health program in Australia. All Australian citizens and permanent residents, New Zealand citizens, and those who are in the process of obtaining permanent Australian residency are eligible for Medicare. Australia also has reciprocal agreements with Finland, Italy, Malta, New Zealand, Norway, Ireland, Sweden, Belgium, the Netherlands, and the U.K. One of the nurses I work with is from the U.K., and she is covered by Medicare. Since I'm only a temporary Australian resident, I do not qualify for Medicare.

Hospitals. There are public and private hospitals. All the public hospitals are owned by the government. For example, the hospital I work at is public and is owned and operated by Queensland Health, a division of the state government of Queensland. I think that all care received at a public hospital is free. Public patients are not able to choose to have a private room. Most of the rooms I have seen on the ward (floor, nursing unit) have 4 patients per room. One of my male patients told me he was once placed in a room with 3 women patients. I don't know that the patients are able to choose which doctor they see either. I think it's just the one that's assigned to their case.

Prescriptions. For prescriptions, some are free; some are not. I work with oncology patients, and I think that any home medications that are to be taken in conjunction with chemotherapy are free. After receiving their treatment, the patients pick up those precriptions from the hospital pharmacy before going home. A medication for a long-standing heart condition, however, would be paid for by the patient.

Doctors' visits. The GP (general practitioner), equivalent to an American family practice or internal medicine doctor, is the gatekeeper in the health system. In order to see any type of specialist, patients must obtain a referral from a GP. Patients are required to pay for doctors' visits, but can submit a reimbursement request to Medicare to be reimbursed for about 75% of the cost. In some doctors' offices, patients can swipe their Medicare card, the same way you would swipe a credit card, and this submits an automatic reimbursement request to Medicare. There are some doctors who bulk bill, and care from those doctors would be free, but I don't think the majority of doctors bulk bill. When the Australian national health system first began, all doctors' visits were free, but when that was occurring, doctors were not making enough money to cover their expenses.

Wait times. One of my friends cancelled her dermatologist appointment and was told she could not get another one for 8 months. Her aunt was found to have a melanoma (the most deadly form of skin cancer) and was told she had to wait either 5 weeks or 5 months to have the surgery to remove it. A person would have to wait about 5 years for a joint replacement.

Dental. Dental care is not covered by Medicare.

Optical. Optical care is free. I'm not sure if this includes the cost of glasses or contacts or not.

Health insurance. Employers do not provide employees with health insurance. Residents are encouraged to purchase private health insurance. Residents are taxed at a higher rate if they do not hold private health insurance. People who have private health insurance can choose their own doctor. They can choose to go to a private hospital instead of a public hospital. They can choose to have a private room while in the hospital. A person having a colonoscopy at a public hospital might have to wait all day, while a person with insurance at a private hospital would probably be taken in with little or no wait time. Health insurance also covers a portion of health costs not covered by Medicare, which the patient would otherwise be responsible for paying out of pocket. Because I'm not eligible for Medicare, I took out my own health insurance policy, for which I pay $115/month AUD ($105 USD). There are wait times with Australian health insurance. I couldn't use my health insurance for the first 2 months I had it, and certain services are not covered until the plan has been in effect for 6 months or a year.

Where does the money come from to fund Medicare? All working Australians pay 1% of their wages in taxes that go to the Medicare system.

How did national healthcare in Australia come about? I think it was around 1971, that workers unions cut a deal with the government. Workers unions agreed to not ask for pay increases for a certain amount of time (I think maybe 5-10 years) if the government would implement a national healthcare system.

For my Australian friends and relatives, feel free to correct me on any points I didn't get right. I'm happy to be educated. Any questions or other stuff you want to know about, just say so.