Australia has a hybrid system with both public and private health care. You can pay for private insurance (like in the USA) if you want to, which covers the costs for private hospitals, better doctors, etc, or you can just use the public system which is funded by a 2% income tax. My family couldn’t afford private health care when I was growing up, so we only used the public system. It was mostly okay, although regular doctors (a general practitioner or “GP”; what you’d call a “primary care physician” in the USA) always had long queues to see them. Sometimes I had to wait 3 or 4 hours to see a doctor. Some specialists have a long wait time of several months or even a year. I did have to go to hospital a few times, which is completely ‘free’ (taxpayer-funded) if you go to a public hospital.
The public system today isn’t quite as good as it used to be due to various cuts over the years, but it’s still a good safety net to have.
Australia also uses a single-payer system for prescription medication, called the Pharmaceutical Benefits Scheme. All prescription medications are government-subsidised, with the government being the only entity that negotiates prices for the entire country. It means they have a lot of bargaining power, and a lot of medications are significantly cheaper than in other countries that don’t use a single-payer system. Medications that are hundreds of dollars list price in the USA are often less than $20 list price in Australia. Insulin is around $8 retail in Australia compared to ~$100 in the USA.
Now I live in the USA and my insurance is pretty good (flat fees of $10 for doctor visits, $20 for urgent care, $100 for emergency room, max $5 for generic medications, maximum $2000 out of pocket per year after which everything is 100% covered), but it varies a lot. Health insurance is often tied to your employer, so if you work at a “better” company, they tend to have higher-end insurance coverage. There’s been some attempts at introducing universal health care (most notably the Affordable Care Act, nicknamed “Obamacare”) but there’s a surprising number of people that don’t want it because “they’ll have to pay for other people’s healthcare”, even though it’ll actually make their health care cheaper too. ¯_(ツ)_/¯
Now that I’m insured, healthcare actually costs more than when I wasn’t. And I’m not talking about premiums - I’m talking about copays and deductibles being non-negotiable.
For instance, I thought I may have hurt my ear scuba diving a few weeks ago, so I went to the ER to see if my eardrum was perforated (ENT visits can take months to get).
They told me it was, had me pay a $300 copay, prescribed me $130 eardrops my insurance wouldn’t cover, and referred me to an ENT.
When I finally got to an ENT, they told me that my eardrum wasn’t every perforated and the ER did didn’t know what they were talking about.
Then I got an additional bill from the ER for another $1800 because my insurance company refused to pay the bill.
Had I been unisured the hospital bill would have been maybe $250 all-in after negotiations, but since I have insurance it’s $2100 for a wildly wrong diagnosis that ended up costing me another $430 in specialists and prescriptions.
When I lived in Alberta, Canada (as a USA expat circa 2010), it had pluses and minuses. Pluses: The cost was very low; in our province the premiums were nominally $44 CDN per month for an individual or $88 per family, but the windfall from oil production meant they could waive that and it was free. Emergencies were treated quickly and well. Drugs were inexpensive. The doctors seemed competent. Minuses: extreme shortages of doctors, facilities, and services. I could not find a primary care doctor taking new patients, so I had to wait at least two hours each time to see a different doctor at the walk-in clinic. They did not take or keep a medical history, so it was all up to me to know if what they prescribed was contraindicated by other drugs or conditions. Drugs, while cheap, were not covered by insurance, and some were simply not available at any price. Dental and vision coverage were not included and had to be bought on the private market. Wait lists for non-emergency procedures or treatments were ridiculously long, like 18 months to get the first appointment to talk about a hip replacement. Three months to get an MRI to diagnose chest pain.
I still have to pay to visit the dentist though, which can be quite expensive.
Regular doctors visits are free, but if youre refered to some specialist, like… i had an issue with my knee, i was directed to some therapeutic pro. That cost me like 20 euros per visit. However, a friend of mine had to visit an eye doctor which was also free.
And medicine also is self paid, like antibiotics or whatever. Its rarely super expensive though.
But i when my kid was born we had no expenses at all. His mother had to stay (with him) for 2 days at the hospital and while there she had full free access to a stocked fridge, stuff for the baby (diapers etc) and all that jazz.
Ive not heard of anyone having other expenses either, like cancer treatments or getting a broken arm fixed
I still have to pay to visit the dentist though, which can be quite expensive.
It’s interesting that this is a pretty common thing across different countries. The public health care system in Australia doesn’t cover dentists either, and in the USA you generally have dental insurance that’s totally separate from your regular health insurance.
That sounds awful having to go through all that! In America, just buy a splint from the drug store for $20 and go back to work same day. No exhausting time in the hospital and seeing lots of doctors. No missed work. No being a drain on society and suckling on the government teat. FREEDOM!!!
National Health Service, currently struggling with lack of personnel, but in general I have a family doctor I visit, on average, twice a year, for general check-up and follow-up. I can be recommended to a specialist if deemed necessary, with varying degrees of waitimg time.
For emergencies, I can either call a line, speak with someone and either have an ambulance sent directly to wherever I am or get directed to the nearest hospital, where they will already be expecting me.
No payments, even if I need an ambulance ride, a surgery and a few days in the hospital.
A good portion of people - mainly in large population centers - resort to private care, through health insurances, some out of pure need (pediatrics, cardiology, ob/gyn, psychology and psychiatry are specialities where long waiting lists exist) but the professionals working at the hospital are usually the same working private, due to a lack of effort from the state to make doctors exclusive to the NHS.
Private healthcare is usually faster to access and feels more luxurious but when things go very wrong you always get sent to the public hospitals. Cancer and other expensive care illnesses are sent to the NHS, which is usually the first to invest in expensive treatments to get a situation solved as quicky as possible and save time and money and free up space for the next in need.
Is it perfect? Hardly but it works. Nobody really knows or even understands how but it truly works.
In the UK the cost of healthcare is included in a tax called National Insurance, it’s about 10% of wages. It can be thought of mostly as emergency use only. Mental health and minor ailments are not treated. If you want that kind of service you need to go private and most people cannot afford that so they go untreated. I know a newly qualified doctor who cannot find a job despite there being a shortage of doctors.
On the plus side, we do have a brand new aircraft carrier and a royal family.
As an American, that’s a way higher tax than I expected. Does everyone pay it, even people earning under a certain threshold? In the US we have social security and Medicare that everyone has to pay.
They say it’s a thousand years old and have no intention of changing anything. It makes sense because the world hardly changed since 927 so they might as well keep going with the same schtick.
It doesn’t really matter, but worth knowing, only a small amount of your national insurance goes toward NHS costs. The NHS is primarily funded by general taxation. Your National Insurance contributions largely go to paying for state pensions.
That’s an excellent point, state pensions are a significant burden, particularly police. We need to look after those guys so they can continue to prosecute the unwinnable war on drugs.
I open Google, search “am I gonna die”, and if it says probably not, then I ignore whatever it is and hope it goes away. And if it says I am, then I wait for the end to come.
I walk into the emergency ward, take a number, give my id to a clerk, sit down and browse reddit Lemmy for a couple hours, see a doc, get some treatment if needed, and leave with a prescription, maybe a referral, and probably a parking ticket.
I guess I’ll give a non-horror story account from the US. My wife and I are fortunate to be on a good insurance plan though my work, we pay about $200/month total for the both of us out of pocket, and my work covers the rest.
Were on an HMO plan, so basically we have a fair bit of restrictions on which doctors we can see, and finding a new primary is always a pain.
On the brightside, medical care for us genuinely is cheap as hell (besides the insurance cost, ofc). My wife recently cut her hand in the kitchen and we had to rush her to urgent care to get stitches. We didn’t pay anything at the time, and got a bill in the mail for $20 the next month, and that was pretty much it.
We’ve never (thankfully) had any major medical issues that need treating though, so hard to say how something like that would play out in reality.
All that being said, if I lost my job, or if my job decided they wanted to cheap out I health insurance and I was - for some reason or another - unable to get a better job, then I’d be fucked. So don’t misconstrue any of this as an argument against universal Healthcare, just because it works well for me personally
Sounds pretty terrible though. Paying $200 monthly to pay $20 for a simple visit is insane to me. I’m an expat living in Europe (so I don’t have the full privileges of locals), yet I pay about $200 per year for private medical insurance which makes doctor visits pretty much free for me. There is also an extended health insurance from the company (costs me about $20 monthly), which covers drugs, dental health an profilactical visits for free
It’s so interesting that the main point against universal healthcare is that it’s cheaper because you don’t pay in your taxes. Yet the US have taxes and you still have to pay 200$/month, and your employee is paying even more money that would go in your check.
Also, you lose your job and you are fucked, that seems like a horror story to me, how do you not live in axiety?
Rural Guatemala and it’s mostly done through mobile doctors because it’s so remote. We have universal healthcare on paper but the government spends so little on it that the resources are awful and private care tends to be a lot better and trustworthy.
I have been told that Guatemala is private insurance. I provide care in rural Guatemala (Huehuetenango) and was told that the natives have in reality no insurance. If they need medical care they have to travel to Guatemala City and pay privately. Is that incorrect?
Concurrunt public and private system, it’s obviously busier with less doctors in the public system, and it’s free. Specialists too. Expect to wait six to twelve months for a specialist.
Private system is affordableish but on the expensive end, especially with complex issues. Also expect to wait six months for a specialist, in complex cases twelve months is not unheard of.
Medications get capped at $30, unless the government doesn’t agree it’s a useful med, then you pay full price.
Late but USA, wanted to share a personal experience. While at work I collapsed and had to take an ambulance to the hospital. I got sent the bills for everything. Including the ambulance ride. I stayed in the hospital overnight for observation. They couldn’t figure out what happened and I didn’t have symptoms anymore so I was discharged. Whole event cost maybe $500.
Here’s the kicker, I work(ed) as a paramedic for the ambulance company that transported me. I had insurance that was not from the company so prices were reasonable relative to what one would expect in the country. Had I been insured through work, well, the insurance provided by the company doesn’t cover transport by that company’s ambulance.
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