Medicare

grannynurse FNP student · Feb 24, 2006

Hi all,
Got a phone interview coming up with the Alfred Hospital in Melbourne (coming from the UK) and just realised that I don't fully understand the whole Medicare thing!
Is care at the point of delivery completely free? What about GPs, prescriptions, ambulances etc? Basically I'm trying to compare it to the UK system of a National Health Service which is funded by National Insurance and taxes and is completely free (and dying under the strain, buts thats another story!).
Can anyone describe it briefly or point me to a link? I looked at a couple of things on the net, but got a bit muddled with which bits have to be paid for (bulk billing, what does that mean??!!). Then again I was looking during a night shift, not really the best time to try to understand anything!!

Are you asking about U.S. Medicare? If you are, go to Medicare. gov. Medicare is not free. We have deductables we must meet. We have approximately 80% of our bill paid. We are responsible for the other 20%. And you do not want to know about Part D.

Grannynurse

gwenith, BSN, RN · Feb 24, 2006

Our system might seem a little complex to the outsider. It is based on the fact that no-one should face an excessive burden of cost.

Medicare - free hospitals, and a basically subsidized pharmacy and GP visit cover. If you are a pensioner or have a health card though you get charged less "Bulk billed". This was a nod toward the statistical fact that the older and poorer populations have more health problems and were less able to pay.

This website is a reasonable explanation as well as quiding you in what you might expect when you get out here.

http://www.health.gov.au/internet/wcms/publishing.nsf/Content/ozhealth-visitors

grannynurse FNP student · Feb 25, 2006

Our system might seem a little complex to the outsider. It is based on the fact that no-one should face an excessive burden of cost.
Medicare - free hospitals, and a basically subsidized pharmacy and GP visit cover. If you are a pensioner or have a health card though you get charged less "Bulk billed". This was a nod toward the statistical fact that the older and poorer populations have more health problems and were less able to pay.
This website is a reasonable explanation as well as quiding you in what you might expect when you get out here.
http://www.health.gov.au/internet/wcms/publishing.nsf/Content/ozhealth-visitors

Gosh, does this mean I can stop paying on my in-patient deductable charges, which are now over $7,000 because of several admissions, none being within the golden three month period? Sorry but hospitals are not free, nor are ER visits, nor are physician visits. They have a 20% billing directly to me. And Part D is something that I and other disabled and elderly, are still attempting to figure out. Or are you strickly talking about your own country and not the United States Medicare system.

Grannynurse

gwenith, BSN, RN · Feb 25, 2006

Granny - you are posting in the Australian and New Zealand forum. we are talking about our health care.

Home Health Columnist / Guide · Feb 25, 2006

Australia's Medicare system completely different that US program. Since post is under Australia forum, they are talking about their countries program. Check out Gwenith's link that describes the program.

In the US, one can obtain a Medigap policy that covers the 20% cost of Medicare part B deductible. It is cheaper in the long run for those with chronic health issues and frequent hospitalizations.

grannynurse FNP student · Feb 25, 2006

Granny - you are posting in the Australian and New Zealand forum. we are talking about our health care.

OOOOPPPPPPSSS I'm sorry. I hear MEDICARE and I think only of the United States. I never thought of another country using the same term for a similar type of delivery. Sounds like you have some of the same problems we do.

Grannynurse:rolleyes:

grannynurse FNP student · Feb 25, 2006

Australia's Medicare system completely different that US program. Since post is under Australia forum, they are talking about their countries program. Check out Gwenith's link that describes the program.
In the US, one can obtain a Medigap policy that covers the 20% cost of Medicare part B deductible. It is cheaper in the long run for those with chronic health issues and frequent hospitalizations.

I know this is the wrong thread but if you are disabled and on U.S. Medicare, most of us cannot afford the 'gap' policy. Pre-existing conditions cause the cost to go just too high for most of us to be able to afford it.

Grannynurse:rolleyes:

prmenrs, RN · Feb 25, 2006

Returning to your originally scheduled thread........

gwenith, BSN, RN · Feb 25, 2006

The huge difference that I can see between the US and Australian systems is that there are inbuilt "safety nets" within the Australian system. If your pharmacy bill is over X amount per year - you get medication almost free (In some cases it is free but I am not comfortable with that as it can lead to abuse). If you choose a "bulk billing" doctor (one that only charges what medicare will rebate) then you don't have to pay for GP visits.

Our system has problems - lots of them (just ask our state Premier at the moment:chuckle) BUT it has the advantage of there being private cover if you want it or a public service that is "no frills".

littlehobo · Feb 26, 2006

OK,

So as I unerstand it, if you are admitted to a public hospital, medicare foots the total bill. If you go to a private hospital, medicare pays part of the bill and insurance pays the rest. If you go to a GP medicare pays part of the bill (unless he bulk bills, in which case he pays all of it).

Does that sound right?! What about ambulances, are they covered by medicare? Presumably only public hospitals have ER departments, and private hospitals only do elective admissions?

And this is all paid for by a percentage deduction on your salary? Sounds like the system this country should move towards as completely free healthcare is starting to strain the koffers!!

gwenith, BSN, RN · Feb 26, 2006

That is it essentially. Here in QLD Ambulance cover is free as we pay a levy with our electricity bill. The other states have other methods. Do check out that website I linked because it is is specifically for tourists;)

Private hospitals DO have ER's - but it costs about $50 minimum to be seen there - mind you you do get seen straight away:D

You would be surprised at what the Private hospitals cover and care for. The BIG money spinner for them of course, is Cardiac - angio's bypasses etc.

The big thing is that Private cover allows you to jump any waiting queues. Especially in relation to elective surgery. i.e. a lot of orthopedic problems such as knee and hip replacements which under the public system may have waiting lists varying from months to years - get done straight away under a private system.

Is the system ideal? Hell NO!! But it is a darn sight better than many other countries.

Pharmacy might take you aback because we have only a limited range of medications - this is because the PBS system only allows a handful of same or similar meds in each group to be on the market.