I arrived in Australia two months ago in mid-December. I showed up soon after I was laid off from my previous job in Alaska last November. There is a law in the United States referred to as COBRA (Consolidated Omnibus Reconciliation Act of 1985). This mandates that employers continue to offer health insurance to employees if they leave the company. However, the employee is then usually responsible for the entire premium. Employers in the United States who offer health insurance typically pay most - if not all - of the premiums for the employees. When I got my COBRA quote to continue with the company health insurance it was almost $900 USD a month.
I knew I was heading to Australia but also knew I needed to have insurance. $900 USD a month was way too much. I went on the healthcare exchange to purchase a high deductible plan. Without getting into how much of an ordeal that was, let's just say it was a real nightmare. Eventually I was able to purchase a high deductible plan. The deductible is $5,000 USD per year. Because I was not working I had to estimate an income for 2017. The monthly premium was $560 USD per month. Based on my income estimate I qualified for a subsidy that lowered my cost to just under $100 USD per month. I will probably earn more than I estimated, which means I will end up paying the difference when I do my 2017 taxes.
Many Americans criticize the healthcare systems in places like Australia, Canada and United Kingdom. Most of them have never lived, or even been to, those places but they sure seem to know how bad things are. "Socialism, high taxes, long waits, bad care, death panels," are things you commonly hear from Americans when talking about the healthcare systems that nearly every advanced western democracy have. Keep in mind America spends more per capita, and more as a percentage of GDP on healthcare than any other OECD country.
Getting Sick Down Under
Soon after arriving in Australia I headed up the coast from Sydney to visit some friends. After seeing a buddy who lives near Newcastle I headed to Coffs Harbor to see another buddy. Him and his wife had a pretty bad cough I was hoping not to catch. After five days I headed back to Sydney, cough free. Two days later I started getting sick. I caught the cough in Coffs Harbor! After a week it got really bad. I can't remember ever having a cough that bad. I decided it was time to see a doctor.
Being the American that I am the first thing I thought was how much is this going to cost? Seeing a doctor in America can cost anywhere from $200-500, depending on the reason for the visit or if they are a specialist. That is just for the visit, not tests or procedures. I called a clinic near where I live and explained I am an American and will be paying out of pocket. I asked what it costs to see a doctor, she said $75 AUD (about $60 USD). I was surprised it was so inexpensive. She said I can come down to be seen.
I walked down to the clinic and signed in. I again asked what the cost would be. She says, "$75, this is not America. I lived in America for a few years and we don't have the kind of mess they do." I got checked in and waited for about 30 minutes before the doctor called me in. He was an older guy named Paul, very Aussie. Paul came to Australia with his family from Poland when he was a kid. He asked me what was wrong and then listened to my chest. He also took my blood pressure, weight, etc. This was surprising as in America this is done by the nurse or assistant. The doctor then looks at the chart when he walks in. He also asked me about my general health. We spent about 20 minutes together. I commented this was the longest time, by far, that I had ever talked to a doctor in an office. He was surprised to hear that and said, "Well how else can you get to know your patient?"
We discussed the differences in Australian and American healthcare. Australia has a single payer Medicare system for all. They also have private insurance that people can choose to purchase to supplement the public Medicare system. To my knowledge this is completely private with no government subsidies, a true market system. It is surprisingly very affordable, usually a few hundred dollars a month. People choose private health insurance to reduce wait times or get coverage for things like dental. Paul told me that, yes, some procedures that are not critical require a wait. Wait times can range but I think they can be up to six months for some things. However, if something is urgent or an emergency, you will be taken care of right away.
Paul told me I have a chest infection and wrote me a prescription for an antibiotic. He told me about a nearby pharmacy where I could get it filled. I walked over to the pharmacy and gave the guy the prescription. I asked how long it would take? He looked at me, confused, and said, "Two minutes." I said, "Oh wow, back in US it can take up to an hour" (Never understood having to wait for a prescription in US). He immediately responded, "Mate if it took more than ten minutes people would yell at me!" Two minutes later he gave me the medicine. I was a bit worried about what it would cost. Total cost was $30 AUD (about $23 USD).
I have only been in Australia for a few months but I have talked to a lot of people about healthcare. They are, for the most part, very happy with healthcare in Australia. Whenever the government tries to tinker or privitize the system there is major public opposition. They are also usually horrified when I tell them about the American system. I had a sinus surgery three years ago. It lasted for two hours, I was in the hospital for around five hours total. I had to pay $5,500 out of pocket (my deductible at the time). A month after I got several bills showing the actual amounts billed to insurance. One was from my doctor, this one was $21,000 USD. Another was from the hospital (Providence Hospital is allegedly a non-profit), this one was $25,000 USD. A third one was from the anesthesiologist, this one was $2,000 USD. For a grand total of $48,000 USD for a two hour procedure.
I am by no means an expert on the Australian healthcare system but it seems to be a much better system than the dumpster fire of a system in the United States. I tell people that healthcare in America is really good if you are rich and not bad if you are poor. If you are middle class then you get screwed. Middle class people don't qualify for Medicaid but also end up paying a huge percentage of their income for healthcare. If someone wanted to invent the most complex, bureaucratic, and inefficient healthcare system, they would only have to look at the American system. Unfortunately, the lobbying power of the insurance and pharmaceutical companies means things are unlikely to change. America could learn a lot from the Australian healthcare system.