this post was submitted on 30 Sep 2023
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Not on a theoretical level, but how would you practically have to pay costs, access specialist doctors?

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Poorly. USA

[โ€“] ryannathans@aussie.zone 2 points 1 year ago

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.

[โ€“] dan@upvote.au 2 points 1 year ago* (last edited 1 year ago)

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. ยฏ\_(ใƒ„)_/ยฏ

[โ€“] TheGalacticVoid@lemm.ee 2 points 1 year ago

In the US with private insurance. I basically just go online, search for providers in my insurance's network, and then check a different list of different procedures and their costs according to my insurance. Sometimes it's $30 if I'm seeing my main doctor, $30 for a specialist, $40 for urgent care, $0 for a specific telehealth provider, 20% for an ER visit etc. The main thing I genuinely like about my plan is that the monthly out-of-pocket price cap for generic medications is pretty low. That being said, I know a few people who pay $0 for 90% of what they need with everything else being cheap

[โ€“] Shotgun_Alice@lemmy.world 1 points 1 year ago
[โ€“] bitsplease@lemmy.ml -1 points 1 year ago (2 children)

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

[โ€“] thepreciousboar@lemm.ee 3 points 1 year ago

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?

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