Feeling (down) under the weather

May 2, 2008 3:53 AM

What's it like to be sick in Australia?

Full disclosure: I'm writing a paper for school about healthcare in Australia, and looking for some help. I have found a good amount of information online regarding the healthcare system in Australia, but haven't been able to find any first person account of what it's like. If you're down under, how do you feel about the healthcare system? Does it work for you? What would you like to see changed? Any information would be helpful, and most appreciated. Also, if there are websites out there beyond what I would find within Australia-healthcare-related Google search results, please send them along. Thanks!

posted by um_maverick to health (27 comments total)

I was sick (well, not ill, but a pretty exciting snakebite that made me see acid-trippy colors) while traveling in Australia, if that counts. I got pretty amazing level of attention at a (small) hospital in Adelaide.

They didn't charge me anything (no travel insurance, either) but I'm not sure if that was policy or just a kind act.
posted by rokusan at 3:59 AM on May 2

Based on the few times a year that I go to the doctor - I try to go to doctors that "bulk bill" (this means that the entire cost of the appointment is covered under Medicare, so I just show my Medicare card, and don't pay a thing). Not all doctors offer bulk billed appointments, particularly in the middle of capital cities, but most suburban doctors do. When I can't get a bulk bill appointment, I pay about $55 up front, and then get about $30 of that back from Medicare when I send the receipt for the appointment off.

I go once a year for a contraceptive prescription - that costs me about $20 every three months for the medication itself, and that (as far as I know) isn't subsidised in any way. When I had a much lower income, I qualified for a health care card, which lowers of the cost of medication.

I also have private health insurance (although every time I pay this I wonder whether it's worth it). This means that I get a rebate on "extras" like dental, optical and physio type services. It also means that if I need to go to hospital for something, I can go through the private system, choose my hospital and surgeon and get rebates on those services. If I didn't have private health insurance I would have to go through the public system, and if it wasn't emergency surgery (for example, something like a hernia), I would go on a waiting list for the surgery. For emergencies, you would go to the emergency department of a public hospital, which (I think) doesn't cost you anything. (I'm always had private health insurance, so I've never gone through the public system, but that's how I understand it works).

My husband and I pay about $1600 a year for our private health insurance, which I think is worth it on the off-chance that we need surgery or have an accident. I assume that any treatment in the public hospital system is free, but I'm not entirely certain about that.
posted by miss cee at 4:13 AM on May 2

We had private health insurance, right about the time the ads said if you got it, you could stay 30 for ever (in terms of your health insurance fees). The next month, my son had a hernia, so that was good because his operation was done the next day instead of having to wait for 6 weeks. 6 months after that, our income dropped and we couldn't afford health insurance. Apart from that one hospital stay, for the most part, we didn't use it. Wemostly, like miss cee, to a doctor that bulk bills. When we had really low income, the government subsidised our medications so that we only had to pay about $2.50 per item. I think expensive life saving drugs are subsidised for everyone so that you will only pay about $18 a time, and if you manage to spend $500 on those kinds of drugs in a year, the rest of the year, they're free.

I had both my kids in hospital under the free system, and my daughter had an eye operation when quite small. Compared to my son's experience, the doctors looked tireder and not as rich. Oh and the rooms had more people in them, some of the time. The quality of care was excellent - the only issue, in my opinion, has been the wait. For my daughter's condition, we'd often spend most of the day there waiting to seen an opthamologist for about 10 minutes, and this was a scheduled visit.

There are hospitals that have bad reputations. They find it hard to attract doctors, and have a lot of overseas trained. One particularly notorious doctor is Doctor Jayant Patel, who is apparently responsible for a number of deaths in a Queensland hospital. I think he is Florida based.

The only thing I'd like to see added to the free medical care (if they get the waiting times down) is free dental - not just the school visits etc.

Oh, last February I burned my arm and went to the Emergency ward. I was seen relatively quickly (4 hours) given that I wasn't screaming or bleeding, and my arm was dressed and I was "given" some painkillers. I got the bill for them in the mail a week later - $8. Dang, I said, what's happened to our free hospitals?!
posted by b33j at 4:58 AM on May 2 [1 favorite]

Oh also, if you go to a doctor who bulk bills, s/he will often refer you to pathology services etc that do the same, so there's no question about doing all necessary tests - if you need an x-ray, you get it. If you need a blood test, etc.

Also, I worked for the Health Insurance Commission for a bit, part of the government that deals with pharmaceutical stuff. My job was to take calls from doctors about dangerous drugs (morphine etc) or expensive ones and check patient records to make sure they hadn't already received a prescription for this from someone else, and that's where I learned that the cut off on subsidised drugs didn't exist, you could be dripping pearls and emeralds and still get your drugs at the cheaper rate.
posted by b33j at 5:04 AM on May 2

I've had pretty much the exact same experience as miss cee, having quite a few more medical appointments in the past few months has made me much more aware of the process involved. I think it is quite good overall, but, my British relatives find it less appealing than their own system (except my uncle who's a doctor, he's much more keen on the pay here).

I'm off to see a specialist next week, and my understanding was that appointment was much easier to obtain due to having private insurance. I don't know how true this is as I'm not as aware of how it all works, but when my mum was hospitalized she was able to get a single room of her choosing, have her own doctor's look after her and extras like that because we have private health insurance.

There was a big push in recent years by the government for everyone to get private health insurance, I've personally seen how much it has benefitted my family but it can seem hard to justify when you're all healthy. We had private insurance for 20 years before it was really used, so there's probably something to be said about that.
posted by liquorice at 5:07 AM on May 2

The major misfeatures of the health system here are:

1. Dental health is not included in Medicare. Publicly-funded dentistry is theoretically available, but the waiting lists make it impossible for most people to use.

2. The Government wastes a fairly large portion of the health budget by handing out rebates to people who choose to buy private health insurance, instead of funnelling that money directly into the public health system. As a result, hospitals are generally somewhat underfunded and there are long waiting lists for elective surgery.

Apart from those, it's a bloody good system - particularly the Pharmaceutical Benefits Scheme, which pits Government buying power against Big Pharma to keeps the cost of medicines at affordable levels. I personally trust out health system enough that I have never felt a need for private health insurance. I'm 46.

I would much rather have this system than the dog's breakfast the US has got.
posted by flabdablet at 5:16 AM on May 2

I have a low income Health Care Card and a Medicare Card and I'd have to say it's pretty damn sweet. (If I need to see a Doctor I just go and see one!)

Also my Implanon cost me.. $3.50/$4.50?? IN TOTAL!! (The Implanon alone was $230 without a HCC plus all the Doctors fees involved... Ugh!)

In an emergancy Private Hospitals will treat you (when you have a HCC) if they are the closest hospital. I found this out when I was stung by a bee (I'm rather allergic). After I was admitted the reception lady came in and mentioned my HCC was expired. (It wasn't but that card was old). She took one look at my horrified expression and just smiled and said she'd put it through anyway. The Doctor was excellent too (I really don't like needles) and I decided then and there that this was the way to go when I have babies!

...not an emergancy visit, I mean having private health cover. :)
posted by mu~ha~ha~ha~har at 5:17 AM on May 2

Oh, and for what it's worth: from my point of view as a patient, the Medicare bureaucracy is the most efficient, most effective, least annoying Government department I've ever dealt with. It just works.
posted by flabdablet at 5:18 AM on May 2

For me it's a matter of what's wrong. I have Private health insurance and for pre-planned hospital trips I'd always go the Private option, however for ER scenarios I now always go Public.

Example:
I fell at Christmas and ended up with a horrible wound on my knee that bled for hours and was really painful. I went to a Public hospital and waited for 5 hours to get seen because I was trying to be tough and told the nurse my pain was only a 6 (bumps you waaaay down on the treatment list). Finally they gave me a tetanus, cleaned the wound and sent me home with crutches to come back the next day for X-Rays. Next day I had the X-rays and they decided that there was something in there and cut out a big chunk of glass (pain 10). I went home with antibiotics, the crutches and instructions to call at any time if it got worse. In total I suppose I sat around for 10 - 11 hours, but for (extremely) minor surgery, crutches, antibiotics and a tetanus I only paid $20 for the crutches hire. Had I wanted to I could have paid an extra $20 and kept the crutches.

For ER at a Private Hospital I have to wait as long as I would at a public Hospital and then pay $$$ for it and chase up the rebates later. Frankly - I can't be bothered.
posted by Rubyspicer at 5:31 AM on May 2

I like our health system, at least far better than what I've heard about the US system. At least visits to a doctor are subsidised by Medicare - I'm always completely horrified when I see people on AskMe saying they can't afford to go to the doctor because they don't have insurance. That wouldn't be an issue here. It's not perfect though; the main drawbacks are that there is a doctor shortage, especially in rural and regional centres, and dental is not included in Medicare. Also if you need "minor" surgery, there is a long waiting queue, especially if you are in one of the aforementioned regional centres. My dad needed a prostate operation and was in considerable discomfort for some months, exacerbated by the fact that he lives in one of the aforementioned regional areas.

I have private health insurance, although I've only used it for optical up until now - but I'm glad it's there in case I ever need it. I also have ambulance membership, which means that I won't pay if I need to be taken somewhere in an ambulance. All up it costs about $1800 a year for my partner and me, and like missfee we think it's worth it in case of major problems or accidents.

Bulk billed doctors seem to be hard to find and hard to get into if you're a new patient. I go to a fee-paying doctor in the city near my work, as it's more convenient and the doctor I have found there is wonderful and very thorough. Fortunately it's been a while since I was on a very low income, so paying doesn't worry me at this time in my life. To tell the truth, I don't always claim back my Medicare rebates because I often just forget. I've been bulk billed for several procedures like ultrasound and echocardiogram over the past year, so I ended up not paying a thing for those. Medicare also gives me a free eye test once a year (or maybe every two years, I don't remember).
posted by andraste at 5:57 AM on May 2

Having just returned from overseas, I'm feeling pretty good about the health system in Australia. Like others have mentioned, my GP bulk bills and arranges any pathology and x-rays to be bulk billed. I can choose my GP, I'm not bound by region -- the same goes for specialists.

I recently had $30,000-odd worth of surgery which was fully funded by private health care (I think I might have paid $700 for the anaesthetist). I would have received exactly the same funding from Medicare. It's put me in a position where I don't feel bad paying my private health care fees for about the next 15 years.

Also, pregnant women generally get to see an obstetrician from the word go -- a pregnant friend of mine who has spent most of her pregnancy in the UK will be making her first obstetrician visit halfway through her third trimester when she returns to Oz.

So all in all pretty good (although every system has its gripes, I'm sure).
posted by prettypretty at 5:57 AM on May 2

I have Private cover for optical and dental but not hospital (I'm relatively young and healthy). The only time I've been in hospital was a recent gallbladder attack that had me screaming in pain. I went to Emergency at the local hospital (also one of the largest in the area). There was only two people ahead of me (a VERY quiet night) and I was seen in under an hour and put into a bed. There was a further delay before I was given morphine as a woman was admitted with chest-pains and bumped me down the list. Eventually, I was given a shot, monitored for a while and then sent for ultrasounds. Then I was monitored again and when I'd eventually sobered up and was pain free, I was sent home. None of this cost me anything beyond my usual tax contribution towards Medicare in the first place.

I was lucky. Emergency fills up when the pubs shut and the fights start and on the weekend when more people try to mangle themselves with either sports or renovations. It's not uncommon to wait a couple of hours if you merely have a broken bone and have made it in under your own steam. Breathing difficulty, chest-pains and bleeding take priority and everyone else has to wait.

When my husband tore his hand open with a pruning saw, we went to the local ER and was advised that the wait was approximately 2-3 hours at a minimum. I had stopped the bleeding so he wasn't counted a priority. We ended up going to a 24 hour medical centre (privately operated) that also bulk-billed. He was seen in under an hour and was stitched up, given a couple of shots (tetanus, pain and antibiotics) and was out in 30 minutes. Again, this cost nothing as it was on Medicare.

However, if you've got a dental problem, the free clinics have waiting lists of about 6 weeks for relatively minor stuff and the care is pretty horrible. My mother tried the local clinic only once (she's a pensioner) and was horrified. She and practically everyone I know goes to a private clinic and pays for it. Some money is returned to you via your private healthcare (if you have it). Many dentists will offer some sort of payment plan to offset the cost. The free dental care is pretty infamous - especially in country areas. There was a scandal recently when some Thai dentists volunteered to donate their services. The view tends to be that we're not some damned 3rd world country that needs that kind of charity, but country australia tends to believe otherwise and generally with good reason.
posted by ninazer0 at 6:03 AM on May 2

I think people have covered the technical/financial aspects pretty well.

My personal experience, having moved to Australia from the UK, is that in the big cities at least, there are lots of doctors competing for patients' business.

For instance, I live in a suburb where there are four doctors on one block, all of whom bulk-bill, which, see above, means you don't have to pay.

We recently went to one of these local doctors for a minor ailment, and the surgery had a few patients waiting, and we were told we'd have to wait half an hour. We walked across the street and were offered an appointment with another doctor, with only a five-minute wait. We cancelled the first doctor and went to the second.

We had a baby two years ago (nine monthly ante-natal appointments and tests, delivery, after care etc.) in the public hospital system and didn't pay anything. In fact the hospital wanted to keep my wife longer and she practically had to break out to go home after four days.

People in the family have had to pay, for things like a specialist cardiology consult/ECG, an MRI scan and so on. But the costs were around $100-$150 or so.
posted by AmbroseChapel at 6:51 AM on May 2

I have private insurance free through my parents, as I'm still a student. When I didn't qualify for that for a while, I was paying $50/month for it myself. It's worth having in my case mostly because I wear contacts, but last April I bought six months of contacts, sprained an ankle, got a wisdom teeth infection and got some kind of flu, and I saved the whole years worth of insurance money with rebates that month alone with about 15 physio and doctors visits. (Fortunately most months are not like that).

I had an operation on my legs for bilateral anterior compartment syndrome when I was 17. The orthopaedic surgeon I saw was apparently really good, so he only worked during the school term, which was tough because I was in year 12 and didn't want to miss too much school. This was done privately, and I think if I had gone through the public system I would have waited up to a year longer (and I couldn't have picked the surgeon). I spent about three days in hospital in a private room, and from what I know of the private health we have it shouldn't have cost my parents more than a couple hundred a day.

When I broke my hand playing sport, I went to a public hospital the next day because it was easier. I waited about six hours for xrays, then got an appointment made with a hand surgeon that I missed, and had to make another one a week later. I had the hand operated on about two weeks after I broke it. I didn't pay a cent, including for the occupational therapy I got when the cast came off (also at the hospital).

When I accidentally cut my brothers chin open ice skating on New Years Eve, I took him to a private hospital because it was closer, and he got about ten stitches in it after ~1 hour of waiting, which cost $300 - I think my parents could claim some of that back on Medicare, but certainly not all. We could have gone to our normal doctors or a public hospital, but we were on the far side of the city with no car and this one was just next to the tram line. If I'd known how much it cost I might have gone out of my way, because he wasn't bleeding that much; Mum told me to go to this one, but it was probably a little hard for her to judge the severity over the phone so she was playing it safe. Also, she rang our doctors clinic and they said it would be at least a couple of hours wait at their surgery, after it took us a couple hours to get there.

This year I qualified for a low income health care card, so I don't pay anything to see a doctor, and most prescriptions seem to cost $5. I go to the doctors clinic at uni (only for students and staff) which takes about a week to get an appointment, although they keep some appointments available for emergencies. They have a psychology clinic attached, appointments are free for me (I think they would be even without the health care card) and take about two weeks to get.

There's a dentist at uni that does $20 checkups, or I can go to one and get most of it back through private insurance, but I think the lack of bulk billing for dentists is the big weakness in the system.
posted by jacalata at 6:54 AM on May 2

I hear they have top-notch care for skin cancer, what with all the sun and all. An Australian I know went ahead and had treatment in the U.S., upon her return the doctors thought her treatment was primitive and out of date.
posted by StickyCarpet at 7:03 AM on May 2

Re-reading you post I realize that my previous answer doesn't really answer your questions so I'll try and be more specific:
I'm a renter on a decent income in a (very) high income suburb, so there aren't many bulk billing places where I live. My GP charges $60 for a short visit, $40something of which I can claim back through medicare. Like andraste, I often forget to claim back my rebate, because as I mentioned in my last comment, I can't be bothered (but probably should). (The Dental and Optical benefits from my Health Insurance I use to their full potential though). Something I'm not sure anyone has mentioned yet is that if I go to my non-rebate dentist ($120+ a visit but totally worth it) and they tell me I have to have teeth pulled under anesthesia, I only have a certain number of practitioners covered by what we call 'The Gap' (ie, there is nothing for me to pay between the cost and what my Health Insurance provider will cover). This, as far as I know differs between funds.
Hope that helps.
posted by Rubyspicer at 7:36 AM on May 2

i got hit by a car 5 years ago and broke both legs. i have no private health care. i was taken to the nearest public hospital (which happened to be a pretty good one) and a surgeon put titanium pins into my legs so i wouldnt have casts. i was in hospital for 2 weeks. i was very well looked after. i was in a room with about 4 other people but that didnt really bother me. the nurses and docs were all very nice and helpful and i had a good time there.

the orthopedic surgeon cost $6000 but that was because it was a motor vehicle accident and i was covered by the motorist (who hit me)'s third party insurance. i didnt have to pay any hospital costs.

my mother is always on at me to get private health care. but i believe in the public system and i generally think insurance companies are EVIL! i think they rely on a lot of paranoia and fear to get you to give them your money. i dont want to sound like an angry anarchist. but i do avoid them wherever possible.

my father is a paediatrician and he works in the public system. he totally vouches for the public system but he has private health care for himself and my mum. his attitude is "if you can afford it, why not?" he had his prostate out recently and it meant he got to choose his surgeon and stay in a cushy private hospital in his own room etc. he would have had to wait a long time otherwise.
posted by beccyjoe at 8:02 AM on May 2

ps i live in sydney and it may be better here than regional areas... you need some feedback from some bush dwellers!
posted by beccyjoe at 8:04 AM on May 2

My experience with the public healthcare system is that it is very good with the "non-important" issues eg. "Doc I have a cold can you get me something for the cough and write me a doctor's note for work?" or "I need to get my prescription for medicine x renewed please." And they it is very good with the urgent "HELP HELP I am bleeding and in lots and lots of pain", but lousy with important but not urgent eg. "I am in constant but low level pain and need surgery x to fix it", to the point where I actually went overseas to fix my problem, which was something more dangerous than that above. (I didn't have private insurance and it was cheaper to go overseas and get it treated there than pay the private hospital in Aus.).

Also I have found that the public system you have to have a lot of faith in the doctors and the staff do not have the time to explain to you what is going on.
posted by Gilgad at 9:42 AM on May 2

Expat experience here. Mr. Amusebuche and I had private insurance while living in Australia and experienced an excellent standard of care for both medical and dental. We paid about AU$250 per month to cover both of us. This is a fraction of what we were used to paying for HMO cover in the US through our employers. We had some out-of-pocket costs, but because we came weathered by the US system, we always found these co-pays surprisingly low. I would say that our experiences with the Australian system far exceeded the quality of care I have experienced with various HMO/PPO systems around the US. Less waiting, easier to make appointments, fewer forms, more quality time with doctors who actually seemed to care about my health and wellbeing.

I will also second the outstanding quality of the government pharmaceutical benefits scheme. It is simply tragic that big pharma have convinced US legislators that this could never be done. Australia is a gleaming example of how well this approach works.

When Mr. Amusebuche required an outpatient hospital procedure, his doctor scheduled this at a private hospital on short notice and the standard of care was excellent. They told us exactly what to expect and how long it would take, and then it ended up taking less time than planned. He shared a recovery area with other patients, but the hospital had a practice of assigning like procedures to the same ward, so everyone there was pretty much experiencing the same thing and the process felt very organized. I think we were required to pay a deductable of AU$200 on an expensive series of diagnostic labs, but everything thereafter was covered fully.

However we had a friend (also an expat on private insurance) who broke a leg badly playing sport. He was rushed to a public hospital, and had a terrible experience, waiting more than 12 hours (overnight) to be seen by a doctor (and to get pain meds!), and waiting more than 36 hours for surgery to put pins in the break. Then he couldn't be discharged for another 36 hours because the hospital didn't have discharge staff on Sundays. It was a horrible experience, although when he returned to the US, doctors here praised the quality of the surgical work that had been done.
posted by amusebuche at 10:28 AM on May 2

As an international student, I am required by law to get Overseas Student Health Care. I didn't realize until I got here that there's actually more than one company that offers them - the uni was pushing for one company.

You get pretty much the same Medicare benefits, but no dental or optometry (unless you get a specific plan that covers for these). Uni doctors bulk bill, so you don't have to pay. Other doctors you have to pay (and sometimes it's rather hefty) but you get that money back on insurance claims. It also covers prescription meds, but not contraceptives.

I also got to be part of the Brisbane Mind Program, which gives you 6 sessions a set (or 12 sessions a year) of cheap psychologist treatment. I had to pay quite an amount up front the first time (with a non-bulk billing clinic) but I got all that money back on insurance.
posted by divabat at 4:49 PM on May 2

I have private health insurance, but have many friends who refuse to get it (hey there beccyjoe), because the public system is fine and there's a fear that we're all being pushed into private health care against our will. But if you make more than $50k a year and don't have private health insurance (covering hospital) you're slapped with a Medicare levy at tax time. The govt also gives you a 30% rebate on PHI as an extra incentive.

What's also great is that they included mental health recently under the public scheme (one of the very few positive things that happened under the Howard Govt), so now with GP referrals you can see a therapist for, I think it's up to 12 sessions, I could be wrong, haven't done it myself.

So if they could just get dental care in there we'd all be happy as larry
posted by mooza at 8:01 PM on May 2

I use the public system. Having dental included would be nice - I recently got adult braces, and by the time they're removed I can expect to have paid $6000+. I considered getting private dental cover, but decided that the ongoing costs of insurance would easily exceed the one-time cost of braces (that's pretty much how insurances companies make money, right?)

Every year, Dad buys me an ambulance membership for about $50. Without a membership, a trip in an ambulance would be invoiced at around $500. Pensioners are not charged, I believe. Dad took a couple of rides in the ambo recently, and I'm sure I would never have heard the end of it if he'd had to pay.

Like many others, I get slack about claiming rebates from Medicare. However, there's no real time limit for claiming: I recently sorted through a bunch of old papers and turned up a handful of receipts for visits to the doctor. Medicare put them through without a murmur. One of them was 8 years old. You can even claim the rebate over the phone. Medicare offices are in every metropolitan shopping centre, and the queue times are usually mercifully brief.

The PBS is, as others have said above, extraordinary. A friend of mine who was diagnosed with breast cancer a couple of years ago was to undergo treatment with Herceptin. At the time, a twelve month supply of Herceptin was going to cost her $60,000. Then it was listed on the PBS. She ended up paying a couple of hundred, I think.

There are problems: If you require ongoing treatment, you'll get heartily sick of waiting to see your specialist, having your specialist schedule visits at inconvenient times, having your specialist go on holidays without properly briefing their replacement, and so on. The wait times for non-lifesaving surgery can be months, which is particularly harsh on the elderly. We need more doctors and nurses. We need better regional cover. We are in dire need of better healthcare overall for indigenous Australians, but I can't speak directly to that.
posted by Ritchie at 9:24 PM on May 2

Oh yea, I meant to say that in Queensland, everyone has ambulance cover automatically - it's paid for by a levy on electricity bills, I think. So there are no issues here with having to be an ambulance member, unlike other states.
posted by jacalata at 1:25 AM on May 3

I'm a full time student and can attend a clinic (through my university) that bulk bills, meaning I simply make an appointment, show up with my health care card and pay nothing, and as was mentioned further upthread, every prescription I've ever had to fill (bar some innoculations for going overseas) has been covered by my health care card - medication that would normally be $50+ has cost me about $3.50 - it's a very good system, particuarly if you consistently need a particular drug (birth control, for example).
When I was school aged I spent a lot of time in hospital with various ear, nose and throat problems and many visits to different specialists - my mother tells me that the medicare rebate is the only reason that she was able to afford it. The level of care was fantastic as I remember it, and as my mother does too - though this was nearly 20 years ago, stories from people I know say the same thing: there's nothing substandard about the state hospitals. My most recent trips to the emergency room were in 2003 (rural, 2am-ish on a weeknight with 2nd degree burns) and 1995 (suburban, 5pm-ish on a friday with a broken leg), and both times I was seen pretty much straight away. I've never had much trouble getting a timely appointment at a local GP who bulk-bills, and when I've been working the medicare rebate means I've never been unable to afford to see a doctor - after the rebate the cost of a visit has been about $15-$25 for a 20 minute consultation.
I've heard the same things that have been said further upthread about elective surgery, and would have to agree with the commenters above me - our system is great if you just need a GP/emergency care, but the stuff that falls between the two needs room for improvement. And yes, better dental would be good.
I had orthadontic work done in highschool through the state dental hospital, and though I've heard some horror stories, my own experience was great - I loved my orthodontist and again my mother tells me that the state funding is the only way it was affordable for me and my two sisters to get the work done. That said, if I wanted to get seen now for any work, the waiting list in Victoria is massive - I was recently told something like 18 months - 2 years to get my wisdom teeth out. I know in Western Australia the government subsidises private practices - you can obtain a list of local dentists covered by the scheme and get cheaper rates through them if you hold a Health Care Card (issued to Students, those who are Unemployed/Low Income/Disabled and Pensioners), but they were pretty few and far between back when I lived there, and of course they are hard to get timely appointments with. I did have one dentist under the scheme mess up one of my fillings resulting in me eventually loosing the tooth in question (thank god it was at the back) but I'd put that down to him being a crap dentist rather than the dental system being crappy. I have a friend who recently had her wisdom teeth out privately, and her dentist allows patients to pay in installments after the work is done, but I don't know how widespread this is here or overseas (maybe it's common? I don't know).
I don't know too much about the subsidised mental health care here, but I know people who have been given ongoing (12 months+) psychiatric care completely covered by the government, including medication. I'm told the wait lists are a few weeks to a few months depending on various factors, but that still seems very good to me.
Of course, all this comes from my own experience/what friends tell me, which is what you're asking for but which is not to say that no one has negative experiences - I'm just not one of them. Apart from there being more bulk-billing doctors and better dental subsidies there's nothing else I would ask for - perhaps as I get older and possibly need more healthcare my opinion on that would change, but for now I think what we have is great.
I can't imagine worrying that I could not afford healthcare. As I get older I expect I will pay for private health insurance, but here it's seen as something you buy if you can afford to/expect to need - if I was in an accident tommorrow I know I'd still be well taken care of even without insurance. Like a lot of Australians, the idea of anyone being refused care because they lack insurance is shocking to me, I am so glad we have our system. Hope this helps :-)
posted by sleep_walker at 5:07 AM on May 3

agh
needs room for improvement
by which i mean has room for improvement
posted by sleep_walker at 5:09 AM on May 3

I had a very ill brother (acute chronic asthma). He was in the public system (until he turned 17, I believe). I think the level of care he received in the children's ward was excellent. The level of care he recieved in the adult's section was not so good, as it was optimised for long-term geriatric palliative care, at which point, my parents decided that they would go private for any future hospital visits. Certainly his visits to intensive care were good; he is still alive, after all.

PBS is fantastic, as is the saftey net. My family usually hit it within a month or so of a new accounting period (bunch of sickos, we were).

My experience with the hospital system was treatment for a ruptured meniscus in my knee, which involved occupational therapy, physiotherapy, and various scans over the course of about eight weeks. The waiting time was occasionally tiresome, but by and large, the experience was good. My other experience was being severely burnt by hot oil; I was seen to quickly in emergency, and my inpatient experience was good (I liked the food, even!).

I use the services of several specialists on a regular basis; my upfront costs are high, but the medicare rebate turns a $200 doctor's visit into a $60 one - since these are weekly appointments, the rebate is really quite appreciated.

I pay for private health insurance, as I have poor eyesight, sucky teeth, and require physiotherapy on a fairly regular basis. My dentist offers a 'no gap' service for customers of long standing - I have been seeing him for 22 years now. For me, private insurance is cheaper than paying upfront for the services I need to keep functioning.

All in all, I would rather be sick in Australia than just about anywhere else in the world.
posted by ysabet at 6:27 AM on May 3