• Zarobi@aussie.zone
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    5 days ago

    It’s not that bad yet, but I feel like we’re on the way there. Luckily we still have a pretty good public sector for emergencies. But there is no public sector psychiatrists, at least not around here. So you’re covered for some things but not others, especially specialist treatment. That’s why I specified appointment, because most of the time appointment refers to private sector. And outpatient stuff, but the line is confusing and arbitrary.

    For example,

    • Dentists are essential but also elective.
    • The hospital will cast your broken leg for free but you’ll pay a lot for the rehab physiotherapy privately.
    • They’ll CT scan a tennis ball sized tumour for free, but refuse to remove it because even though it’s growing it’s “benign” i.e. if it won’t kill you then we don’t care.
    • Two doctors will cost wildly different prices even though both use Medicare.
    • You can go to the hospital 10 times for the same cardiac problem for free, but getting it investigated or fixed is private, unless you’re critically in danger.

    It’s hard to know whether something will cost you or not until you try and get it treated. It’s very “reactionary” instead of “preventative” is how I’d describe it. Like they’ll chop off a diabetic foot for free, which is hugely expensive medical procedure requiring a surgeon, but seeing a dietician to learn how to manage your diabetes costs $200+ per appointment.

    I almost feel like if I had to choose, the reverse should be true. Focus on preventing problems rather than putting out fires.

    • Tollana1234567@lemmy.today
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      4 days ago

      dentists, dental procedures are barely covered in the states as well, only a very limited amount of dentist, or dental specialist will even accept medi-caid/care. so you might have to pay outof pocket anyways.

      usually the dentists on these programs, are less than what you call decent, they may do something so-so, but might be not keen other things wrong with your teeth. and at least one here at has earned the reputation in our area, as peddling deep cleaning, which is a known scam.

    • Jessicat@lemmy.world
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      4 days ago

      Having such a reactionary approach is counterproductive, I agree. I know people for who psychiatric care is not optional, they’re doing fine on the right meds though that requires monthly follow ups. That would cost a fortune! Also not covering physical rehabilitation is confusing as it’s pretty much needed after surgery, how are people supposed to regain as much function as possible?

      Our health insurance here costs $600 per person per month but then it covers specialists with a $40 copay, includes vision and dental. Basically if you can afford private insurance it’s manageable but that’s a horrible way to design the system since you often loose your insurance if you change jobs.

      I miss the French system, it’s not perfect but it was more affordable and teeth were not considered optional. The main inconvenience that I remember were the wait times so you just have to be organized for your routine care and it’s no problem.

      • Zarobi@aussie.zone
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        4 days ago

        Yeah exactly… It’s emergencies only really then you’re on your own. I needed 20 physiotherapist appts after a severe car crash, thankfully we have special insurance specifically for car crashes that is very good, but if the same thing happened from a random fall or something then idk what I’d do.

        Interesting how insurance works differently around the world. It’s really weird here. Most people here in AU have private health insurance, even though it does absolutely nothing for them. I ran the numbers myself. As an example, you would pay $1200 a year for something you can max optimistically get $600 value per year from, and that’s after multiple years of building up “trust”. There’s clauses like, only these specific kinds of treatment, only $x per year, only x% of each treatment covered, etc… It’s extremely restrictive. But if you tell anyone, they’ll get mad and say you’re an idiot to not have this scam health insurance. It’s better to self-insure here and just try to have ~$1000 set aside for health emergencies.

        • Jessicat@lemmy.world
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          4 days ago

          Glad you were covered to get back on your feet.

          That all sounds quite complex to navigate. Crazy with all the tech and resources that we have available now and these are the systems that were designed.