[scorpioxy]

Oh yes. Quite bad and I don't know if things are getting slightly better than "bad" or the media is tired of reporting about it.

Up until a year or so ago, an appointment at a GP would take weeks of waiting. Specialist appointments were 1+ years waiting time. This is somewhat better now with the establishment of critical-care clinics operating after hours. This is from personal experience.

The emergency rooms often had waiting time of 12+ hours(or more). I know someone who has been waiting on a procedure at the public hospital for 6+ years. Another has a child waiting for an appointment with an estimated wait time of 3+ years. All non-urgent but a wait list in the years is no longer a wait list to me, it's a system that is not fit for purpose.

Initially all of this was attributed to the pandemic and the harsh lockdowns in Victoria. But a few years out, it seems difficult to still do that. When asked, our government just re-states that they've invested in this and that and then deflect. Recently, due to the horrible state finances, the healthcare system was being downsized with services cut and the bloodshed continues. This is without talking about the systemic issues and incompetence I've seen.

The funny thing is that outsiders think that public health care means free. It's really not. We pay for it on top of our income tax(1-2% on top, more if you're above a certain threshold) and it is not cheap. It wouldn't be so bad if it was working like you'd expect but paying for a non-functional system is....I don't know what to say.

[d0ublespeak]

This isn’t an inherent flaw of public health care. A lot of the health care problems in this country (Australia) stem from a continued disinvestment in the public system after a decade (prior to the current government) of conservative mismanagement. Most state funding here comes from the federal governments standard sales tax. They intentionally gimped our public system to fund a private system that isn’t financially viable. Reversing that is going to take time. The problem exists it’s just important to attribute it to the correct sources. Medicare (our public insurer) is an incredible privilege that we should protect and hold our leaders accountable for managing.

[scorpioxy]

I don't understand where you got that I am saying public health care systems are flawed. Both systems have pros and cons. And I have seen the "going to take time" phrase for quite a long time now and so don't think it holds any value anymore.

In terms of affordability which you also referenced in a separate comment, I disagree. Compared to some prices I've seen in the US, it is cheaper. Compared to other countries I've experienced, it is more expensive. Comparing private and public systems is not straight forward and I don't think this adds any value to the discussion.

In terms of attributing failure to correct sources, Victoria hasn't had a "they"(who you're claiming gimped our public system) for many years now but I am not interested in a discussion about politics.

[sqrt_1]

I think it is mostly just a problem with Victoria - and they are are hardly conservative. Hospitals and ambulance service is a state issue and other states fair much better.

[shushpanchik]

That's not nearly true, at least for Melbourne as a metro area. I never heard of weeks waiting for GP appointment, and I never waited for more that 2-3 days for GP both in east and west suburbs. Usually you have at least 3-5 GP medical centres in 5 km radius, and in half of them appointments are avaliable same day or next day. That's the case now, and was the case 5 and 10 years ago, with only obvious exception during COVID. 6+ years wait could occur, but it would be ~1% of elective surgeries. Basically, elective surgeries are covered by private healthcare, that's the unofficial limitation of Medicare. I got an elective surgery twice, wait was 4-6 months. Just to stress, that's an elective surgery fo non-life threating condition that just affect your quality of life, so it's reasonable to expect people paying up private insurance/hospitals for getting this done quickly.

Emergency 12+ hours wait is not an ordinary situation - could be when there is a combination of very busy night (like Friday during long holidays) and lowest triage category. Every time I attended emergency I was almost immediately triaged and when things were serious, was admitted in minutes. When it was just a cut with bleeding stopped, I was advised after triage that I can wait for 4+ hours or just come back in the morning. All my friends had the similar experience with Melbourne's public hospital ERs.

2% medicare levy is cheap compared to taxes in other countries with free healthcare.

I'm actually very surprised that someone has such negative impression about Melbourne's medical system. There was a short period several years ago, related to COVID, when ambos ramping time could be hours, but that's not not typical for Melbourne, and was resolved pretty quickly.

[scorpioxy]

That's incorrect. I'll choose a couple of points to correct.

For the "elective" surgery, it's false to state that they are covered by private healthcare. There was also a push to move away from the term "elective" to something like "non-critical" if memory serves. Simply because a knee or hip replacement, as an example, isn't really something you can choose to do or not do when you're unable to walk. You can wait for a few months perhaps but since it affects your quality of life, including your ability to earn an income, then it's not a choice.

For the 1% claim, that's unlikely considering all the "operating blitzes" that had to be done in Victoria to decrease the huge list(the numbers were reported by the media if you're interested).

The pandemic lockdowns wasn't "several" years ago and the effects were felt long after, definitely not a "short period". You're forgetting to mention the ambulances writing on their vehicles where they're coming from and how long were their shifts just last year. Ramping is also still a problem but I am reading less about it in Victoria since the beginning of this year. Again not sure if it is better or just less reporting on it.

I'll grant you that some people don't get to experience this side of the system and some are lucky that they don't need it at all. Hopefully the more people talk about their negative experiences, as opposed to being surprised, the more accountability and improvements can be introduced. It can be a very good system if it was better maintained.

I'll refrain from commenting any further on this topic and thank you for your contribution.

[tecoholic]

Wow. I didn’t know that things are this way. I am a recent immigrant living close to the city and always seem to be able to see a GP on the same day. Is that because I have private insurance and I pay out of pocket anyways? If I were a citizen, I wouldn’t be able to go to those places (at least for “free healthcare”), and will have the same wait times? Or is it geography dependent with rural Victoria having issues and Melbourne city being well covered?

[scorpioxy]

It depends on the location and it depends on what services you're after. If you have private healthcare insurance, you get to skip the wait times at hospitals and get a choice of public or private hospitals. For clinics, it's a different story and can get quite detailed. The private insurance can help you with the payment there but not wait times.

For some regional and rural locations, the wait times can be better or can be worse than metro depending on the service.

By the way, I also pay out of pocket on top of the medicare rebate so my experience is not with bulk billing clinics. When you get access to medicare, you'd probably still need to pay out of pocket on top of the rebate as bulk billing clinics have all but disappeared. Recent government incentives aim to bring them back but with cost of living increases I doubt that'll work.

[koolba]

> The private insurance can help you with the payment there but not wait times.

That must be a great deal for the insurance company. If it takes multiple years to get an appointment, they must pay out significantly less claims as well.

[tecoholic]

Thank you for taking the time to explain.

[d0ublespeak]

With seeing a doctor we have two main systems that you can use and each will have a different waiting time. Bulk-billing and the fully public option has longer waiting times because there aren’t enough clinics/specialists or doctors, The reasons for this are complex but they stem from an unwillingness from prior governments to raise the amount the government pays for each service to adequately to support this system meaning less doctors and practices being willing to support it.

You’ve then got practices/specialists etc… that charge copays and they tend to have less waiting times because less people are willing to pay copays. A lot of these practices will also do outright private billing which is what you’re experiencing.

[tecoholic]

Got it. In India, I am used to the concept of Government hospitals vs Private hospitals. Things are pretty clear on how they work. Insurance was introduced a couple of decades or so back in my home state, which allows people to use private hospitals at govt expenses (premiums paid by govt), but it’s still heavily govt (free) vs private (paid). Here it seems like there are no “govt hospitals” if I understand correctly. So things are a little more complicated.

[0_____0]

I pay ~500 US/mo for health insurance. Just for me, no dependents. Not an exotic low-deductible health insurance plan. 2% on top of income tax sounds like a dream.

[scorpioxy]

It's actually anywhere between 1%-5% depending on your income but I didn't want to get too detailed in my comment. And you'd still have the absurdly long wait times. And the out of pocket expenses. Again, not a problem if you can actually make use of what you're paying for.

I do have to state though that the US healthcare system, minus the fact that most healthcare research/advancements happens there, is crazy.

[shushpanchik]

I don't think anyone pays 5%, practical limit would be ~3% (2% levy, and ~1% for cheapest private insurance to be exempted from levy surcharge)

[scorpioxy]

I am not confident enough to say that someone in Australia does or doesn't pay the 5%. I can ask the ATO but otherwise can't know. I am stating the range of how much it is.

[d0ublespeak]

It can be less/more than 2 percent too dependent on income. But yes we are extremely blessed in this country with a healthcare system that isn’t perfect but is extremely affordable.