5 December 2005

Comparative Medicine - US vs Australia

Last night Rose was feeling absolutely miserable - in pain from a sore throat and slight temperature. So from 10:00pm onwards she dozed for 10 minutes and then awoke screaming. It made for a very sleepless evening for everyone in the house.
Today we went to the doctor's and obtained a prescription for Rose's throat and made sure it wasn't anything more serious. Today Rose just stayed attached to Lana. Just like previously.

I was reminded of the difference in medical systems. This country practice of two doctors has one full time admin assistant. We walked in and let her know we were in and she gathered our files ready for when the doctor came out. He finished with a patient and then gathered the next file calling their name. When Rose's name was announced we went into his office and he asked what was wrong and examined her for various symptoms. On his computer screen was any history he had of the patient (none for Rose) and then entered his diagnosis and prescription on the computer. The prescription printed and we left together, paying our bill whilst he saw the next patient. Very efficient and anyone could read the prescription. No duplicated data entry or chance for transcription errors. And the total cost - not counting the government rebate for which our taxes pay - was $44.00 AUD (about $33 US) The prescription cost $14.95 ($11.20 US) with no insurance discount.
The US comparison?
A two doctor country practice has between six and eight extra staff. The appointment time and time you are called are mutually exclusive. You arrive at the scheduled time and enter your name on a list then join the other hopeful patients who have been waiting for ages. About an hour or more past your appointment time you are called by a nurse/assistant who takes your weight and blood pressure as you are led to a small cell. Between 10 and 30 minutes later the doctor rushes in and tells you what is wrong with you and determines his favourite prescription. He then rushes out and you wait in the cell until he returns with a piece of paper that allegedly has your name and prescription written in heiroglyphics. Then you go out and pay between $75 and $125 ($100 AUD to $167 AUD) before insurance. The prescription will be between $10 and $30 US ($13.50 and $40 AUD) after insurance. You just hope the pharmacist is able to translate the handwriting and gives you the right medicine and dosage.
I have excluded the Australian rebate provided by the government scheme. The price for the Doctor's visit is determined by the practice and is not controlled by government policy. The primary difference is the level of computerisation. Any government or insurance paperwork is provided by the computer system.

2 comments:

One who listens said...

Wow. Makes me really appreciate the NHS. The cost of a prescription is about £7.

Mind you, taxes are high. :)

Owl.

DavidofOz said...

Hi Owl. Thanks for dropping by.
We really have a hybrid public/private system in Australia. That way we try to get the best of both - a health safety net for everyone, with access to specialist care and services for those who don't want to wait. Also enough scope for profit to allow innovation, and an Insurance industry which hasn't taken over the system.
It is very scary in the US without any health cover. Our health insurance cost $1400 (US) per month!