I live in New Zealand, so this is hyper specific to how our healthcare system is set up, other countries will have radically different systems.
The way it works in NZ is that all hospital visits are free, and all medicine dispensed within the hospital are free. Visits to your GP are free if you are under 16, over 65 or pregnant. Medicines prescribed by your GP have a price cap ($100NZ/year/person iirc), as long as they are on the “Pharmac” list.
The 2 main caveats to this:
Hospitals don’t have infinite capacity. If you need non-acute treatment (ie, you aren’t going to suffer serious harm by not getting treated immediately), you could easily be waiting a year to see a specialist
Pharmac. The way the government ensures that drug prices stay affordable is by giving a government agency a big chunk of cash, and telling them to use it to buy the drugs that are going to have the best “bang for the buck”, and use the bulk purchase negotiating power to get as good a price as possible - hospitals pretty much exclusively prescribe Pharmac drugs because they don’t have the budget to buy anything else. This means that in general, if you’ve got something common, the drugs you’ll need will probably be on the Pharmac list and you’ll not have to pay anything, but if it’s rare, or you want a newer more expensive treatment, or you just get unlucky and need a drug that Pharmac doesn’t cover you can be in a really hard spot.
Private medical insurance does exist, and is pretty much there to let you “skip the queue” - there are private hospitals not funded by the government that employ their own specialists (who typically also work in the public system) - or to fund drugs that Pharmac won’t. Is fairly common in mid-end white collar jobs (especially finance and tech) to have private insurance paid for by your employer, but is pretty much just there for “what if I get an exotic cancer” or “what if I fuck up my knee and don’t want to have to wait a few months for surgery”. My wife needed her gall bladder removed a couple of years ago, and we just used the public hospital even though we do have insurance that might have paid for private - the public system is excellent for 95% of things.
If you need non-acute treatment (ie, you aren’t going to suffer serious harm by not getting treated immediately), you could easily be waiting a year to see a specialist
This is also true in the U.S. entirely for-profit healthcare system. I had to wait over 9 months just to get an appointment with a new neurologist when my previous one retired.
It’s also something that a lot of Republicans claim is a problem in countries with socialized medicine but not in the U.S., which always gets a derisive laugh from me.
Yeah, I get that from the US perspective the idea of there not really being a hard price tag on everything is a bit odd - the US system is bonkers and confusing from the outside as well (and it kinda feels like that’s by design).
Another example as to how this works in practice; my daughter was born a couple of years ago
As soon as we found out my wife was pregnant picked a midwife from the list of available ones in our area (we talked to 3, picked the one we liked the best)
We saw her once a month for the first 2 trimesters, then weekly from then
We got ultrasound scans every 8 weeks to keep tabs on development
Due to some minor complications we saw an OB/GYN at the hospital a couple of times
My wife needed to be induced, and there were some more complications during delivery so our total hospital stay was 9 days
She had an epidural, and needed a pair of specialists to help deliver the baby
We kept seeing our midwife fortnightly for 3 months after birth
We saw the OB/GYN again after that to check in on the complications and make sure everything was ok
Our out of pocket expenses were
The ultrasounds, because we chose to go to a clinic near where we lived
Parking
The insurance excess for when someone put a dent in my car door in the carpark
Food delivery for me for the time we were in hospital; I could have got very cheap meals from the canteen, but didn’t really fancy any of it
Grand total was less than $500 NZD (not counting the insurance excess), and we could have avoided the majority of those costs if we wanted to.
Not saying the system is perfect; it’s functionally impossible to get mental health support publicly, dental care isn’t publicly funded if you are over 18, it seems like nurses and junior doctors have to constantly fight to get pay rises that keep up with inflation, and the system as a whole has been chronically underfunded for decades - but we don’t have people choosing between death or bankruptcy, and we have higher life expectancy so shrug
Sort of.
I live in New Zealand, so this is hyper specific to how our healthcare system is set up, other countries will have radically different systems.
The way it works in NZ is that all hospital visits are free, and all medicine dispensed within the hospital are free. Visits to your GP are free if you are under 16, over 65 or pregnant. Medicines prescribed by your GP have a price cap ($100NZ/year/person iirc), as long as they are on the “Pharmac” list.
The 2 main caveats to this:
Private medical insurance does exist, and is pretty much there to let you “skip the queue” - there are private hospitals not funded by the government that employ their own specialists (who typically also work in the public system) - or to fund drugs that Pharmac won’t. Is fairly common in mid-end white collar jobs (especially finance and tech) to have private insurance paid for by your employer, but is pretty much just there for “what if I get an exotic cancer” or “what if I fuck up my knee and don’t want to have to wait a few months for surgery”. My wife needed her gall bladder removed a couple of years ago, and we just used the public hospital even though we do have insurance that might have paid for private - the public system is excellent for 95% of things.
This is also true in the U.S. entirely for-profit healthcare system. I had to wait over 9 months just to get an appointment with a new neurologist when my previous one retired.
It’s also something that a lot of Republicans claim is a problem in countries with socialized medicine but not in the U.S., which always gets a derisive laugh from me.
This is a great explainer but I do want to let you know I chuckled at “mid-end”.
Thanks for this! Starting to get my head around it 😃
Yeah, I get that from the US perspective the idea of there not really being a hard price tag on everything is a bit odd - the US system is bonkers and confusing from the outside as well (and it kinda feels like that’s by design).
Another example as to how this works in practice; my daughter was born a couple of years ago
Our out of pocket expenses were
Grand total was less than $500 NZD (not counting the insurance excess), and we could have avoided the majority of those costs if we wanted to.
Not saying the system is perfect; it’s functionally impossible to get mental health support publicly, dental care isn’t publicly funded if you are over 18, it seems like nurses and junior doctors have to constantly fight to get pay rises that keep up with inflation, and the system as a whole has been chronically underfunded for decades - but we don’t have people choosing between death or bankruptcy, and we have higher life expectancy so shrug