I live in Australia, where we have a form of socialised healthcare. However, we also have a private system. This means that we have public hospitals (those controlled by local governments) and private hospitals (those controlled by organisations or companies).
We have a number of systems with quite complex interactions so I will try give you a run-down of how it all works.
Medicare is a federal government-run system (in other words, comes from our taxes) which provides subsidies for medical treatment. An example of Medicare in action is when we see a local general practitioner, we will get charged, say, AU$55. We take our receipt to Medicare and they give us AU$25 back.
The Pharmaceutical Benefits Scheme (PBS) is also a federal government system which means that subsidies are provided for most medical prescriptions. Most CF meds are covered, like enzymes and albuterol, but some are not, like Nasonex and vitamins. A PBS prescriptions costs most people AU$30.
People who are receiving any form of welfare such as unemployment or disability benefits, receive a 'health care card'. A health care card entitles you to cheaper PBS prescriptions (around AU$6) and sometimes 'bulk billing' when it is offered (this essentially means you can get some doctor's appointments for free). A majority of adult CFers don't have a health care card as it's quite difficult to get benefits if you can still work.
Public hospitals will treat you for free but there are huge waiting lists for 'elective' procedures. I see my CF doctor at a public hospital and see him for free, HOWEVER, it takes months to get an appointment.
This is where the private system comes in. Private hospitals offer the same services as public hospitals, but with a large fee. We can choose to join a 'private health fund' for a monthly fee. Different packages cover different things, but generally this means you will get a rebate for private health services that you wouldn't have otherwise. You might pay $50 to see a physiotherapist and get $20 back. Or you might go to a private hospital and stay for a minimal fee. Mid-range private health funds are about $150/month for a couple.
Phew. To answer specific questions:
- CF care is pretty good.
- There are some 'CF centres' and CF doctors but also many pulmonary or thoracic doctors.
- If you needed a knee replacement surgery, I'd say public waiting lists would be at least one year. Privately you'd probably get in within a few weeks.
- In the public system, a doctor is generally assigned to you. Privately you can choose.
Any questions, feel free to PM me <img src="i/expressions/face-icon-small-smile.gif" border="0">
EDIT: Thought I'd mention that our public system would NOT hold up on its own. Even though we are highly taxed there is not enough money for a public system to be the only solution.
