2010年7月26日 星期一

羊毛出在羊身上的醫療保險

移民初踏足澳洲,請趕快登記申請澳洲聯邦政府的國民醫療卡(Medicare),看醫生會獲得發還全部或部分診金----視乎該醫生的經營方法和收費高低,藥費必須自付。

生活在澳洲最怕入醫院,公家的醫院便宜,服務及得上香港的私人醫院,壞處就當然是不夠床位,如非生死攸關不會收你。你病得未死但辛苦到不想等,或指定由某位私人執業的專科醫生為你做手術,就要入私家醫院。私家醫院好到像住酒店或度假村一樣。

私家醫院收費貴到嚇死人動不動就是萬萬聲。投保醫療保險(澳洲也叫 Health Fund),可以代付大部分的住院費。人老了,死也未必怕,最怕病和窮,有醫療保險就心定了。


但這世界哪會有免費午餐呢?澳洲的 醫療保險乃私人經營的商業,兩家最大的醫療保險是Medibank PrivateMBF,還有幾間規模小一點的;前者雖然政府注資和控制,總的來說還是自負盈虧,不可能賠本來益街坊,不夠錢就加價!

保費一定是年年加的啦,算起來這十幾年來已經加了接近一倍,現在我夫婦兩人一個家庭單位,買最基本的一種,一個月要160澳元。

醫療保險互相競爭,為了招徠客人,不是鬥平,而是推出種種的「福利」,如此問題來了。

除了津貼傳統的西醫治療開支,近年也加入物理治療、針灸、治療式按摩等等的另類療法。大多數人反正付了錢,不用白不用,就把每年津貼的限額用到盡,例如有事無事都去relax 下,按按摩。有個朋友是算死草,坦言看物理治療是當為一種「娛樂」。現在澳洲的按摩場所越開越多,想做的話讀幾個月的訓練課程便可以註冊領牌,在家中車房也可以開檔營業;一個鐘頭收五六十澳元,還是其門若市,要預約才有得做。

初來澳洲的一兩年我沒有買醫療保險,後來政府鼓勵國民投保醫療保險,減輕公家的負擔,實施政府津貼40%的保費,登時人數大增;但是跟著保險費年年加,就算有政府津貼還是很可觀的數目!

醫療保險為了控制「濫用」,大很多服務退款都有要用家「墊底」若干的要求。

這可滑稽了,記得十多年前自付洗牙或拔一隻牙只是50澳元,現在牙醫知道你是claim醫療保險的,收費都不一樣!其他的項目,有理無理都做到足----照一兩張X光片,又是幾十元,洗完牙叫你張大嘴巴,噴一堆所謂加氟的泡沫在口中,說是防止蛀牙又保護牙肉,但是含半分鐘後就吐出,到底有甚麼效用?天曉得。這一劑要收幾十元的呢,是最容易賺的治療。

現在半年做一次的例行檢查,就算不須補牙,埋單二三百元不出奇,病人一樣要墊底幾十元。

前幾年,醫療保險為了搶客,推出每人可毋須墊底claim 200元買運動鞋。多做運動促進健康,少看醫生,其本意不壞。結果人人買他兩三雙運動鞋,你知我知,大多只是用來日常穿著,與做不做運動全無關係。醫療保險在這個項目上支出浩大,「一鑊玩殘」,第二年都不敢這麼笨了。

(文章允許轉貼,請具作者名字:梁煥松)

37 則留言:

  1. 無辦法,不敢不買額外醫療保險
    我的case,就是明明無此需要每年配一對眼鏡
    所以說,任何醫療制度都有它的好處和流弊
    當年我在香港服務的機構
    每年有一定最高數額的免費看醫生quota
    於是每年臨近年結
    大家有事無事都去看醫生
    而醫生也識做
    無病當然無藥但有護膚品送
    死未

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  2. 我不做按摩、針灸、物理治療很多年了,無事都去?浪費我時間!
    只claim配眼鏡和牙醫,可以算是蝕了俾佢。

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  3. 我比較好一點,要看chiro,所以用一下health fund,不然的話,只有一年去換換眼鏡,半年去看看牙醫,沒其他了...不過說到尾,唔需要用好過需要用...

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  4. Have you seen Sicko by Michael Moore? A former hospital CEO was on the brink of bankruptcy because of a serious illness that the health insurance company refuse to cover. A man who cut two fingers accidentally had to choose between the index finger and the middle finger, because he could not afford to pay for both reconnections...
    That's the sorry state of healthcare here in US. Those opposing the healthcare reform often mention medical frauds and abuses and the national debt. Universal healthcare according to them is "socialism". Yet, they were all too willing to bail out the riches during the financial crisis. Because those opposing the reform are ones who have access to healthcare--they ARE the riches... I have been working at a pharmacy for about half a year. And I have seen first hand the waste and abuse. However, I still believe some kind of basic healthcare should be provided for everyone. Abuse is a totally separate issue. It should not be the excuse. Since I am only a part-time employee, I do not qualify for any health insurance through my job. It's like walking on a wire everyday...
    FYI, private health insurance premium can cost US$1000/month. That's why most people in US depend on employer sponsored insurance. When I was working full-time, I was paying about US$240/month for the health insurance for me and my husband.

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  5. Raymond上午9:47

    曾患罕見怪病,想買醫療保險也會很貴的了。

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  6. linerak,
    講真我都希望永遠不用Claim,供死會都無所謂!

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  7. 美國保費更勁!
    聽講在大陸,無錢的話,死在醫院門口都唔收你。
    相比之下,香港算是不錯的了。

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  8. Raymond,
    祝君健康,用不到它。

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  9. 大陸的醫生做手術得附一定數量的「紅包」,要不然病者得到的服務半生不死。中央電視台也曾作出報導批評,但批評歸批評,大陸的醫生多還是醫者父母「金」,很可怕。

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  10. 不用介意蝕底,最緊要身體健康. catcat都希望 Chris & 松嫂不用Claim. Besides, there maybe no claim bonus? :)

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  11. aabman,
    得人驚!

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  12. catcat,
    沒有No Claim Bonus的,所議有些人認為唔claim就笨。

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  13. 香港醫療算是好了,我往院兩日都是100元,再加急症100元!
    是我做多年香港人以來發覺做香港人真係好幸福!

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  14. 其實不管在香港還是澳洲
    人患急症時醫療服務都很不錯收費也不高
    最怕是患上沒有即時危險但又半生不死的病
    輪候公立醫院經常都是以年計算的

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  15. Fung,
    只是床位迫D,阿嬸惡D,其他的都OK。

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  16. Joe Tsang,
    在澳洲我也試過陪人看急症,其實是無生命危險,結果都是等了五六個鐘。

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  17. 維珍航空下午6:13

    看來看急症的地方都是要久等。

    有時會想想,既然來看的是急症,怎麼比門診還要久,有點滑稽哩~

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  18. 幾十人在等,其中不乏檢便宜看免費症的,駐診醫生只有那一兩個,還要先看那些十字車送進來的......

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  19. xiaohua下午7:29

    大陸醫療全是公立,公立醫院的醫生沒有辦法通過私人開業賺錢,於是出現紅包現象。其實如果公私兼立,不但公立醫院有更多財政收入保障,醫生也可以通過私家病人增加收入,病人也有了更多的選擇。

    澳洲公立醫院的急診經常被濫用,我見過有病人看急診是因為剛好陪親人手術,閒著也是閒著,反正都是等,“順便”掛個急診和醫生聊一聊...

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  20. 這也太缺德了吧?

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  21. 當日不見迫,都有床位空!
    阿嬸ok nice!
    最差可能是洗手間...好似冇人清潔!

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  22. Chris, my employer pays US$ 1133.00 monthly medical premium for my family of 3 ( excluding dental )in an HMO plan ( which is the cheapest already ), you 're right, US medical thing is a joke !
    shum

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  23. 嘩!在美國退休後怎辦?

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  24. Medicare is supposed to help the elderly in US. But a lot of old people fall into the "donut hole"... they have to spend maybe over US$1000? (i don't know the exact figure...) out of pocket before the prescription benefits start kicking in... a lot of retired people work at Walmart just so they can get some kind of health benefits... some people skips their medication to save money... then they end up going to the ER. so, the ER get overwhelmed by cases that could have been avoided...
    the US provides the best healthcare for the rich, but the worst or zero -care for the poor. The only people who benefit from this system is probably the CEOs of the health insurance companies. Doctors are getting less pay under the system. But their expenses are getting higher because they have to hire so many more administrative staff just for filing claims to the insurance companies. Malpractice insurance is getting expensive, too. That's what you get when healthcare is run by For-Profit organizations - lose-lose situation for doctors and patients.

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  25. 澳洲也有所謂Safety Net的措施,每年買藥費用到一個限度之後,便由政府支付大部分,不過住院費就自理了。
    另外有Health Care Card,低收入家庭可以申請,醫生處方不論多貴的藥,持卡人都是付幾元。
    澳洲醫療制度開支很重,人口老化,不夠人納稅,政府蝕到眼坦坦。

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  26. That is still fine, because 30% rebate on health fund.

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  27. 我想指出的是,人同此心,付了保費就想拿到盡,造成惡性循環,加無止境。

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  28. chris, I'm currently with the LA County Dept of Social Services,after 25years'of service, I'll get free medical coverage ( covering my wife as well ),if I retire after 24 years , then I have to pay 4% of the medical premium. In the US , the most beneficial group of people are those who are " poor " ( the immigrants from Mainland China are among those who never pay a dime of tax ) and over 65 , they get free medical plus more than $800 cash aid from the government.
    I'm a local government employee, not qualify for the Federal gov't's Social Security retirement benifits, but I have my own retirement plan from the LA County.
    Shum

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  29. 老兄可以安享晚年了。
    我在澳洲十幾年自由工,沒任何保障和退休福利,現在都是靠以前在香港的公務員生涯的餘蔭過活。

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  30. Chris, you are really enjoying your retirement life "eating " HK Gov't pension for life already, I joined the Civil Service in 1994,9 more years to go before I can get the full medical coverage, you are much much better off than I'm.
    shum

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  31. 台灣的健保醫療是比澳洲香港好很多,看病住院都便宜快速.但也因便民而造成很多人濫用浪費.我也很不樂見此資源浪費情形.在澳洲,我們也買了medibank.只是連生了二個小孩都沒去私人醫院而去公立醫院生,一來公立醫院設施都不比私人差,二來去私人醫院後向medibank claim後仍要多自付au$2000多.沒這必要.
    所以,除了老公的眼鏡及一家大小固定半年看牙醫洗牙外,私人保險很少用,但這是一種對生活的保障,能不用上它最好,若未來身體有個意外疾病時,還是有它來的好.

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  32. 人人好像你和我的自律又知足,天下太平了。

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  33. 在外國患上長期病,不如回港就醫吧。
    可省下不少醫藥費。

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  34. 希望不需要啦。

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  35. simonlee上午12:53

    其實咁可以將d人分流到私院,減輕公院的負擔.未嘗唔係好事.
    而d市民投多d保險,咪當促進經濟.又可以'保養'一下身體,何樂而不為?

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  36. 不過保費加得這麼高,已經有人吃不消要退保,死到臨頭靠公家醫療算了。

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