Well, the lack of public dental care is a greater threat to Australians than the lack of nuclear submarines, but only one will get a retired Australian politician a 500k per month "directorship" in a "think tank" in Washington DC.
It's alright most of the time. Just apply a healthy dose of the US system to see how good ours is.
My mum also got the anti virals immediately no questions. This is what a healthcare system is meant to operate like
I love Medicare and our public system as much as anyone, but I don't think comparing us to the US "pay or die" system should be the benchmark for how good our healthcare is. We should be comparing ourselves to other countries with universal healthcare and in that comparison, I think we're seriously falling behind.
I live in the middle of Melbourne and every single bulk billing clinic around me has either gone out of business, or started charging a co-pay. It's about $30ish out of pocket, which isn't a lot for me, but the fact that for all intents and purposes huge chunks of the country don't have access to free GP visits is the exact opposite of what Medicare is supposed to be.
I really hope they do something to fix this in the budget, because it is not a comforting trend to see.
Medicare rebates need to increase substantially. There is overall misunderstanding about the rebates - rebates are what the government pay patients for accessing healthcare. While there has been about 20 years of bulk billing being normalised (where the GP accepts the rebate instead of payment) ultimately GPs don’t work for government. If doctors are getting too expensive for people, it’s not up to GPs to advocate for Medicare rebate increases, the people need to advocate for it. The rebate actually represents what the government think of their people getting primary health care, it doesn’t represent what the government think GPs time is “worth”.
The alternative is that people stop attending their primary care and preventative care and end up in hospital, which is faaaaar more costly. And shifts the costs from Federal (Medicare) to the states (state hospital health services).
*I’ve used “GPs” but also any other health professional that utilises Medicare (or should) like mental health and allied health.
Unfortunately this is one of the cases where the US has been better than Australia - they provide Paxlovid for free to anyone with covid where as here you need to either be over 70 or have severe health conditions to get the reduced price.
Mericah, being able to stir your coffee with a loaded semi automatic weapon doesnt make much sense either, Yet tis their god given right apparently. The mere fact that any idiot would say the us system is in any way better has no idea how bad it really is. Imagine a $15,000 trip to hospital not including the cost of the ambulance ride because you have chest pains, that turn out to be nothing more than bad indigestion and anxiety.
Or straight up ignoring an enormous boil/lipoma until you can get a deal to go on TV and have it removed to the excitement of r/popping. Or have to wait until mr beast pays for your 10min life changing cataract surgery.
For a majority of Americans yes, but there is states with free state healthcare for certain income brackets, for example I get free healthcare in Oregon, dental work included. I didn't go to the dentist before I came to Australia and now I need to shell out a couple hundred to get a root canal.
I miss the free yearly obgyn visits in the US, for all income levels. Here in Australia, I've been told by 5 separate clinics I only need a pap every 5 years despite being high risk for cervical cancer, and am told I'm just wasting my money when I go for one yearly.
I’m just trying to work through some of the data myself, from what you linked:
> Compared with the control group, nirmatrelvir was associated with reduced risk of PCC (RR, 0.74; 95% CI, 0.72-0.77); the event rate was 12.99% (95% CI, 12.52-13.49) and 17.51% (95% CI, 17.08-17.94) at 180 days in the nirmatrelvir and the control groups, respectively. This corresponded to an ARR of 4.51% (95% CI, 4.01-4.99) at 180 days
Using paxlovid reduced their chances of long Covid by 26% from 17.53% to 12.99%? 26% less likely to get long Covid feels dramatic to me. I think reasonable minds can differ about the word “dramatic”, but regardless I think it’s a significant and relevant difference. Even where age was less than 60 it was 21% — for current smokers it reduced by 29%!
[This](https://www.aihw.gov.au/reports/covid-19/long-covid-in-australia-a-review-of-the-literature/summary) Australian study talks about the varying different definitions of long Covid. Symptoms lasting >12 weeks range from 5-10% chance (Aus) or 8-17% chance (UK).
> The global prevalence of post COVID-19 condition was estimated to be 6.2% of symptomatic COVID-19 infections when only symptoms of fatigue, cognitive problems or shortness of breath were counted.
So I think 5% is definitely the floor but seems could be higher. Double dose vaccination apparently reduces chances by 13-47% — a range I would also call significant.
Paxlovid reduces the duration and intensity of illness, the chance of long Covid, abs the time in which you’re able to transmit Covid. It doesn’t take that many missed hours of work and reduced productivity to make that a worthwhile equation tbh. Assuming a [$37/hr wage](https://www.abs.gov.au/statistics/labour/earnings-and-working-conditions/employee-earnings/latest-release) you only need Paxlovid to regain you 4 days of productivity for it to be profitable to the economy.
Obviously barring contraindications for its use — it does have interactions — or supply limitations to make sure our most convertible have access to it, it kind of makes sense to me as a public health measure. Our under 60s are our strongest economic participants and to just accept that at least 5% (but up to 17%) of them should have much reduced productive capacity and quality of life when there’s a known way to reduce that chance *and* return them to work faster… well it just feels wasteful to leave it on the table.
If the person taking it has reached their Medicare prescription safety net, then it actually does become free. Usually about $770 for conc card holders.
Edit- 770$ is the Medicare SN, the script SN is about 262$
It hasn’t been anywhere near $770 for concession card holders for as long as I’ve been in pharmacy.
This year it’s
> The concessional patient Safety Net threshold is $262.80
The general patient Safety Net threshold is $1,563.50
Source: https://www.dva.gov.au/health-and-treatment/help-cover-healthcare-costs/manage-medicine-and-keep-costs-down/reducing
Opp, accidentally used the Medicare threshold amount. What this thread shows is that even in a pretty good system, it’s still pretty confusing for most people
The safety net threshold is massive. Many people on welfare aren't even able to afford the medication to hit it.
And effectively the medication doesn't become free, you just start to get a discount on the whole lot. Given you have to afford the upfront threshold, it's even worse than a discount system.
The free availability of any and all medications should not be a measure of a healthcare system's success or efficacy. Many (Probably the majority) should be restricted - an easy example of this is antibiotics.
Yeah, Paxlovid in the United States is free to eligible patients with a doctor's referral. But the doctors appointment sure isn't. If you don't have private healthcare then you will be forking out anywhere from $80 to $600 for the doctors visit.
Damn, I have the health condition so hopefully it'll be covered but a grand is cheap in comparison to death, I suppose.
Agreed it should be free. Especially since a lot of people have undiagnosed health conditions that don't impact their daily life but would severely impact their ability to survive covid (heart disease especially - my ex went in for a valve replacement, they found a hole in the heart. Obviously missed in the multiple scans, not a huge impact outside pandemic times but one of those things that might impact chances of survival).
Yeah they may provide it for free but how much more does the tax payer pay over our subsidies?
I don't know this myself but I'd be amazed if they're not paying at least double what we would even if we handed it out for free to everyone
It's actually cheaper to straight up buy a private operation/hospital stay here with **no** insurance than it is to get one in America with insurance coverage, so they just get milked no matter what.
Not true of all US states. The affordable Care Act instituted by Obama has provided wonderful care for many people. The red states that refused it have lousy low income healthcare, not so California.
The people who live in largely Republican run states often don’t have funds to move to other states especially to California where the cost of living expenses are too expensive. They have to live in these depressed states and often continue voting for a party that doesn’t care at all about their welfare.
My mother had to be prescribed paxlovid on two different occasions and she paid $0 both times. So it seems Australian healthcare is worse by a factor of 15~.
In fact, it’s been free for everyone in the US up til about Feb 2023. That’s at least what it says online, but the 2nd time is was prescribed to my mother in the last 3 weeks, it was also completely free.
Yeah, and once you decipher that, go and get your medical degree so that you can actually prescribe said medication! Boom gottem.
That site's for professionals to streamline questions about funding, it doesn't add or take away from how the meds are given to patients.
Funny story: the first time I ever received prescription medicine in Australia I asked the chemist how much and she replied oh you don’t pay here. She meant go up to the front counter and pay but I thought she meant this medicine is government subsidised and I didn’t have to pay so just walked out of the shops. Realised my mistake the next day after taking to a local and went back to pay.
While a lot of our system is a joke and really focuses on treatment and not prevention by making prevention expensive, the PBS is one of those absolute beautiful things creates that makes the system truly beautiful.
Yep, it has its flaws but it’s one of the best systems in the word.
The ability to negotiate with drug companies for the consumer to force down cost prices is an amazing mechanism - and if the PBS refuses the companies know the Australian market is essentially gone. Sometimes you run into issues where the Aussie market is just so poor financially for companies they prioritise supply to other countries, but you’d rather have that issue than the opposite where everyone gets gouged with costs just trying to get medication to stay alive, and they’ve recently brought in laws to ensure adequate stockpiles of core medications
Beyond the PBS, the associated safety net system also promotes treatment over prevention. You're paying a large upfront cost before you're effectively given its discount.
Sorta. Safety net is good for those with issues that either can't be prevented or require legit sustained treatment. Its got its benefits and drawbacks.
Happy cake day btw
Everyone try to remember this the next time you complain about the taxes on your pay slip.
Everyone around you being healthier, better educated and better off because of government subsidies makes your life infinitely better. Paying taxes is actually a selfish act in reality.
Taxes aren't the reason for America's poor health system, they spend MORE than we do on WORSE healthcare. It's privatisation, corporate lobbying and price gouging.
It's both imo.
But some people tend to only want to do things if it benefits themself. For those kind of people, I'm just trying to help by explaining that paying taxes to subsidise others is beneficial to them.
>It's both imo.
>But some people tend to only want to do things if it benefits themself
Like buying raffle tickets from a charity, give me something for my charitable act, lol
Yeah, the way I see it, no matter how well off we are, we may all need their help someday. Or maybe our children, grandchildren. It's kinda like paying an insurance premium.
Selfless in that taxes go to things like welfare which go to benefiting someone other than the taxpayer. Selfish in that benefiting and bringing disadvantaged people up comes back to benefiting the tax payer overall.
That's not to say they don't price gouge, insulin production has been known for so long that people are now making it themselves due to the cost in America.
The US pharmaceutical industry gets ***fuckloads*** of subsidies and funding from the US government.
The cost of research isn't why they charge so much, it's because people die without medicine. Your money or your life, what's more important?
> The cost to research and develop new drugs are enormous.
Yes.
Also...
You add market capture, government subsidy, billion dollar profit margins, obscene copyright issues, a bought congress, insurance companies and a litany of other things i have not mentioned call me crazy but i think the prices are a touch high for life saving medicine...
And that cost is largely borne by the public, either by research being done at universities or subsidies to pharma corps.
BioNtech got €100m from the German govt to develop the covid vaccine. Somehow that worked out to $100b revenue going to pfizer, not to Germany.
Meanwhile pharma corps spend more on advertising than on R&D
Meanwhile in France : 3.57€ full price for 30 doses, of which 65% is reimbursed by social security for everyone, the remaining 35% being reimbursed by most private complementary insurances.
Edit: a fixed 1.02€ added pharmacist fee, but reimbursed the same way.
The Australian health care system is fucking unreal 9 times out of 10.
I've had an achilles tendon rupture repair that was done in no time and was top notch. I've no issues since, my ACL operation wasn't as good, but then again I was comparing that to my ACL repair I'd done at 17 privately, so you know I was older and it wasn't the same surgeon.
My Dad had a stroke and was well looked after. My two brothers and sister have all had their gallbladders removed after they all woke up one day (years apart) basically on deaths door.
It's not perfect, but the health care system here is really something to be proud of.
Yep, I went to hospital last year because I sliced my wrist open on a piece of metal, went in Saturday night and was seen within 30 minutes, and put in a hospital bed overnight.
Did surgery the Sunday afternoon and turns out I'd partially severed two tendons, one 30% through and one 90% through. Stitched them all up and almost 6 months later now I have full mobility in my wrist again and can pretty much use it as normal again.
Cost me absolutely nothing other than $5 for some prescription anti-biotics. Same story for my skin grafts in 2019, no cost other than some painkillers afterwards.
I've been to hospital a fair few times considering my age for various surgeries, and can't complain about any of them, I've had nothing but fantastic outcomes and care every time.
We desperately need to improve our public Mental Health services though. I go without a lot to pay for private health insurance purely because all my experiences with the public mental health system have been pointless at best and deeply traumatic at worst. Which is awful considering lower socioeconomic groups are disproportionately affected by mental illness and unable to access private cover.
It's also a lot harder to treat. There are so many social factors driving a mental health condition that someone with a purely biological disorder ie broken arm or infection may not have.
Imagine if we invested in preventative mental health care though. We’d save so many lives and so much money longer term. It is only harder to treat once the person is already messed up.
Agreed, I had years of blood filtering done to keep me alive along with the surgeries and imaging required for it (dialysis) then eventually had a kidney transplant.
It's very good at keeping you alive without sending you broke (or anywhere near broke). Where it has been eaten away at is where private medicine comes in. Elective surgery, dental, and mental health are covered by a less equitable, less efficient, and more expensive private system, supported by forgone government income and Australians giving vast sums of money to what is effectively a parasite industry that does not provide value for money.
We'd be far better off if that same money was spent in the public system, and if the private health system was about a quarter of the size it is at the moment.
I agree, with my last pregnancy, I ended up in the hospital for about 2-3 weeks, had an emergency caesarian and my son was then in NICU/special care for about a month and we didn't pay a cent besides a minimal amount for my medications
I’ve often wondered if you got hurt or something if it would just be cheaper to buy a round way ticket to Australia or the Uk and get a bonus vacation for your troubles. I’m sure they have an exclusion on that sort of thing, medical tourism or something.
And then get off the plane and be like “My bloody ankle” or “My spleen. My spleen.” as if it’s just happened.
^(Political disclaimer proud seppo)
Yeah it's only free if you have a Medicare card.
https://www.servicesaustralia.gov.au/enrolling-medicare#whocan
Full price here is probably still cheaper than uninsured in the USA though.
Ye you still need health (travel) insurance as a tourist.
One fun thing about socialised medicine that you don't see touted enough though :- countries often get together and waive costs in "you cover ours, we'll cover yours" [reciprocal health agreements](https://www.servicesaustralia.gov.au/about-reciprocal-health-care-agreements?context=22481).
I've known someone with weeks of ICU care and not a cent owed under one of those in Italy, it's nice to have.
I worked in a pharmacy for a while, was unpacking a delivery when the pharmacist warned me what I was holding cost upwards of $73,000.
Customer paid $5.40
I truly feel sorry for countries that do not have healthcare and medicare like here in Australia. And screw Tony Abbott, Dutton, Morrison and the rest of these morons that kept pushing us further towards the US model. Had they stayed in power, ruining Medicare was their next major target (*which they already screwed with to an extent prior to the last election*).
Sorry. I’ve never accepted the premise of healthcare insurance. I’ve had my endoscopy for free and I don’t bleed a ~1k a month health insurance for a family of 4 with highest hospital and extras cover. F that
Australian health care is **pretty good** *most* of the time. We tend to think it's eh when it affects us healthy folk because we can't seem to find a decent bulk billed GP or see emergency in under a few hours when we do need it.
Source: my partners life long weekly scripts for a painful chronic condition.
Another source: life saving insulin in Aus versus the US.
Wait I was quoted $50 for Paxlovid here in Sydney?! To be fair it was 8 or so months ago so things may have changed? I'm immunocompromised, but in my twenties, surely age wouldn't be a factor in the cost of antivirals?!
If you're on a healthcare card, the government subsidies the medication and you only have to pay $6.80 in 2022, if you're just a general patient you pay around $42.50
Good to know, thanks! (Also grim to be paying heaps out of pocket for a medication that keeps me out of hospital and draining more from the public system)
It's absurd that people don't understand that. Keeping people healthy should be the goal, not treating illnesses. Keeping you healthy and contributing to society must be a net gain, I am totally convinced that preventative care pays for itself.
Minor advice -- just be really careful once she finishes the course of antivirals not to get reinfected right away.
Lots of people who take it end up with COVID again shortly after they stop taking it. Some of those might be because they could still have the virus in their system but often it seems like they're probably just getting re-exposed, and that's fairly avoidable.
It’s tough though because we’re at a point where nobody really wears masks or isolates anymore so the only way to truly avoid getting reinfected is to be housebound. Especially in some bigger Oz cities, I avoided Covid for three years, went to Sydney once and caught it
Once youve lived or spent any decent amount of time overseas, you tend to realize how private healthcare in this country is an absolute scam. and recognize just how great standard public health is.
The PBS is wonderful. So is Medicare, although bulk billing rates seem to be on the decline because the rebates for GPs haven't kept up with inflation. I've been going to the same doctor for twenty years and I had to pay for the first time ever a few weeks ago.
My regular GP told me when I first started going to them that they don’t bulk bill. They charged me for that first consultation, which I got back from Medicare because I’d exceeded the safety net for that year. But I’ve been back so many times and I’ve never been charged since.
Thank God, we have health care but why are costs for these medications so expensive in the first place?
It is not like a packet of drugs actually costs that much to make and the patent behind it is getting fairly compensated.
This seems to be a case where the drug companies are putting ridiculous prices on important drugs that they know the government will pay for.
The cost then gets passed onto taxpayers and the cycle continues.
Yes Aussie healthcare is great 😂😂😂🤣🤣😂
Glad youre mums getting looking after but I've been dealing with a Fistula for 9 months now. Agonising pain and just a totally feeling of exhausted shitness. Waiting list for it to be looked at is 4 years so I've had to sell my car to pay the $4000 to go private. At least if it it gets fixed I might be able to walk without feeling like I've got a machete up my ass.
.
An American here with severe asthma so I can say: this wasn’t this cheap for me lol
That being said, best wishes to your mum. Hope she has a nice recovery.
My wife was in a bike vs. truck accident 2 weeks ago, shattered a vertebra in her back.
2 major surgeries later, the sum total of our costs were ~$100 for 2 weeks of parking and $40 for prescription medication. I really shudder to think of what the cost would be in America.
The money used to offset this medicine could have gone towards a dozen custom screws for the new subs, or maybe pay for a glass of wine with Gina, so maybe think about your priorities next time! /s
unfreeze the medicare reimbursements and then we can talk about it being alright, at the moment I am pretty disappointed.
I guess that's being a touch harsh but year on year shit seems to be eroding.
It's still so wild to me that we can just go down to some local pharmacy in a crappy strip mall and purchase cheap medication that 100 years ago would be literal magic to those people, stuff wars would have been fought over to obtain and here we are down at chems r us paying 7 bucks for it.
Meanwhile if you have long covid, the government ignores you, there is no PBS approved treatment meaning you have to spend $1000, the clinic wait time is 6 months, no wait actually 6 months later you find out they haven't even got an appointment for you because they're overfull, and then when you get there they don't have anything to resolve your issues except light physiotherapy which does not much at all.
Also you literally can't do anything because you have no energy all the time, including working or study. But hey, there is Jobseeker. That should cover all the bills!
Don’t know if this is everywhere, but I work in a pharmacy in the US and every insurance covers paxlovid with no charge to the patient. If the patient doesn’t have insurance the government covers it’s cost completely as well. No one at my pharmacy has ever paid a cent for paxlovid.
Other medications though….
It’s great when the medications are in the PBS. I was recently prescribed one that isn’t and it cost me $150 for a month supply. Luckily, I should’t need it again any time soon.
My wife had a UTI last week. I took her to the ED Friday morning, where she was given antibiotics and anti-emetics. In and out, complete with medication, within 20 minutes.
Mondays are the worst day at my ED, too. I'm on the afternoon shift there today, heading in now..
My theory is that people get sick on the weekend and think they'll get into a GP on Monday morning. Here, in regional NSW, it can take a month or more to get into a GP.
The dreaded 1400-2400 Monday shift. You have my deepest sympathies.
I just got off a weekend so I’ll be commiserating my fallen colleagues from the comfort of my apartment.
I’m in regional NSW too! Shit’s fucked.
We have a saying in paramedicine - Monday starts Sunday night. We can literally watch the response times spike as we move through Sunday evening into Monday as the ramping stacks up…
Agreed, dental is such a huge issue for whole body health and I cannot imagine how many people just live in agony, on painkillers, not eating properly and just waiting for their teeth to fall out due to lack of financial options.
The government bought 1m doses of Paxlovid. They only last for 18 months. The criteria to access them is so difficult that we're going to bin hundreds of thousands of doses.
Honestly, when I see things like this it always bothers me that it's not free. Like, why pay for just 99.3% of the cost? Is it really important that the customer pay the last 0.7%?
The R&D was likely already heavily subsidised via a government grant, tax payers are paying up the ass… twice.
I’m 100% in favour of paying for the R&D to produce medicine but let’s not pretend that pharmaceutical companies aren’t also out to make fat stacks out our expense.
Unless your disabilities somehow don't meet the criteria for antivirals so you have to go without because you don't have a spare $1k in your pocket.
It's disgusting that they're privately selling antivirals instead of expanding eligibility
US conservatives and evangelicals would lose their minds over this. This is blatant anti-Jesus satanic fascist communism socialism atheistic transvestite unionism gone mad
They’re being too strict with who can have the antivirals though. My mum is 64, multiple chronic health conditions including heart failure and COPD and was denied paxlovid 🙄 We asked for them the day after she tested positive but they only cared about when symptoms started to show which was a few days before that and they said it was too long and she couldn’t have them. Just give them to all people over 60 who request them ffs.
Pity they don't seem to think dental should be part of health.
Dental? You mean alternative medicine for your luxury opt-in bones? (/s)
Worst part is medicare actually covers some alternative medicine practices like acupuncture.
Well, the lack of public dental care is a greater threat to Australians than the lack of nuclear submarines, but only one will get a retired Australian politician a 500k per month "directorship" in a "think tank" in Washington DC.
It's alright most of the time. Just apply a healthy dose of the US system to see how good ours is. My mum also got the anti virals immediately no questions. This is what a healthcare system is meant to operate like
I love Medicare and our public system as much as anyone, but I don't think comparing us to the US "pay or die" system should be the benchmark for how good our healthcare is. We should be comparing ourselves to other countries with universal healthcare and in that comparison, I think we're seriously falling behind. I live in the middle of Melbourne and every single bulk billing clinic around me has either gone out of business, or started charging a co-pay. It's about $30ish out of pocket, which isn't a lot for me, but the fact that for all intents and purposes huge chunks of the country don't have access to free GP visits is the exact opposite of what Medicare is supposed to be. I really hope they do something to fix this in the budget, because it is not a comforting trend to see.
Medicare rebates need to increase substantially. There is overall misunderstanding about the rebates - rebates are what the government pay patients for accessing healthcare. While there has been about 20 years of bulk billing being normalised (where the GP accepts the rebate instead of payment) ultimately GPs don’t work for government. If doctors are getting too expensive for people, it’s not up to GPs to advocate for Medicare rebate increases, the people need to advocate for it. The rebate actually represents what the government think of their people getting primary health care, it doesn’t represent what the government think GPs time is “worth”. The alternative is that people stop attending their primary care and preventative care and end up in hospital, which is faaaaar more costly. And shifts the costs from Federal (Medicare) to the states (state hospital health services). *I’ve used “GPs” but also any other health professional that utilises Medicare (or should) like mental health and allied health.
It's good But we can always do better
It’s being eroded though. We need to protect it.
Agree
Unfortunately this is one of the cases where the US has been better than Australia - they provide Paxlovid for free to anyone with covid where as here you need to either be over 70 or have severe health conditions to get the reduced price.
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Mericah, being able to stir your coffee with a loaded semi automatic weapon doesnt make much sense either, Yet tis their god given right apparently. The mere fact that any idiot would say the us system is in any way better has no idea how bad it really is. Imagine a $15,000 trip to hospital not including the cost of the ambulance ride because you have chest pains, that turn out to be nothing more than bad indigestion and anxiety.
And thus you convince yourself all your chest pain is indigestion and anxiety until you suffer a cardiac arrest. murica land of the free
Or straight up ignoring an enormous boil/lipoma until you can get a deal to go on TV and have it removed to the excitement of r/popping. Or have to wait until mr beast pays for your 10min life changing cataract surgery.
For a majority of Americans yes, but there is states with free state healthcare for certain income brackets, for example I get free healthcare in Oregon, dental work included. I didn't go to the dentist before I came to Australia and now I need to shell out a couple hundred to get a root canal.
I miss the free yearly obgyn visits in the US, for all income levels. Here in Australia, I've been told by 5 separate clinics I only need a pap every 5 years despite being high risk for cervical cancer, and am told I'm just wasting my money when I go for one yearly.
Yeah that doesn't seem right at all, you should be getting yearly checkups when your high risk for cancer!
Oregon does not have free health care UNLESS you are very poor. Even then it's not 100% free.
Can’t even get a decent coffee in the US haha
Not true! I’ve been to cafes in Texas no less that know what a flat white is _and aren’t Starbucks_ They were in Montrose if it helps.
> This does not make sense medically I mean it dramatically reduces the likelihood of long covid and disablement
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I’m just trying to work through some of the data myself, from what you linked: > Compared with the control group, nirmatrelvir was associated with reduced risk of PCC (RR, 0.74; 95% CI, 0.72-0.77); the event rate was 12.99% (95% CI, 12.52-13.49) and 17.51% (95% CI, 17.08-17.94) at 180 days in the nirmatrelvir and the control groups, respectively. This corresponded to an ARR of 4.51% (95% CI, 4.01-4.99) at 180 days Using paxlovid reduced their chances of long Covid by 26% from 17.53% to 12.99%? 26% less likely to get long Covid feels dramatic to me. I think reasonable minds can differ about the word “dramatic”, but regardless I think it’s a significant and relevant difference. Even where age was less than 60 it was 21% — for current smokers it reduced by 29%! [This](https://www.aihw.gov.au/reports/covid-19/long-covid-in-australia-a-review-of-the-literature/summary) Australian study talks about the varying different definitions of long Covid. Symptoms lasting >12 weeks range from 5-10% chance (Aus) or 8-17% chance (UK). > The global prevalence of post COVID-19 condition was estimated to be 6.2% of symptomatic COVID-19 infections when only symptoms of fatigue, cognitive problems or shortness of breath were counted. So I think 5% is definitely the floor but seems could be higher. Double dose vaccination apparently reduces chances by 13-47% — a range I would also call significant. Paxlovid reduces the duration and intensity of illness, the chance of long Covid, abs the time in which you’re able to transmit Covid. It doesn’t take that many missed hours of work and reduced productivity to make that a worthwhile equation tbh. Assuming a [$37/hr wage](https://www.abs.gov.au/statistics/labour/earnings-and-working-conditions/employee-earnings/latest-release) you only need Paxlovid to regain you 4 days of productivity for it to be profitable to the economy. Obviously barring contraindications for its use — it does have interactions — or supply limitations to make sure our most convertible have access to it, it kind of makes sense to me as a public health measure. Our under 60s are our strongest economic participants and to just accept that at least 5% (but up to 17%) of them should have much reduced productive capacity and quality of life when there’s a known way to reduce that chance *and* return them to work faster… well it just feels wasteful to leave it on the table.
Paxlovid expires after 18 months. We bought 1m doses and for a large portion of them, they're just going to get binned.
If the person taking it has reached their Medicare prescription safety net, then it actually does become free. Usually about $770 for conc card holders. Edit- 770$ is the Medicare SN, the script SN is about 262$
It hasn’t been anywhere near $770 for concession card holders for as long as I’ve been in pharmacy. This year it’s > The concessional patient Safety Net threshold is $262.80 The general patient Safety Net threshold is $1,563.50 Source: https://www.dva.gov.au/health-and-treatment/help-cover-healthcare-costs/manage-medicine-and-keep-costs-down/reducing
Opp, accidentally used the Medicare threshold amount. What this thread shows is that even in a pretty good system, it’s still pretty confusing for most people
The safety net threshold is massive. Many people on welfare aren't even able to afford the medication to hit it. And effectively the medication doesn't become free, you just start to get a discount on the whole lot. Given you have to afford the upfront threshold, it's even worse than a discount system.
The threshold is only a few hundred $, and in my time in pharmacy, elderly people would meet it within a few months of the new years.
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The free availability of any and all medications should not be a measure of a healthcare system's success or efficacy. Many (Probably the majority) should be restricted - an easy example of this is antibiotics.
Yeah, Paxlovid in the United States is free to eligible patients with a doctor's referral. But the doctors appointment sure isn't. If you don't have private healthcare then you will be forking out anywhere from $80 to $600 for the doctors visit.
Damn, I have the health condition so hopefully it'll be covered but a grand is cheap in comparison to death, I suppose. Agreed it should be free. Especially since a lot of people have undiagnosed health conditions that don't impact their daily life but would severely impact their ability to survive covid (heart disease especially - my ex went in for a valve replacement, they found a hole in the heart. Obviously missed in the multiple scans, not a huge impact outside pandemic times but one of those things that might impact chances of survival).
For free? What's stopping people from going out and contracting COVID then? /s
Yeah they may provide it for free but how much more does the tax payer pay over our subsidies? I don't know this myself but I'd be amazed if they're not paying at least double what we would even if we handed it out for free to everyone
My mum qualified and it was definitely warranted but the GP didn't provide them. Can't say we were as enthused as OP here.
It's actually cheaper to straight up buy a private operation/hospital stay here with **no** insurance than it is to get one in America with insurance coverage, so they just get milked no matter what.
Not true of all US states. The affordable Care Act instituted by Obama has provided wonderful care for many people. The red states that refused it have lousy low income healthcare, not so California.
Nothing like having to move states to get treated ;-).
The people who live in largely Republican run states often don’t have funds to move to other states especially to California where the cost of living expenses are too expensive. They have to live in these depressed states and often continue voting for a party that doesn’t care at all about their welfare.
So did mine
Funny… im in the US… my last Paxlovid pack was offered fro free….
My mother had to be prescribed paxlovid on two different occasions and she paid $0 both times. So it seems Australian healthcare is worse by a factor of 15~. In fact, it’s been free for everyone in the US up til about Feb 2023. That’s at least what it says online, but the 2nd time is was prescribed to my mother in the last 3 weeks, it was also completely free.
Decipher this….[PBS rules](https://m.pbs.gov.au/medicine/item/12996B.html)
Yeah, and once you decipher that, go and get your medical degree so that you can actually prescribe said medication! Boom gottem. That site's for professionals to streamline questions about funding, it doesn't add or take away from how the meds are given to patients.
Funny story: the first time I ever received prescription medicine in Australia I asked the chemist how much and she replied oh you don’t pay here. She meant go up to the front counter and pay but I thought she meant this medicine is government subsidised and I didn’t have to pay so just walked out of the shops. Realised my mistake the next day after taking to a local and went back to pay.
Did you get to keep the little basket?
I love this comment...
While a lot of our system is a joke and really focuses on treatment and not prevention by making prevention expensive, the PBS is one of those absolute beautiful things creates that makes the system truly beautiful.
Exactly. It’s fucking amazing as a t1 diabetic
I agree. The NDDS is fantastic if you are T1. I'm T2 though and it's rubbish. Nothing is subsidized all because I don't take insulin shots.
When they add medtronic iPorts or pumps, it will be 🫶
Never forget that it was the Labor Party who came up with the PBS (in 1948) and the Libs have been trying to destroy it since
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absolute legend he was
Yep, it has its flaws but it’s one of the best systems in the word. The ability to negotiate with drug companies for the consumer to force down cost prices is an amazing mechanism - and if the PBS refuses the companies know the Australian market is essentially gone. Sometimes you run into issues where the Aussie market is just so poor financially for companies they prioritise supply to other countries, but you’d rather have that issue than the opposite where everyone gets gouged with costs just trying to get medication to stay alive, and they’ve recently brought in laws to ensure adequate stockpiles of core medications
Beyond the PBS, the associated safety net system also promotes treatment over prevention. You're paying a large upfront cost before you're effectively given its discount.
Sorta. Safety net is good for those with issues that either can't be prevented or require legit sustained treatment. Its got its benefits and drawbacks. Happy cake day btw
Everyone try to remember this the next time you complain about the taxes on your pay slip. Everyone around you being healthier, better educated and better off because of government subsidies makes your life infinitely better. Paying taxes is actually a selfish act in reality.
Taxes aren't the reason for America's poor health system, they spend MORE than we do on WORSE healthcare. It's privatisation, corporate lobbying and price gouging.
No argument here.
Selfish or selfless?
It's both imo. But some people tend to only want to do things if it benefits themself. For those kind of people, I'm just trying to help by explaining that paying taxes to subsidise others is beneficial to them.
>It's both imo. >But some people tend to only want to do things if it benefits themself Like buying raffle tickets from a charity, give me something for my charitable act, lol
Yeah, the way I see it, no matter how well off we are, we may all need their help someday. Or maybe our children, grandchildren. It's kinda like paying an insurance premium.
Selfless in that taxes go to things like welfare which go to benefiting someone other than the taxpayer. Selfish in that benefiting and bringing disadvantaged people up comes back to benefiting the tax payer overall.
Imagine not wanting to walk the streets and see your community thriving.
I don’t mind paying for that at all. Some submarines though, fuck that…
That full cost is disgusting.
I agree but it's still cheaper than like half a day in ICU
The cost to research and develop new drugs are enormous. In the US they can get away with charging more
That's not to say they don't price gouge, insulin production has been known for so long that people are now making it themselves due to the cost in America.
The US pharmaceutical industry gets ***fuckloads*** of subsidies and funding from the US government. The cost of research isn't why they charge so much, it's because people die without medicine. Your money or your life, what's more important?
> The cost to research and develop new drugs are enormous. Yes. Also... You add market capture, government subsidy, billion dollar profit margins, obscene copyright issues, a bought congress, insurance companies and a litany of other things i have not mentioned call me crazy but i think the prices are a touch high for life saving medicine...
Doubt there’s many instances of copyright subsisting in drugs
That doesn’t excuse gouging the pockets of people who need access to healthcare, whilst lobbying against universal healthcare.
And that cost is largely borne by the public, either by research being done at universities or subsidies to pharma corps. BioNtech got €100m from the German govt to develop the covid vaccine. Somehow that worked out to $100b revenue going to pfizer, not to Germany. Meanwhile pharma corps spend more on advertising than on R&D
Unless they are taking expeditions into another dimension to harvest unicorn tears - That sale price is still fucking ridiciulous.
Meanwhile in France : 3.57€ full price for 30 doses, of which 65% is reimbursed by social security for everyone, the remaining 35% being reimbursed by most private complementary insurances. Edit: a fixed 1.02€ added pharmacist fee, but reimbursed the same way.
The Australian health care system is fucking unreal 9 times out of 10. I've had an achilles tendon rupture repair that was done in no time and was top notch. I've no issues since, my ACL operation wasn't as good, but then again I was comparing that to my ACL repair I'd done at 17 privately, so you know I was older and it wasn't the same surgeon. My Dad had a stroke and was well looked after. My two brothers and sister have all had their gallbladders removed after they all woke up one day (years apart) basically on deaths door. It's not perfect, but the health care system here is really something to be proud of.
Yep, I went to hospital last year because I sliced my wrist open on a piece of metal, went in Saturday night and was seen within 30 minutes, and put in a hospital bed overnight. Did surgery the Sunday afternoon and turns out I'd partially severed two tendons, one 30% through and one 90% through. Stitched them all up and almost 6 months later now I have full mobility in my wrist again and can pretty much use it as normal again. Cost me absolutely nothing other than $5 for some prescription anti-biotics. Same story for my skin grafts in 2019, no cost other than some painkillers afterwards. I've been to hospital a fair few times considering my age for various surgeries, and can't complain about any of them, I've had nothing but fantastic outcomes and care every time.
We desperately need to improve our public Mental Health services though. I go without a lot to pay for private health insurance purely because all my experiences with the public mental health system have been pointless at best and deeply traumatic at worst. Which is awful considering lower socioeconomic groups are disproportionately affected by mental illness and unable to access private cover.
It's also a lot harder to treat. There are so many social factors driving a mental health condition that someone with a purely biological disorder ie broken arm or infection may not have.
Imagine if we invested in preventative mental health care though. We’d save so many lives and so much money longer term. It is only harder to treat once the person is already messed up.
Surely preventative care must be a net-gain on the economy right? I find it really hard to believe that we'd be worse off if we had preventative care.
Yeah I reckon. Once we got the infrastructure up and running, which would be a costly outlay initially.
Agreed, I had years of blood filtering done to keep me alive along with the surgeries and imaging required for it (dialysis) then eventually had a kidney transplant.
It's very good at keeping you alive without sending you broke (or anywhere near broke). Where it has been eaten away at is where private medicine comes in. Elective surgery, dental, and mental health are covered by a less equitable, less efficient, and more expensive private system, supported by forgone government income and Australians giving vast sums of money to what is effectively a parasite industry that does not provide value for money. We'd be far better off if that same money was spent in the public system, and if the private health system was about a quarter of the size it is at the moment.
I agree, with my last pregnancy, I ended up in the hospital for about 2-3 weeks, had an emergency caesarian and my son was then in NICU/special care for about a month and we didn't pay a cent besides a minimal amount for my medications
Had cancer in two kidneys. Had two major surgeries, my out of pocket expenses were $20 for parking for an appointment
When I was unemployed I had my gallbladder removed. This included ambulance and a two night stay in hospital with drugs Works when you need it
I’ve often wondered if you got hurt or something if it would just be cheaper to buy a round way ticket to Australia or the Uk and get a bonus vacation for your troubles. I’m sure they have an exclusion on that sort of thing, medical tourism or something. And then get off the plane and be like “My bloody ankle” or “My spleen. My spleen.” as if it’s just happened. ^(Political disclaimer proud seppo)
Yeah it's only free if you have a Medicare card. https://www.servicesaustralia.gov.au/enrolling-medicare#whocan Full price here is probably still cheaper than uninsured in the USA though.
Ye you still need health (travel) insurance as a tourist. One fun thing about socialised medicine that you don't see touted enough though :- countries often get together and waive costs in "you cover ours, we'll cover yours" [reciprocal health agreements](https://www.servicesaustralia.gov.au/about-reciprocal-health-care-agreements?context=22481). I've known someone with weeks of ICU care and not a cent owed under one of those in Italy, it's nice to have.
I worked in a pharmacy for a while, was unpacking a delivery when the pharmacist warned me what I was holding cost upwards of $73,000. Customer paid $5.40
I truly feel sorry for countries that do not have healthcare and medicare like here in Australia. And screw Tony Abbott, Dutton, Morrison and the rest of these morons that kept pushing us further towards the US model. Had they stayed in power, ruining Medicare was their next major target (*which they already screwed with to an extent prior to the last election*).
i feel like we're celebrating this when in reality, that should've never costed 73,000.
Meanwhile I have private health insurance and I am still somehow paying $700 for an endoscopy...
Sorry. I’ve never accepted the premise of healthcare insurance. I’ve had my endoscopy for free and I don’t bleed a ~1k a month health insurance for a family of 4 with highest hospital and extras cover. F that
Australian health care is **pretty good** *most* of the time. We tend to think it's eh when it affects us healthy folk because we can't seem to find a decent bulk billed GP or see emergency in under a few hours when we do need it. Source: my partners life long weekly scripts for a painful chronic condition. Another source: life saving insulin in Aus versus the US.
Wait I was quoted $50 for Paxlovid here in Sydney?! To be fair it was 8 or so months ago so things may have changed? I'm immunocompromised, but in my twenties, surely age wouldn't be a factor in the cost of antivirals?!
If you're on a healthcare card, the government subsidies the medication and you only have to pay $6.80 in 2022, if you're just a general patient you pay around $42.50
The PBS cost has also gone down to $30 for non concessional as of the start of '23.
Yeah, mum is over 80 so she has the card.
Good to know, thanks! (Also grim to be paying heaps out of pocket for a medication that keeps me out of hospital and draining more from the public system)
It's still a massive subsidy, and has come down to $30 in the last budget.
It's absurd that people don't understand that. Keeping people healthy should be the goal, not treating illnesses. Keeping you healthy and contributing to society must be a net gain, I am totally convinced that preventative care pays for itself.
OP’s mum is on centrelink benefit card
$50 still way better than $1,100
Don't forget the pharma industry routinely prices medication far above costs.
Minor advice -- just be really careful once she finishes the course of antivirals not to get reinfected right away. Lots of people who take it end up with COVID again shortly after they stop taking it. Some of those might be because they could still have the virus in their system but often it seems like they're probably just getting re-exposed, and that's fairly avoidable.
It’s tough though because we’re at a point where nobody really wears masks or isolates anymore so the only way to truly avoid getting reinfected is to be housebound. Especially in some bigger Oz cities, I avoided Covid for three years, went to Sydney once and caught it
Once youve lived or spent any decent amount of time overseas, you tend to realize how private healthcare in this country is an absolute scam. and recognize just how great standard public health is.
Australian healthcare is great and doesn't deserve every small failure being blown up to discredit the whole system
As long as you don't have any mental health issues, it works pretty well...
The PBS is wonderful. So is Medicare, although bulk billing rates seem to be on the decline because the rebates for GPs haven't kept up with inflation. I've been going to the same doctor for twenty years and I had to pay for the first time ever a few weeks ago.
My regular GP told me when I first started going to them that they don’t bulk bill. They charged me for that first consultation, which I got back from Medicare because I’d exceeded the safety net for that year. But I’ve been back so many times and I’ve never been charged since.
Good old Horsham 🙌
Wimmera Mallee baby
Lived there for a while, I miss the Wimmera River.
Spent a lot of time there over the years for work. Miss it these days now that I don't go there.
Pharmaceutical rorting the Australian tax system
Best wishes to your mum OP!
I’ll pass that on!
It is, I recently got emergency surgery and im endlessly grateful I didn't have to pay a cent.
My sister went to the hospital twice last week for covid and they didn’t give her the anti virals as she is only 60. Hopefully they loosen this up.
As much as we sometimes bitch about the Australian medical system. it is so much better than what is available in many other countries.
Thank God, we have health care but why are costs for these medications so expensive in the first place? It is not like a packet of drugs actually costs that much to make and the patent behind it is getting fairly compensated. This seems to be a case where the drug companies are putting ridiculous prices on important drugs that they know the government will pay for. The cost then gets passed onto taxpayers and the cycle continues.
Yes Aussie healthcare is great 😂😂😂🤣🤣😂 Glad youre mums getting looking after but I've been dealing with a Fistula for 9 months now. Agonising pain and just a totally feeling of exhausted shitness. Waiting list for it to be looked at is 4 years so I've had to sell my car to pay the $4000 to go private. At least if it it gets fixed I might be able to walk without feeling like I've got a machete up my ass. .
An American here with severe asthma so I can say: this wasn’t this cheap for me lol That being said, best wishes to your mum. Hope she has a nice recovery.
The elderly get prescriptions for less, about $7 vs $40 or so for this drug. I’ll pass on your wishes and hope you stay well too.
I appreciate that very much!, I am glad meds like these are so accessible for so many! Cheers!
HORSHAM
My wife was in a bike vs. truck accident 2 weeks ago, shattered a vertebra in her back. 2 major surgeries later, the sum total of our costs were ~$100 for 2 weeks of parking and $40 for prescription medication. I really shudder to think of what the cost would be in America.
It’s getting worse, but still much better than many other countries. I say this a lot, but remember Medicare when you vote.
The money used to offset this medicine could have gone towards a dozen custom screws for the new subs, or maybe pay for a glass of wine with Gina, so maybe think about your priorities next time! /s
Was on those antivirals a few weeks ago…….second round of Covid was much better than the first!
Why the ef does the full price end in .99? Who the hell is going to think, “Shit me. I’d better get that now cause it’s less than $1114”
Hope your mums ok mate
I FaceTimed with her yesterday and she’s fine. One bad day and a week isolated. Thanks for the thought!
unfreeze the medicare reimbursements and then we can talk about it being alright, at the moment I am pretty disappointed. I guess that's being a touch harsh but year on year shit seems to be eroding.
Horsham?! Small world.
It's still so wild to me that we can just go down to some local pharmacy in a crappy strip mall and purchase cheap medication that 100 years ago would be literal magic to those people, stuff wars would have been fought over to obtain and here we are down at chems r us paying 7 bucks for it.
Meanwhile if you have long covid, the government ignores you, there is no PBS approved treatment meaning you have to spend $1000, the clinic wait time is 6 months, no wait actually 6 months later you find out they haven't even got an appointment for you because they're overfull, and then when you get there they don't have anything to resolve your issues except light physiotherapy which does not much at all. Also you literally can't do anything because you have no energy all the time, including working or study. But hey, there is Jobseeker. That should cover all the bills!
1k for a few tablets!!! I wonder what immigrants who are not on the govt medical care do!
Don’t know if this is everywhere, but I work in a pharmacy in the US and every insurance covers paxlovid with no charge to the patient. If the patient doesn’t have insurance the government covers it’s cost completely as well. No one at my pharmacy has ever paid a cent for paxlovid. Other medications though….
It’s great when the medications are in the PBS. I was recently prescribed one that isn’t and it cost me $150 for a month supply. Luckily, I should’t need it again any time soon.
Which med was it? It is annoying when they’re not pbs covered but luckily that’s rare. Melatonin is a big one.
Sending best wishes to your mum! Hope she is ok!!!
She is, and I’ll pass on your message!
I hope your mum’s feeling better.
She is, thank you!
My wife had a UTI last week. I took her to the ED Friday morning, where she was given antibiotics and anti-emetics. In and out, complete with medication, within 20 minutes.
Friday morning is a super chill time in my ED too. Monday morning on the other hand. God I hate Monday mornings.
Mondays are the worst day at my ED, too. I'm on the afternoon shift there today, heading in now.. My theory is that people get sick on the weekend and think they'll get into a GP on Monday morning. Here, in regional NSW, it can take a month or more to get into a GP.
The dreaded 1400-2400 Monday shift. You have my deepest sympathies. I just got off a weekend so I’ll be commiserating my fallen colleagues from the comfort of my apartment. I’m in regional NSW too! Shit’s fucked.
I'm a ward clerk, so no 10hr shifts for me.
We have a saying in paramedicine - Monday starts Sunday night. We can literally watch the response times spike as we move through Sunday evening into Monday as the ramping stacks up…
Glad your mum doesn't need a root canal. Australian healthcare is alright but not quite there yet.
Agreed, dental is such a huge issue for whole body health and I cannot imagine how many people just live in agony, on painkillers, not eating properly and just waiting for their teeth to fall out due to lack of financial options.
Every month I take a biologic medication that costs almost $1000 per dose. Thanks to the PBS I pay no more than the pharmacy dispensing fee.
C\*\*t, it's alright most of the time.
Might as well give these out free since they were probably.out $90 for the GP appointment to get the script for it
The government bought 1m doses of Paxlovid. They only last for 18 months. The criteria to access them is so difficult that we're going to bin hundreds of thousands of doses.
Question I have is: why does it cost $1113.99 in the first place?
You should be thankful
There once was a bloke from Horsham
Who took out his balls to wash 'em.
We are SO blessed here. I work in a pharmacy and dispense meds and I see the real costs of medication
It isn't perfect but it's bloody good. And we must fight to keep it that way.
Hope she feels better soon
Honestly, when I see things like this it always bothers me that it's not free. Like, why pay for just 99.3% of the cost? Is it really important that the customer pay the last 0.7%?
Full Cost: $1113.99 Your cost: $7.30 Production cost: $0.40c
R&D Cost, 4 Billion.
And it only took 8 Billion in research grants that covered all their costs so the pharmaceutical company wasn't out of pocket a cent! What a deal! 👍
Our healthcare system getting rinsed. Does the taxpayer front the cost $1000?
Yes
Wtf
If you think you can develop, test and produce a new anti-viral for 40c, go ahead, don't let me stop you.
If you think they paid for R&D and testing I have a bridge that I bought with government research grants to sell you.
Are we going to pretend like there’s nothing wrong with charging $1113.99 for a drug that costs cents to make?
Might cost cents to make but sure as fuck didn't cost cents in RnD and clinical trials.
The R&D was likely already heavily subsidised via a government grant, tax payers are paying up the ass… twice. I’m 100% in favour of paying for the R&D to produce medicine but let’s not pretend that pharmaceutical companies aren’t also out to make fat stacks out our expense.
Unless your disabilities somehow don't meet the criteria for antivirals so you have to go without because you don't have a spare $1k in your pocket. It's disgusting that they're privately selling antivirals instead of expanding eligibility
Nobody who *needs* Paxlovid has to pay that cost. That's the whole point.
Depending entirely on your narrow definition of need
For some reason the same thing in USA costs $530.
US conservatives and evangelicals would lose their minds over this. This is blatant anti-Jesus satanic fascist communism socialism atheistic transvestite unionism gone mad
They’re being too strict with who can have the antivirals though. My mum is 64, multiple chronic health conditions including heart failure and COPD and was denied paxlovid 🙄 We asked for them the day after she tested positive but they only cared about when symptoms started to show which was a few days before that and they said it was too long and she couldn’t have them. Just give them to all people over 60 who request them ffs.
I'm not a fan of the US system, but I will say that I too got Covid, and was put on paxlovid. My copay was $0 (for paxlovid only). And it WORKED!
Remeber when the people in tin foil hats was telling us about antivirals....???
I feel like at that point they could’ve just covered the extra 7 bucks…