Monday, September 19, 2016

Paying the price of healthcare

Last week I received the final bill for my healthcare adventure. The photo above shows the relevant part of the ambulance bill: $98 (today, about US$71.55). This means that my out of pocket expenses for my adventure totalled less than $200.

When I talked about the cost of the healthcare I received, I guesstimated that it would be about $200, and the reason I didn’t know for sure was that I didn’t know how much the ambulance cost. As it turned out, I was pretty accurate.

The bill was dated exactly one month after my trip to the hospital on August 15, which means it was pre-dated since I received it (and paid it) September 15, but it wasn’t the predated bill that caught my attention, it was the other charges. As I said when I talked about the costs, the ambulance charity, St John, offers a household membership, which offers a free ambulance trip. However, what I didn’t mention is that most trips in an ambulance after an accident are free because they’re covered by ACC (Accident Compensation Corporation), the New Zealand government’s universal no-fault accident and rehabilitation insurer. That’s another great thing about our health insurance, but funded by a separate levy paid by employers and workers alike through a payroll deduction, as well as levies on insurance, among other things. I knew about all that.

The bill’s surprise was that the fee paid by people not covered by our national healthcare system is $800, so that’s the true cost of the hospital ride for which I paid $98. Put another way, my direct cost was 12.5% of the total. The rest comes from taxes, including what I pay, of course.

Anyone in New Zealand temporarily might face that $800 charge. A tourist with travellers’ insurance (or really good coverage from their home country) might have that paid by their insurance. Workers in New Zealand temporarily may be covered by ACC, since a portion of their wages might be used to pay the levies. However, that’s something the worker should find out in advance because not all such workers pay the levy. People in New Zealand with a residence permit (also known as “permanent residence”) are, as far as I know, always covered by the national health system (as is true for temporary workers, it pays to ask).

The larger point here is that the value of my healthcare was, at a BARE minimum, some NZ$26,000, but I paid less than $200 directly.

Since then, I renewed my prescriptions and got a three month supply of them all for $20, which will be my quarterly cost for awhile (I’ll pay that at least once more, but one of the pills is only for six to twelve months, so it’ll stop at some point and my quarterly cost will drop to $15, plus doctor appointments, the cost of which can vary a bit and is only partly subsidised. So, using only high costs, my annual out-of-pocket cost for my routine healthcare will be about $NZ260 (US$189.84). That's it, since I don't have to pay health insurance premiums.

I can—quite literally—live with that.

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