4 years

6th March, 2018

Well I had other ideas for today’s blog, but Facebook reminded me that today 4 years ago I was recovering at home, supervised by my hubby working from home, after a VERY long afternoon/night in the emergency department having finally come to the crunch point of my nervous breakdown.

It was the first day of many days off work: 6th March 2014 to 22nd July 2015.

It felt long!

It felt like it would never to over, that life would just trickle by forever. Me at home, on my own, barely able to fill the hours of the day, just dragging along until the next…what? Hour, day, week, year?

After 18 years of full time school; 4 years of full time study plus part time work; an intern year of full time work and study; and 4 years working full time (apart from a period of 9 day fortnights during 2013 for health/stress reasons, and a brave if futile attempt to get back to work and save my job by dragging myself 2 days a week to work in the outpatient dispensary at the Alfred in the month before my contract expired late 2014) it was a shock!

I didn’t know what to do with myself physically, let alone mentally. So came a long list of attempted hobbies to try to fill up my time, more or less successfully. 4 years on, some have stuck, some haven’t, but it’s a different problem now: finding time for those hobbies! Time for bird watching, for photography, for blogging, and my re-discovered love of gardening. I’m back at work, currently 4 to 5 days a week! Who would have ever thought?! And it’s cramping my style! How’s that for ironic? For months, years in fact I’m dying to get back to work, really back to working full time or close to it, and 5 minutes later I’m missing my me time!!

It could be worse. If anyone can say that it’s me. I was worse, I’ve been worse; so I really know that it could be worse. I do. But it’s the perspective you have at the time that frames how you see things. And my perspective now is mental wellness and relatively good physical health, so the smaller things weigh more, like doing my hobbies! It’s not a bad place to be, hey? Four years on.

Private hospital 101

I work at a private hospital, in the emergency department (ED). Prior to starting this job in August last year, I had spent all of my career, apart from the obvious gaps when I was sick, in public hospitals. The change has been quite interesting from several financial prespectives.

  1. Funding private hospital ED

In a public hospital emergency department, as long as you have a Medicare card, everything is free. To you, I mean; obviously the cost has to go somewhere, so it goes to the government because they believe in free access to healthcare for all Australians through their funded hospitals. It’s actually one of THE most amazing, and EXTREMELY underappreciated benefits to living in Australia. Whatever you think of any government down under, you absolutely SHOULD respect and appreciate this benefit of life here. If you had any idea how much money you rack up in one long wait in ED for nursing care, medical care, tests and scans, medications, interventions and so on, I think you would be shocked! We are talking hundreds if not thousands of dollars over several hours, and that’s just in ED. Try to think of healthcare, and paying your taxes, from this perspective; maybe you’ll be calmer in the ED, and more resigned to all that money you fork over to the government.

To access the emergency department where I work, you pay $300 upfront before you walk in the door which is an out of pocket fee, not rebatable by your health insurance, paid on the spot before anything else happens. Basically it’s a general fee against the types of costs you rack up, such as medications, blood tests, Xrays and CT scans. If you end up accumulating costs above this payment, they may be charged to you. At the beginning of working here I thought this wasn’t great, or fair, as far as healthcare equity goes . But now I think about it differently. We are one private hospital. In the city of Melbourne there are 3 major public hospitals: Royal Melbourne Hospital, St Vincent’s public hospital, and The Alfred, as well as specialized public hospitals: Victorian Comprehensive Cancer Care, Royal Children’s hospital, The Women’s, Eye and Ear hospital. That’s plenty of public health to go around, and its just in Melbourne city; not the suburbs. There are other private hospitals as well, and I’ve come around to accepting that there’s a valid place for both. We are only trying to recuperate costs outlaid because the government doesn’t fund our patients, we do, at least in the outpatient setting. That’s what category the ED technically falls into, outpatient; in fact sometimes you hear it referred to as outpatients. Private health insurance, check the small print, only covers the INPATIENT stay once the patient is admitted to the ward so if we don’t get some money somehow for what we do in ED, we are totally out of pocket ourselves, and as a private enterprise, we wouldn’t be able to continue to offer healthcare, which would be bad for everyone, not least of all me whose whole day is spent in ED which I love!! So yes, I do now see the virtue. Yet somehow, when I see someone on a stretcher with a vomit bag being asked to sign waiver forms for their $300, it still generates an ick factor!! Weird, huh?!?

I would add, because it is relevant, that the $300 fee does also serve a function of natural selection where those who can afford it come into our ED, and those who can’t afford it, don’t. That’s not to say that they are just turned away, not at all. We always ensure they are transferred to a public hospital that can care for them without the money burden. And all patients coming in by ambulance are informed before arriving that the fee applies to them, so that they can choose to go to a public hospital should they not want to pay. So, would you pay?