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?

Change

I have some big news! HUGE news! We’re moving cities!

What?? Yep we’re moving interstate! Not what we thought we’d be doing for the rest of the year!

Why?? My husband has been chosen by his workplace for a project. It involves tailoring and implementing his workplace’s software, and the customer wants him on site to help smooth the whole process.

Where? We’re moving to Canberra!

When?? Well apparently his start date is still Monday 12th September, as it was set a couple of weeks ago when the project came up. Yep, as in next Monday!! It seems that that is still going ahead, despite the fact that his workplace still haven’t organized our accommodation at all!! They are meant to be covering our moving costs etc, but right now it feels like what move?! Are we really moving? In a week? Like next weekend??

How long? The project is meant to be for 3 months, but you know projects…we’ll see. We might still be up there in February!

So! Once the shock subsided, I think we like this idea! I think we like it a lot. So many new things to be experienced.

Of course the list of down sides can be significant: missing friends and family, feeling displaced or lonely, far from my doctors/support network, leaving my stuff behind etc. But let’s leave all that til it happens. Right now, the opportunities are spilling out in front.

It’s going to be exciting!

What better time to be an unemployed pharmacist with no job ties? Talk about silver linings! This has to be a pretty big one. No taking leave, or a leave of absence. No having to quit a job I like. I can just up and go at a moment’s notice; which as it turns out is just as well, since it might come down to that!

I’m going to be a tourist in a new city with unlimited time to check out all the fun places it has. I’m smiling spontaneously and getting a buzz just thinking about the endless possibilities, the sights I might see and the people I might meet. And I’m off the hook about jobs! It is a relief. I’m unlikely to fall across a short term part time job while I’m up there so free time! Like last time when I was off work, when I was still sick enough to not need to think about returning to work, but well enough for short daytime adventures. Like an organ concert, a blogging class, a river cruise, taking the tourist bus or the city circle tourist tram around the city, a couple of hours at the zoo or wildlife park, sketching in the botanic gardens…I had so many hobbies and attempts at hobbies and really tried to get around the city as much as I could for free or cheap.

Remember this, self, remember the excitement when your anxiety about not knowing when you’re leaving for this new city, when you need to be packed up by, where you’re going to be living, what you need to take, how you’ll get around, if you’ll miss home, if you’ll find new friends, if you’ll….argh!! The big ol’ IF!!

I don’t deal as well with change these days, not like I used to. I tend to get anxious and become stressed about the unknowns in life which I would have sailed right through before I got sick. I need more notice, more time to think and consider the options, and I’m generally just more of a pain in the butt about the details! I need details!! Ask my poor long suffering husband! I have to be reminded, and reminded that things will work out just fine and not to get bogged down in the minutiae of a situation. Just breathe, and things will be fine. Of course they usually are just fine, but my brain doesn’t keep a record of all the times things have been just fine. It still goes straight to the what ifs.

And now I’m feeling thoughtful and pondering after that little detour, instead of happy and anticipatory of the future! Annoying. Let’s get this back on track: excitement, happiness, adventure!

I started a list of things to do once I get there, whenever that turns out to be. A reminder of all that I can look forward to, and a prompt for me to get out of the house once I get there and make the most of my time.

I’ve looked up places to go bird watching and practice my photography. I’ve ordered some tourist brochures for all the typical things to do. I’ve thought of a couple of friends I have up there, as well as my brother and sister in law. I’ve started checking out women’s bike riding groups and places to go riding. I’ve planned visits from people who may not yet be aware that they are coming to stay! I’ve chatted to some people who live an easy weekend away from where we’ll be living. Actually there’s so much to look forward to if you put your mind to it. Which I try to do these days.

I’m still writing my packing list and checking it twice. But since nothing has been happening about accommodation and no new information has come up, I’ve sort of put the packing thing off until I know for sure there’s a furnished house with our name on it that I can direct my things to. I had my initial freak out about which knives we must take and which tea towels were essential, but a Valium and a good night’s sleep mostly calmed my heart rate and thinking speed down to normal levels about that, and I’ve only been a normal level of anxious since. Well I think so anyway.

I will miss being close to my doctors. I think that will be the hardest thing. I don’t want to find new doctors; I’ll stay with the ones that I have. That probably means a couple of trips back for my psychiatrist, and I’m not sure what I’ll do about GP appointments. I know I can always call them on the phone so that’s reassuring. I’ll need to get new scripts for everything before I go. I just have to remember that I’m only a phone call away, rather than thinking of it being a 6 hour car ride away! Or however long the flight is. But nothing is impossible really. Just have to think of another way around it.

All of this shows, I think you’ll agree, that I’m going pretty well right now. Being able to see the positives, the blessings, the advantages, is not something you can force while you’re unwell, however much other people try to get you in the frame of mind. It comes with time, and with health. I’m grateful to have been able to take this enormous change so calmly, for me, and so positively. It could have thrown me well off kilter and returned my to bed for days. I’m glad that’s not the case.

So, all things being well, I’m off Canberra to have a fun and adventurous time for a couple of months, and I’ll certainly be filling you in on my life living above the blue line!