aussiejono

Thought you guys might find it interesting to read about how we do it in Australia.

Some of the things we do are better than in the US, some worse, some just different.

1. We have a national health service.... the government insures everybody for health and sickness. You can chose your doctor, the government pays a set rate per visit, some doctors accept this as full payment, others charge about $10 or so extra

2. We have a national pharmacuticals plan..... the government subsidised drugs, and is the sole buyer, so drive prices quite low. They insist on price being linked to effectiveness. You pay the first $30 per script, the government pays the rest. Low income earners pay only $5. There is a list of covered drugs, drugs for trivial conditions arnt covered (nasal decongestants, hayfever remedies etc)

3. Most pain management is conducted by PCP's. Provided they obtain a second oppinion they can prescribe six months opoids at a time (one months supply and 5 repeats) Pain clinics at major hospitals are usualy used for terminal cancer patients or those who dont respond to opoids

4. The Australian equivalent of the DEA has no role to play in the medical use of narcotics.... it is soley a health department matter. To prescribe a narcotic for more than 4 weeks, a doctor has to notify the health department.... they supervise prescriptions to check for reckless prescribing or people obtaining scripts for more than one doctor.

5. because we are a small market, we have a somewhat smaller range of drugs than the US. The biggest lack I see is there is nothing between the weak narcotics (codeine/tramadol) and the potent ones such as oxycodoene and morphine.... no hydrocodone, or dihydrocodeine. Codeine Paracetamol isnt a controled drug, neither is tramadol. Indeed, we can buy tablets containing 500mg paracetamol and 15mg codeine over the counter.

6. We seem to love paracetamol/acetamonophen.... it is used for virtualy every pain patient, in a dose of 100mg 4 times a day, as a base which is built on, even if you are on Oxycontin or Kapanol, you will still be told to take regular paracetamol.

7. Chronic pain is still badly understood and treated by many doctors.