Moving to Australia as a progressive in 2016: logistics

This article is part of a short series on one person’s perspective on what people might want to know before considering immigrating to Australia as a person with progressive politics, in 2016.

Money and privilege

While there are innumerable ways of immigrating to Australia ranging from skilled migration to attempting to seek asylum as a refugee (there’s a more comprehensive list here) it is very hard to move to Australia unless you are on an above average income for a rich country, and have other privileges such as education and health.

I’m not in a position to advise on getting around that, but I do want to acknowledge it, and I will focus on the big costs of living in Australia, now and in the future, in this post so you know what you’re getting into.

If you need to seek asylum, you probably know that Australia’s refugee policies are cruel and inhumane. I’ll come to that in the politics entry. I am profoundly sorry you are in this position and that Australia is making it worse.

Skilled migration

In this section I’ll talk about skilled migration as I understand it. If you may be eligible for other Australian immigration pathways such as having close relatives who are citizens or possibly being a citizen (for example, you were born here prior to August 1986) I won’t touch on that here, be sure to look over your connections to Australia and the different visas for possibilities.

Very important: I am not a lawyer or immigration expert. If attempting to immigrate to Australia under our visa regime, you should make use of official advice and, if possible, advice from an immigration lawyer. You may also want to seek perspectives from Australian immigrants; I’m an Australian citizen by right of birth and have been a resident my entire life, so my perspective is from second hand experiences.

First: skilled migration to Australia is considered to be pretty tough to do. I have no special insight into New Zealand’s equivalent regime, but I have known people in the past who chose to naturalise as a New Zealand citizen and then work in Australia (most New Zealand citizens can enter Australia and work here under a special visa category) rather than attempt to immigrate through Australia’s system. That should give you some idea.

Australia’s immigration regime, particularly for permanent residency, discriminates in many ways, specifically, in favour of young, healthy, highly educated people in particular professions. Your education will be assessed. Your ability to work in a targeted profession will be assessed. Your health will be assessed. It is a points-based system where certain attributes give you “points” and you must pass a certain threshold to be granted residency. The older you are the more points you will need. Again, I am not an expert but the last time I saw the points assessment applying for permanent residency on the basis of skills was increasingly difficult after age 30 and close to impossible after age 45.

A permanent residency skilled migration visa presently costs AUD 3600 to apply, which is not refundable if your application is denied. Assessment of your skills and your health check are not included, and can cost AUD 500 or more each.

Smaller but still substantial difficulties I have had friends encounter:

• bridging visas: these visas are often granted to people transitioning between Australian visas, such as between a student and a residency visa. Bridging visas very frequently last for a year or more and on some of them you cannot leave Australia without a good reason, at penalty of forfeiting your right to return.
• wait times for visa assessment can be long, and may hinder any travel to Australia in the meantime
• targeted professions: these change, and changes can apply to existing applications, not just to new ones

The main alternative is entering temporarily on a work visa, usually a 457. These last up to four years after which the normal pathway is transitioning to skilled migration in any event. They obviously require a sponsoring employer with all the difficulties that entails, including the risk of needing to leave Australia if your employment ends or you can’t get permanent residency.

Finally, if you are considering (further) tertiary education or are open to it, you could apply to an Australian university and enter on a student visa. Holding a specifically Australian university degree is in turn a boost to your later skilled migration case. Major cautions: there are some scholarships, particularly for research degrees, but if you aren’t awarded one, tuition fees may be tens of thousands of dollars per year; and the university application cycle may not suit your plans to move. You can typically work on a student visa but only for a limited number of hours a week.

My understanding is that Australia typically does extend visas to your immediate family (under a certain definition of family that you can more or less guess at) if you are a permanent resident or on a long term work visa, and these include the ability for your spouse or partner to work. (This also includes student visas, last I heard.)

While Australian law does not recognise same-gender marriages for immigration or any other purpose (coming in the politics entry), you are recognised as de facto spouses along with unmarried woman-man partners, and de facto partners including same-gender partners can get visas. Either marriages or de facto relationships may be examined for being whatever the immigration authorities consider genuine relationships to be. It looks like marriages and de facto partnerships are, among other things, expected to be “exclusive”, ie, there is not support for your multiple spouses or partners obtaining a visa when you get one.

Again, there are visa categories not discussed here, definitely do some research.

Other experiences

As a special and very terrible example of the way that health and ability status can interfere with Australian immigration, there are many folks with Down syndrome whose diagnosis caused their or their family’s visa applications to be declined: Lukas Moeller in 2008, David Robinson in 2008, Eliza Fonseka in 2016 (all these cases were overturned in the applicant’s favour by the Immigration Minister, but presumably most aren’t).

Earning money in Australia

Australia has a highly educated workforce and a resources and service economy; we mine raw materials, and we sell things to each other. The resources economy is boom and bust, and presently more towards bust. The wealth and education level of the country means that R&D certainly happens here, but it isn’t a major economic driver and political interest in it and support for it waxes and wanes.

Australia was one of the few wealthy countries to avoid a major recession and employment crisis circa 2009 and has had around 20 years of continuous economic growth. For an aggressively pro-Australia take on this — much more than I’m willing to go with — here’s former Prime Minister Paul Keating this last week (warning for some mention of gun violence):

[T]his society of ours is a better society than the United States, than the society of the United States.

I mean, it’s more even, it’s more fair, we’ve had a 50 per cent increase in real incomes in the last 20 years, median America has had zero, zero.

(As a note in interpreting Keating if you read that interview: he is a famous advocate of much closer ties with Asian countries; that isn’t a truly mainstream foreign policy position in Australia. He’s also famously provocative. And… he was the Prime Minister ending those 20 years ago. the story of his relationship with Australian economic growth is a long one and I’m not the person to tell it.)

Many of my readers would be interested in software jobs. There is a comparatively immature but growing software startup scene (with major involvement from Australians and other residents who have lived in the US) and a growing amount of funding. Several major US technical employers have a long-time presence in Australia, including Google and Microsoft, and due to the timezone, it’s also a reasonably popular base for at least a small ops/SRE site. Atlassian is the best known company that is the other way around: Australian founded, expanded to the US, and there are others. Major banks, both retail and investment, are fairly large technical employers. I feel that Sydney and Melbourne are not the Bay Area, or New York, or Boston, but there are certainly software jobs, including very senior ones, around, and increasingly so.

Unemployment stands at 5.8 percent. It was slightly worse in 2014–2015, but that’s because those two years were the worst two in the last ten. (That said, it was above 10 percent in the 1990s — again, when Keating was Prime Minister… — so it is far from historically high.)

This may be stating the obvious but there are big regional variations in employment, income and wealth, with urban residents of inner cities doing the best.

There are welfare payments for unemployed citizens and permanent residents funded by the state, they’re subject to increasing restrictions and strict interpretations of the rules and recipients are an easy target for any government that wants to look tough.

Risks: I think there’s a strong risk that Australia’s growth trend will not continue much longer. There’s a resources bust. Graduate un- and under-employment is at a record high. Our interest rates are now very low (although not as low as in many countries) and the Reserve Bank therefore has less levers to pull to stimulate the economy in the event of a slump, particularly without further stimulating the housing market which really doesn’t need their help. And we’re strongly vulnerable to global shocks, although not more than anywhere else I think. If I had a choice — and anyone looking at skilled migration has some financial resources unfortunately — I would be cautious about immigrating to Australia without an offer of employment in a seemingly stable workplace, or else savings or an independent income stream.

Paying for big stuff in Australia

Short version: a lot of stuff is pretty expensive in Australia. Consumer stuff-wise: it’s a wealthy country with a small population that’s a long way from most other places. Food and consumer goods are priced accordingly and this can be tough. I’m sticking with big ticket things here.

Housing

Real estate in Australian capital cities, especially Sydney, is world-leadingly expensive and likely to be a shock unless you are moving from Manhattan, the San Francisco Bay area, or Tokyo, and perhaps even then if you were hoping to save money. Presently in Sydney, houses have a median price of AUD 1,000,000 and apartments AUD 650,000. And keep in mind that Sydney is a large metro, and that data includes dwellings with a commute to the business district in the order of two hours each way. Those aren’t the prices of “lifestyle” suburbs. Meanwhile, Sydney rents are a AUD 490 weekly median for houses (about AUD 2200 monthly) and AUD 465 weekly (AUD 2100 monthly) for an apartment. Expect other cities to be cheaper, research how much. Prices vary a lot by city and local conditions.

At present in Sydney rents are quite stable, even arguably about to fall. Purchase prices continue to climb. There is a heated and long-running debate about whether Sydney in particular or Australia in general are in a housing bubble, if so when it will burst, and if it bursts how big the falls will be. As with, as far as I can tell, all bubbles, almost no one will be close to the mark on the details and the person who is will have done it by accident. It’s been seven years since the Mount Kosciuszko bet now and as far as I can tell the various arguments remain. But at the very least if you buy a dwelling in a major Australian city, you are buying it in what could be a bubble.

Personal opinion: Australia needs higher density housing in major cities. I’d prefer that housing prices flatlined for a long time while inflation degrades their real value rather than collapsed because of knock-on effects.

Medical care

Right now, as best I can tell, acute medical care in Australia is fairly cheap by the standards of rich countries, and of excellent quality. There is universal healthcare for citizens and permanent residents, some of which is free, particularly acute care in a public hospital, and, for many people, regular care from a GP. There’s a set fee called the Medicare Benefits Schedule. Medical practitioners are free to bill the MBS (called “bulk billing”, free to you) or charge what they want above the MBS and you pay what is called a “gap” (the term “co-pay” is only starting to show up).

The best specialist tertiary acute services such as neonatal intensive care are most commonly only available in the free-to-the-patient public hospitals.

Likewise, there is a single payer for pharmaceuticals, the Pharmaceutical Benefits Scheme. The upshot of this is that typically, if a medication is PBS listed, you pay around $30 to $40 for it (less if a low income earner, there’s an additional scheme) and the balance is paid by the PBS as negotiated between the PBS and the supplier.

The existence of the PBS and the MBS apparently often mean that even unlisted drugs and procedures are cheaper than they would be in the United States, as they drive down consumer expectations of cost. If everything else costs $40, you’re less likely to pay $5000 for a particular drug even if you can afford it.

Bulk billing is offered by many but far from all GPs (and more often to children, students and pensioners) and some specialists, but specialists less so. A gap is common there. To give a sense of it, as a thyroid cancer patient, I end up about $100 out of pocket to see my endocrinologist, my endocrine surgeon bulk bills for office consultations but decidedly not for the surgery itself, and my imaging can run to a few hundred dollars. However I’m lucky enough to be a bit price-insensitive: I could have had the surgery for free in a public hospital by the surgeon’s registrar, and I could get cheaper imaging in a few other places.

Billing is usually quite predictable to the practitioners and they (and especially their receptionists) can usually state it entirely accurately in advance. There are esoteric exceptions, the main one that’s happened to me was a couple of genetic tests where the exact price was uncertain.

Holders of 457 visas and student visas and similar will need to buy health insurance, both in case they get sick but also as a condition of the visa. A quick look places it at between $20 a week for singles to $60–$100 a week for families. Private health insurance in Australia, both the kind citizens and residents can buy to afford care in the private system, and the kind that visa holders need to get access to the public system, has strong regulatory restrictions avoiding much health risk discrimination; it’s group risk. The major form of restriction they can and do apply is waiting periods; usually six to twelve months for pre-existing conditions to be covered. I am not sure how this applies to visa-holders who need care for a chronic condition, or preventative care to prevent a pre-existing condition worsening; this would obviously be something you’d need to seek advice on.

As for the private system, there is a parallel health system of non-emergency care with some benefits, such as choice of doctor and ability to be on shorter waiting lists. Public benefits apply to procedures but not in-patient stays in the private system; many Australians carry optional additional health insurance against such stays. Honestly, it’s a complicated and weird system and I won’t get into it here.

I like our medical system a lot, and I’ve been its reluctant guest several times. However it is of course not all bright side. Some downsides:

• It’s completely possible for all the little gaps to not be so little to you, and for this to be too expensive.
• Non-emergency care for public patients is accessed in order of urgency; as a public patient, you can wait months or years for a procedure that would substantially improve your quality of life but is not putting your life at risk.
• Just as the MBS and PBS spare you detailed arguments with your insurer about a procedure or drug, they deny you arguments. If a procedure or drug isn’t on the schedule, it isn’t on there. You or your doctor may be part of a group making a case for it to be on there, but in the meantime, you’re buying the drug out of pocket; there’s no individual consideration. For some newer cancer therapies for example, this can cost tens of thousands.
• New drugs tend to be accepted for coverage by the PBS later than they are by, say, good US medical insurers, and the alternative is out of pocket. I’ve only twice in my life encountered this situation, once was for the Nuvaring contraceptive which I bought out of pocket for about $1 a day, and the other, unfortunately, is potentially far more impactful but it’s a thyroid cancer specific case.

Risks: this system has never been beloved of our conservative (currently governing) Liberal-National coalition. They developed an active policy a few years ago to begin charging $7 gap fees on all medical care (if applied to all GP visits, and all blood tests ordered, and all imaging ordered, this adds up; trust me, I’m a cancer patient with regular lifetime monitoring requirements) and I assume that was an opening salvo in a move towards a much more user-pays health system. It was a deeply unpopular proposal and failed. It was popular with neither doctors nor the public. However, I can’t see very far into the future on this one, and I’m not assuming that the current system will substantially survive into my old age.

Trans care

Briefly, I researched this and it seems that top surgery is sometimes covered under MBS codes for mastectomies and similar breast surgeries. Other affirming surgeries often have no MBS coverage, and hormones also have patchy if any coverage under the PBS. Here’s a 2014 statement calling for change from the National LGBTI Health Alliance.

Movement on this seems generally slightly towards improved coverage. Eg, in 2013, several procedures related to eg uteruses stopped being restricted by gender on the MBS. There’s a long way to go.

In terms of papers, for federal government paperwork see Australian Government Guidelines on the Recognition of Sex and Gender. In very very short form, there’s an ‘F’, ‘M’, and ‘X’ designation and the preference is to collect identity unless your assignment at birth is considered specifically relevant. (Note: there’s the fairly common distinction between sex and gender in those guidelines, which I know does not capture the experience of many people.)

Updating birth certificates is a state-based issue, and some states, including NSW, require affirmation surgery as a prerequisite.

Personal opinion: this sucks badly, I’m sorry.

Reproductive choice

Contraception is widely available in Australia and many medical methods are covered under the PBS. For example, the Mirena IUD costs around $40 for the device plus (potentially) any private fee to have it inserted by a privately billing gynaecologist if you don’t or can’t wait for a public clinic. (Family Planning Australia also trains GPs to insert them but I’ve only ever met one who has done the training; I’ve known quite a few who can do Implanon insertion.) Many common formulations of the contraceptive pill are covered on the PBS, resulting in a cost of around $0.30 a day. Condoms are available in pharmacies and supermarkets.

Risks: Denying or restricting contraceptive access is not a topic of regular political debate; I can recall it arising once in my adulthood. I don’t fear loss of access to contraceptives absent a major change in public opinion or national politics. (Obviously, that’s not zero risk.)

Doctors and pharmacists can refuse to issue or fill prescriptions. (See a 2015 news story.) This has never happened to me, and in major cities there’s a lot of ability to switch practitioner if this happened. In isolated rural areas it can be a problem, as can access to medical care at all without considerable travel and cost.

Abortion availability is governed by state law, because the states inherited the English Crimes Act which forbade it. At the present time, abortion is fully legal in several Australian states up to a certain week of pregnancy, some time between week 14 and 24; state-by-state details here. In some states doctors who personally refuse to perform or refer for abortions must at least provide a list of willing doctors to patients. Abortion remains illegal in NSW and Queensland. In practice in NSW at least there’s case law which gives a fairly wide definition of “harm to the mother” that includes social and economic factors and abortion can be accessed in NSW but it’s more expensive, more tightly overseen by doctors and ethics committees, than it would be if it were decriminalised. Several years ago I transcribed a detailed talk by a lawyer about the NSW situation.

In general, the legality of abortion is supported by a reasonably sized majority of the Australian voting population (albeit increasingly less so in late pregnancy) and it is not a central political issue. This has some cons in that legalising it in NSW and Queensland is not perceived as an urgent issue. In NSW Upper House member Mehreen Faruqi is championing the decriminalisation of abortion, you can learn more at #end12.

Risks: Aggressive restriction of abortion is not something I see looming or worry about but it’s possible and more likely than aggressive restriction of contraceptive access. There have been attempts to establish fetal personhood under law in several Australian states, notionally aimed at injuries to the fetus incurred when the mother is harmed, but championed by politicians who are anti-abortion and presumably therefore ultimately aimed at (further) criminalising abortion. To date they have not become law but it remains a risk. In addition, my sense is that there is some complacency that the current status quo is good enough, even though Queensland criminally tried a woman for an alleged home abortion in 2009 and abortions stopped throughout the state for periods of time due to the legal danger to doctors.

I won’t deal with reproductive rights of people who are pregnant and plan to continue in as much detail, but Australian birthing largely takes place in hospitals, with access to midwifery care and especially homebirth often not available or based on very strict medical criteria (eg, most or all of: normal BMI, no prior birth over 4kg, at least one prior full term birth, no diabetes or blood pressure issues, singleton…). Caesarean section rates are around 30% of births; choice-wise I believe requests for maternal-choice Caesareans are frequently denied, especially in the public system.

Disability resources

Could be vastly improved, although I am not myself disabled or experienced with navigating the system so cannot speak to it in great detail. One major issue disability advocates talk about is a continuing political focus on “return to work” if at all possible, including if returning to (or starting) work is technically possible for you but would leave you unable to do anything else.

If disability resources and caretaking are part of what you need to consider, you should carefully evaluate the National Disability Insurance Scheme rollout, its scope, and the political threats to it. A small sample of writers and activists you could learn more from are:

• Sam Connor
• Lauredhel at Hoyden About Town and Feminists With Disabilities
• Stella Young

Mental health care

A limited amount of outpatient mental health care is available under the MBS, for more details see the Department of Health. Private health insurance often has some cover for additional therapy.

I have some limited experience of this process, and it was that MBS funded therapy tends to be focused on whether you have a DSM diagnosis, and on discharge if and when it appears that you don’t. Most folks I know have had slightly better experiences although the number of sessions funded per year is very low for a lot of people.

Acute mental health care is somewhat available through the public hospital system, but my understanding is that the availability of acute care hospital beds has basically never met demand.

Education

There is publicly funded primary and secondary education in Australia for permanent residents. In NSW, schooling is Monday to Friday, 9am to 3pm, roughly 40 weeks of the year.

Primary and secondary schooling are funded by the states (recall though: we only have six states and two territories). The states also set the curriculum. My belief is that this somewhat evens out inequality relative to a local funding and curriculum model, but it’s not magical. There are seriously disadvantaged schools in Australia. There’s also the outsourcing of tuition fees to the housing market: schools perceived as desirable drive up local housing costs. And there’s increasing discussion of race-based moves away from local public schools. I have definitely had white Australians tell me (usually subtly) about their schooling and housing choices being driven by wanting their child to attend a majority-white school.

Free schooling is not necessarily available at all to children in families without permanent residency.

There is a competing private school system, which by and large adheres to the same curricula as public schools with the odd exception (mostly offering the International Baccalaureate). Many but not all of the system is run by religious organisations, and since religious organisations in Australia are allowed to discriminate, so too are their schools. Private schools also receive substantial public funding, but charge tuition fees ranging from nominal to astronomical.

Personal opinion: public funding of private schools should be abolished. I don’t expect to see this any time soon; I expect this would be exceptionally difficult both politically and in terms of planning (as there would be increased demand for public schooling), but, it should be.

Risks: means-testing of public education is on the table, and some members of the government are of the opinion that all education should be private. I think in the medium term this would only go as far as some kind of mandated but not large fee for wealthy children attending public schools (and a corresponding move of some of those families to equivalently priced private schools, which is probably the policy goal).

There is public funding of tertiary education in Australia, but tertiary education is not free; universities charge a regulated and often substantial amount. In addition, the public funding is attached to, you guessed it, Australian citizens and permanent residents; full tuition is charged to others and is usually in the multiple tens of thousands per year.

Australian citizens (only) admitted to eligible university places can borrow their tuition fees from the Australian government at (presently) only CPI-linked interest rates and with repayment through the tax system once your income is high enough.

Risks: I think there is a serious risk of tertiary tuition fees being fully deregulated in Australia in the next ten years, especially since some of the universities support deregulation. There is also serious risk of the loans scheme moving more towards a private model with market interest rates and the ability of the lender to, eg, have input into the jobs you choose. I don’t think our tuition would rise as high as the United States for two reasons: one is that the universities aren’t held in as high regard as some in the US, and the other is that there’s an entire generation of wealthy children whose parents have not been saving for their university tuition since birth, so there’s a medium-term limit to the fees that even rich people would accept.

Caretaking

There is only very limited fully publicly funded childcare in Australia, and most of it is educational in nature (ie, focuses on children at a preschool age). Childcare that is more designed for the benefit of adults in the household (ie, childcare so you can work) is privately provided, sometimes not-for-profit and sometimes for-profit. Centre daycare is pretty tightly regulated, daycare in the carers’ home increasingly regulated, nannies not very regulated. There is some public contribution to centre fees for permanent residents and citizens, particularly those on low incomes. Unfortunately, because the fees aren’t regulated, they have arguably simply risen to absorb the public contribution while keeping out of pocket costs the same, which is bad news for folks who aren’t eligible for the public contribution.

There is no universal daycare right recognised in Australia. Your ability to find care depends on a private market. My experience is that people usually can find it, but needing to alter your workdays or defer working to wait for a place, commuting out of your way to daycare, accepting a daycare place at a place neither you nor your child like, and an awful lot of anxiousness, are all very normal.

Out of school hours care for school-aged children (eg, 3pm to 6pm, school vacations) is similarly privately provided. Individual schools may or may not have an arrangement with a particular provider and that provider may or may not be able to accommodate demand.

Personal opinion: I think having a scheme involving public contributions to private unregulated fees are pretty silly.

Risks: there is no question that the funding for childcare is changing radically because policies are actively being worked on. I haven’t read them closely but some of the changes seemed progressive if anything: moving an already means-tested system towards supporting low income people. (I’m agnostic on whether means-testing for state benefits is a good thing, but when it exists it should be clearly progressive.)

I unfortunately have little insight into accessing and affording paid caretaking for young or old adults who need or want it.

Conclusion

As you can tell, there’s two big issues here: migration is by far the easiest if you are financially well-off and basically the same kind of person who is less at immediate risk of punitive economic policies and severe employment discrimination in your own country, and the other is that as in any country, Australia’s publicly funded medical and educational resources, and policies in general, are always at risk from our governments and economic conditions. I partly wrote this so that you know that.

In the next entry I will discuss how some issues that progressives may care about are dealt with in Australia.