Health care
Health care is one of my pet issues. I have dificulty believing what I have read above about keping the private health system private.
The excessive power of the private health insurance industry is part of the PROBLEM in the USA <br
Australia has an interesting system, a mix of state owned, religious owned and private health care. I am particularly proud of our country having such a system, though it is being undermined and eroded by our current (conservative) administration. (as an aside, our main conservative political party is called the Liberal party - go figure...)
All the main hospitals are state owned, except for a few religious owned which operate with State funding as long as they abide by the rules for the State system. They are free to operate privately outside the system if they wish, too, but they would get no government funds.
Every Australian who earns above a certain minimum wage contributes a pecentage of their income (3%?)as a Medicare Levy. It is collected as part of your taxes. In return you get a medicare card which entitles you to treatment for free at all hopsitals for necessary medical treatment. Also visits to your doctor are heavily subsidise by Medicare. For example a consultation with my GP costs me $45, of which I get a refund from Medicare of $28, so the visit cost me $17 net.
Doctors if they prefer can opt to "bulk bill", a system where they don't charge their patients anything, but bill Medicare directly for a reduced rate. Most bulk billing practises don't allow you to book ahead, you just turn up and wait your turn, often up to an hour wait. Bulk billing practices are most common in larger cities where there is competition between doctors, in smaller towns it us unusual. People who earn below a minimum level get a "health care card" which entitles them to bulk billing at most doctors and reduced fees at the few others.
There are also Community Medical Centres where a combination of medicare and other Government grants (Federal, State and Local) provides free health care for services not provided by GPs or hospitals. A couple of years ago when I started to have problems with anxiety and depression, I was referred by my GP to a community health centre where I got the following assistance: weekly visits to my home, 1 hour per week, from a counsellor for about 3 months to assess my situation, calm me and get me on course for further help; attend a "living with anxiety" course in town, 1 day per week for 8 weeks plus access to extra if needed; weekly visits to a psychologist for cognitive behaviour therapy, for 6 weeks, could have gone longer if needed; later occasional follow up if needed.....all this cost me absolutely nothing, just my regular medicare levy. Had I not had this assistance I would probably have committed suicide by now. As it stands now I am happy, really over the problems, the help was really effective and not drug treatment
Pharmacy costs are also low in this country - all prescription drugs must be assessed under the Pharmaceutical Benefits Scheme (PBS). No PBS approved prescription medication will cost more than $28 per script. (might be a bit higher now??) For healthcare card holders the max cost is about $5. No family will have to spend over about $200 per year on prescription meds - more than that, you get an equivalent tax refund. The PBS approval process involves an assessment of the benefits of each drug, any extra benefit or risk compared to existing drugs, the cost of the drug, lots of other stuff I guess. The interesting part is that the government is the sole customer for PBS listed drugs - they are sold for the PBS price through pharmacies but the government pays the negotiated price to the drug companies, so there is, to the drug companies, only one customer. That gives great market power to the PBS authority and really drives drug prices down. The drug companies hate it amd lobby against it constantly but we Aussies reap the benefit.
The facts are that the USA spends a much greater percentage of its GDP on health care than Australia, yet Australia has demonstrably better health outcomes. This is for a number of reasons: 1. Our system removes power from huge insurance companies and drug companies, who gouge the system where they can. 2. Our system means it is easy and cheap to visit the GP, so we tend to visit the GP earlier in an illness, are less likely to try to avoid a doctor visit on cost grounds, so serious diseases tend to get picked up earlier when treatment is simpler, cheaper and positive outcomes more certain. 3. Our system gives very similar support to all income levels, there is not one good system for the "haves" and a miserable one for the "have-nots". Despite the rhetoric to the opposite, mostly whether you are a "have" or a "have not" is a matter of luck, not hard work. So we do not have an underclass of people who can't afford health care <br
Our system is not perfect, it is stretched and it is under attack from the current administration. Fortunately it is immensely popular so there is only so much damage they can do,go too far and they will be thrown out. (it happened in the 70's - in 74 the Labor government brought the new system in, at that time called Medibank. For other reasons they were thrown out in 75, the Liberals quickly abolished the scheme, turned Medibank offices into an ordinary health insurance company. It was really unpopular and at the next election they were defeated, Labor got back and re-introduced the scheme under the new name Medicare.)
It is also under threat from the US federal administration, who are lobbying our government to abolish the PBS scheme as it is unpopular with US based drug companies who can't gouge the Australian system like they do at home. The US gov't says it is a trade restriction violating some free trade agreement.. <br
Bill and Hillary Clinton visited Australia early in their administration and were very impressed with our health system. Bill said he was going try introduce some aspects of it but said it was most likely the medical lobby in the USA would kill any hope of such reforms. Unfortunately it seems he was right.. <br
oh and by the way it ain't Socialism. It's called a mixed economy, where both government and private industry can participate in the same sectors of an economy. It means government can create competition to private operators, forcing them to reign in some of their worst behaviours. It works <br
Chris.
