Australia's ideologically-triggered health care crisis
A widely-publicized report in the Washington Post addresses the fact - long known to most people who have studied the issue - that while Americans spend more on health care than anyone else, they derive far less value for money. 'The survey, published in the journal Health Affairs, questioned 6,957 adults who had recently been hospitalized, had surgery or reported health problems between March and June of this year.' The respondents came from the United States, Australia, Canada, New Zealand, Britain and Germany. (SOURCE)
The report's conclusion, albeit one I would have expected, seems to me incontrovertible proof that in many respects central to our lives, welfare state solutions are by far the most efficient.* Indeed, out of the countries surveyed in a study those who seem most contented with the quality of their health care are the British, whose national health care system is usually depicted by conservative ideologues as a little more than a joke.
A hitherto unremarked aspect of the survey is the fact that Australians do not differ radically from Americans in their dissatisfaction with the quality of the health care they receive. While 'about half' of the Americans surveyed said 'they had decided not to fill a prescription, to see a doctor when they were sick or opted against getting recommended follow-up tests,' New Zealanders and Australians weren't too far behind, with 38 percent and 34 percent respectively (but only 26 percent of Canadian and 13 percent of British respondents). In every aspect of health care examined in the survey, Australians are firmly located on the dissatisfied end of the spectrum. 'Americans also reported the greatest number of medical errors. Thirty-four percent reported getting the wrong medication or dose, incorrect test results, a mistake in their treatment or care, or being notified late about abnormal test results.' Canadians and Australians followed with 30 percent and 27 percent respectively.
Strikingly, Australians are paying more than most other countries for health care. 'Nearly a third of U.S. patients reported spending more than [a thousand USD] in out-of-pocket expenses for their care, far outpacing all other nations. Canadians and Australians came next, with 14 percent of patients spending that much. The proportion reporting similarly high costs was far lower in the other countries (my italics).' In short, Australia may not be doing as badly as the U.S., but it is doing badly compared to other countries. This report therefore obliges Australians to ask harder questions about what is happening to health care in this country since the advent of the Howard government, which has subverted the foundations of Medicare (our national health care system) to the point that for many of us it scarcely exists anymore. As Peter Sainsbury, President of the Public Health Association, complained in 2003,
The current Commonwealth Government is deliberately dismantling Medicare piece by piece, no matter what its rhetoric. It is misrepresenting the aims and principles of Medicare. It is shamelessly wasting over $2 billion a year on the totally ineffective private health insurance rebate. It is redefining bulk-billing to destroy its purpose. It is entering into trade agreements with the USA and other countries (through GATS) that seriously threaten the integrity, efficiency and excellent cost-control record of Australia's healthcare system. Why a government would want to destroy a highly productive, cost-effective, well-liked, internationally admired system to create a more fragmented, more costly one (for individuals and for Australia) is totally beyond me. Anyone who cares about health, equity, universality, and service availability on the basis of need not ability to pay must oppose this underhand deconstruction of Australia's healthcare system. (SOURCE)
The Health Affairs survey implies that the crisis which Sainsbury forecast only two and a half years ago has already arrived. This is, moreover, an unnecessary crisis triggered by Howard's ideological aversion to the welfare state, exemplified by the 2004 Medicare Plus plan, but also the tacit consensus embracing both major political parties in favour of health care retrenchment. The consistently positive results for the U.K. belie such ideologically-motivated antagonism, showing that so-called 'socialized' medicine can work well, even without spending a lot of money. Germany's results also seem rather impressive, while several other European countries have still superior systems, including not just the Scandinavian countries but also Italy, France and Spain, the latter being a country which, according to the 1997 WHO World Health Report, does not spend anywhere near as much on health as Australia does. Since Australians are paying a great deal more than the British and many (most?) Europeans, we have a right to know why we are not receiving health care of at least comparable quality.
* That this proposition would be true is almost self-evident to those with a knowledge of history. This is because public provision of welfare services developed only because they had been so poorly provided by the private sector. We have therefore reached a historical juncture at which it is necessary to largely re-invent the wheel.
The report's conclusion, albeit one I would have expected, seems to me incontrovertible proof that in many respects central to our lives, welfare state solutions are by far the most efficient.* Indeed, out of the countries surveyed in a study those who seem most contented with the quality of their health care are the British, whose national health care system is usually depicted by conservative ideologues as a little more than a joke.
A hitherto unremarked aspect of the survey is the fact that Australians do not differ radically from Americans in their dissatisfaction with the quality of the health care they receive. While 'about half' of the Americans surveyed said 'they had decided not to fill a prescription, to see a doctor when they were sick or opted against getting recommended follow-up tests,' New Zealanders and Australians weren't too far behind, with 38 percent and 34 percent respectively (but only 26 percent of Canadian and 13 percent of British respondents). In every aspect of health care examined in the survey, Australians are firmly located on the dissatisfied end of the spectrum. 'Americans also reported the greatest number of medical errors. Thirty-four percent reported getting the wrong medication or dose, incorrect test results, a mistake in their treatment or care, or being notified late about abnormal test results.' Canadians and Australians followed with 30 percent and 27 percent respectively.
Strikingly, Australians are paying more than most other countries for health care. 'Nearly a third of U.S. patients reported spending more than [a thousand USD] in out-of-pocket expenses for their care, far outpacing all other nations. Canadians and Australians came next, with 14 percent of patients spending that much. The proportion reporting similarly high costs was far lower in the other countries (my italics).' In short, Australia may not be doing as badly as the U.S., but it is doing badly compared to other countries. This report therefore obliges Australians to ask harder questions about what is happening to health care in this country since the advent of the Howard government, which has subverted the foundations of Medicare (our national health care system) to the point that for many of us it scarcely exists anymore. As Peter Sainsbury, President of the Public Health Association, complained in 2003,
The current Commonwealth Government is deliberately dismantling Medicare piece by piece, no matter what its rhetoric. It is misrepresenting the aims and principles of Medicare. It is shamelessly wasting over $2 billion a year on the totally ineffective private health insurance rebate. It is redefining bulk-billing to destroy its purpose. It is entering into trade agreements with the USA and other countries (through GATS) that seriously threaten the integrity, efficiency and excellent cost-control record of Australia's healthcare system. Why a government would want to destroy a highly productive, cost-effective, well-liked, internationally admired system to create a more fragmented, more costly one (for individuals and for Australia) is totally beyond me. Anyone who cares about health, equity, universality, and service availability on the basis of need not ability to pay must oppose this underhand deconstruction of Australia's healthcare system. (SOURCE)
The Health Affairs survey implies that the crisis which Sainsbury forecast only two and a half years ago has already arrived. This is, moreover, an unnecessary crisis triggered by Howard's ideological aversion to the welfare state, exemplified by the 2004 Medicare Plus plan, but also the tacit consensus embracing both major political parties in favour of health care retrenchment. The consistently positive results for the U.K. belie such ideologically-motivated antagonism, showing that so-called 'socialized' medicine can work well, even without spending a lot of money. Germany's results also seem rather impressive, while several other European countries have still superior systems, including not just the Scandinavian countries but also Italy, France and Spain, the latter being a country which, according to the 1997 WHO World Health Report, does not spend anywhere near as much on health as Australia does. Since Australians are paying a great deal more than the British and many (most?) Europeans, we have a right to know why we are not receiving health care of at least comparable quality.
* That this proposition would be true is almost self-evident to those with a knowledge of history. This is because public provision of welfare services developed only because they had been so poorly provided by the private sector. We have therefore reached a historical juncture at which it is necessary to largely re-invent the wheel.
