Tuesday, February 05, 2008

Health perspectives

Australians express as much anger over the delivery and support of the country’s health system, but complaints are trivial when compared to the US. There are aspects in the Americanisation program form PM Howard could never change. The best he could do was to reduce hospital infrastructure funding.

Australians might be subjected to long waiting lists for hospital, or even emergency admission, but at least there is something to wait for, even for those who can’t afford health cover.

The arguments here, as a consequence, are quite different:

Health Cover

Since the 1970’s Australia has had basic health cover for every citizen. It isn’t perfect but the safety net is sort of there. There have been repeated attempts to cajole and force private cover, the problem there is that private clients still tend to pay over and above those under free cover.


There is a mix of public and privately run hospitals. They both suffer the same issues, a shortage of health care professionals and unwillingness to provide sufficient reward to staff. Hospital staff are increasingly treated like hospitality workers when it comes to wages and conditions.

In line with current business thinking the major investment is being put into equipment as though the whole system can simply be automated. There are constant horror stories coming out of outpatient and emergency departments, mainly because the personnel are not there to deal with patient numbers.

Early Intervention

Screening and early intervention have long been key issues here. Breast and prostate screening, the most common cancers here, and an effective program saves more than just grief but extends through to cut the enormous cost of potential hospital treatment.

Prostate screening is no as simply for blokes as getting a ‘little prick’, a small blood sample. Breast screening is problematic, with at risk women often unable to access an affordable service. Well they can get a rebate, but they still need the money to pay up front.


US negotiators have gone to great lengths to force Australia to abandon its subsidised pharmaceuticals program. John Howard was keen to accede to this demand, Australians weren’t.

The problem for Howard is that the subsidy program costs money, OUR money! The US negotiators were more concerned that the program effectively makes the Australian government the primary buyer of pharmaceuticals. With the subsidy issue in mind imports must be approved for price as well as the various efficacy issues.

The US tried to pull the pricing thing on India too. They said “fuck your intellectual property rights” and have developed a full parallel industry delivering affordable pharmaceuticals to their market.

I’m just skating across the top here, but the differences are comic, I’m sure. And we Australians are still not happy with out lot…


D.K. Raed said...

a couple years ago, in a fit of serious emmigration consideration, I looked up the details of the Australian health system. I recall a lot of touting it as the best of both worlds, combining features of euro national health and american-style private providers. I had trouble understanding what about our system was desireable, but apparently PM Howard fixated on pharma (as you point out). The more I looked into it, the less desireable it seemed from the standpoint of a non-citizen. I don't know if that aspect was ever modified, but it sure seemed to me that a person who was willing to accept the rather onerous terms of an Australian Retirement Visa (something like US$800K in assets to be held in some kind of natl trust acct) should at least be entitled to the basic health care provided under your national health system. At least, that's my perspective.

Cart said...

d.k. Howard took his instructions directly from the WH. He failed at times, purely because populous will only accept so much.
Unfortunately the populous of bloody immigrants have no problem accepting limits on people coming here from elsewhere.
It is one of the things I detest about this country. Okay, people are narrow and self serving everywhere, but this row boat ain't big enough for us to be precious.
I don't really believe in borders!

D.K. Raed said...

amen. lovely planet earth is a pretty small rowboat. and there are no borders when viewed from space. the only real barriers are in people's minds. ok, I'll stop the flower-child talk now.

Cart said...

bloody! "flower-child talk" is a damned sight better than closed minds.
Your point was a good one. I just reject the unthinking pseudo opinions of the populous.
Sort of limits my reach too :)

TomCat said...

Here in the US, 18,000 people die each year because nobody without employer-provided health coverage, except the very rich, can afford basic health care. Thousands more die every year because their greedy insurance companies routinely deny life-saving care to patients, who had coverage for such care, to increase their profit.

You folks there don't know how fortunate you are to have your system, despite its imperfections.

Cart said...

Tom, I don't have cover here, and know I will have to wait for treatment. If I had cover I would still have to wait. But I know I will be treated, and basically for free.
The differences are enormous and I can't see Australians settling for what we have.
Still, I hope there are some guidelines for the wish list there too.

TomCat said...

Cart, I'm certainly not saying that your system does not have room for improvement.