21 April 2016
by Aaron Tucker
Medicare: We can do better
As the Federal Government's proposed cuts to Medicare loom, our public health services need to be protected and funded "like they are responsible for saving our lives.
It's the middle of the night and your phone rings. Your heart sinks when you hear the news. Your son is in hospital after being involved in a motor vehicle accident.
You arrive at the emergency department in tears. Your child is stable and conscious. He has a team in blue and green monitoring him for any drop in his vitals. He’s going to be okay.
In the time since the accident occurred, your son has been cared for by ambulance drivers, paramedics, experienced emergency department nurses and doctors specialising in emergency medicine. He’s received a CT scan to check for head injuries and X-rays to check for broken bones.
What might be the bill when you take your son out of the hospital? There is no bill.
One of the greatest things about living in Australia is that when you are most in need of medical help, you can get it. You also don’t receive invoices in the mail after having lifesaving procedures. As a country, we have, over many decades, decided to fully fund our public system through taxes. As a result, we have qualified staff waiting to treat you, without checking your credit score first.
It is fair, however, to ask those that can afford it to shoulder a greater load. These people have been “encouraged” through the open threat of a medicare levy surcharge to take out private hospital cover. Measures like these do take a load off of the public system but at what cost?
In the 2012-13 financial year, the private health insurance rebate paid out by the government was estimated to be near $5.56 billion. Consider that for every procedure performed in a private hospital that could have been performed in the public system, the government will pay up to the Medicare schedule fee to the private hospital operator.
Looked at another way, this is just an implicit subsidy to private health providers at the public expense to the value of $5.5 billion every year and even this number is growing at better than six per cent a year.
To those who support a largely privatised system, let me take a moment to point some things out. Australia has some inbuilt handicaps. We have a relatively small population at just over 24 million people to cover an enormous area of 7.692 million square kilometers. In a very real sense our health spending needs to stretch to cover such a large expanse.
The poster child often put forward for a privatised health system is the United States of America. As you can see in the table provided the U.S. has over 10 times our population density.
However, this is not the most striking statistic.
The richest country in the world, with a much higher population density than our own, has an overall average life expectancy for its people of 79 years. This places it at 34th in the world according to this 2015 World Health Organisation report.
Where does the little Australian battler place in these same rankings? As it turns out when it comes to healthcare, Australians are giant killers. With an overall average life expectancy of 83 years we hold an equal second place ranking in the world with the likes of Switzerland, Andorra, Italy, San Marino, Singapore and Spain. We are at the cutting edge of modern healthcare.
Yes, our public health system is under strain but instead of bickering and trying to reinvent the wheel, maybe we need to take a step back and look at what a great job we have done so far. At the core, everything we do within the health system should be a drive to always do better. We need to fund our public health services like they really are responsible for saving our lives.
What does my ideal public health department look like?
It’s a group of highly trained health professionals who, at a moment’s notice, make their number one goal in life to keep you alive and we’ve given them the resources they need to succeed. And when that time comes, what will they ask for in return?
Just to see your little green card, thanks.