Health Care: The Australian Option


Australia has had universal health insurance in place since shortly after the enactment by the Whitlam government of its Medibank legislation in 1974. Changes have been made to the system from time to time, but its core principle of universal access to medical treatment and public hospital care has remained the same. Basically, Medibank - or Medicare as it has been known since 1983 – provides an 85% refund of an agreed fee schedule for medical services, along with free public hospital treatment and accommodation. Doctors can either ‘bulk bill’ Medicare for 85% of the scheduled fee as payment in full for their services, or charge the fee directly to the patient who then claims the 85% rebate against it. Public hospitals also recover their costs directly from Medicare. Social Security pensioners usually are bulk billed, as also in most instances are low income earners.

In return, taxpayers other than those on low incomes pay a 1.5% income tax surcharge known as the Medicare Levy. Insurance against the cost of private hospital accommodation is available from a government insurer (Medibank Private) or a number of private sector insurers, some of which are mutuals or former mutuals. Measures introduced by the former government encouraged private hospital insurance through a 30% subsidy of the premium. Taxpayers with incomes of $AU75,000 and over who fail to take out private hospital insurance are penalised with a 1% loading on their Medicare levy. Currently, some 43% of Australians choose to be privately insured. There is a separate Pharmaceutical Benefits Scheme, whereby most prescribed medicines are priced down in negotiations between the government and the manufacturers, and subsidised at the point of delivery to patients.

The upside is that nobody – and in particular no child – is denied necessary medical treatment or hospital care, and the aggregate cost of health services has been contained well below that of comparable countries. Conversely, public hospital waiting times for some procedures are unacceptably long – albeit also currently being systematically reduced – and, as regard private medical services, there is a gap in many instances between the scheduled fee on which the 85% rebate is payable, and the amount actually charged by practitioners either to maintain their profitability or because they believe they can get away with it. However, Australians overwhelmingly and with good reason support Medibank/Medicare, see its continuation as being in both their own and the public interest and have indicated repeatedly at elections that they would reject any attempt to weaken or dismantle it.

6 comments:

Athena,  Saturday, August 8, 2009 at 12:58:00 PM CDT  

I am a believer in the right of any human being to get medical care. Period. Money should not even be discussed when it comes to taking care of one’s health.One of the big obstacle in solving the health care crisis in US is the INSURANCE COMPANY.Most of them are profit organizations making their executives filthy rich. I have not seen charity as being a value for insurance companies and I have worked for a big one. They are mostly concerned with their own profit and the “shareholder profit”. I think this is preposterous for organizations that pretend to “bring value” to people health need and help “pay for the poor”.

"Insurance" is costing the nation an arm and a leg, it’s a huge bureaucracy that we pay for to come between us and the doctors. We all lose from their existence. Patient and doctor alike. All that money that goes to these huge bureaucracies should be spent on assuring that everyone gets medical attention to whatever level it is needed.

Charity however is a value and a reality for not-for profit hospital and medical foundation organizations.
They could do so much better in taking care of everyone if they did not have to run (themselves) huge bureaucracies to keep up with regulations and insurance.
I do not think insurance and more insurance will help the poor, or will bring down the cost of health care.
It is a paradigm that needs to be broken.
Let’s open our minds to how to get rid of non-value adding organizations and activities and move our attention to things that really matter to ensure “health care” to all, not “health insurance”. That is where I would like to see this nations creative minds working and not on how to come up with yet another bigger bureaucracy.

Race Mathews Saturday, August 8, 2009 at 6:54:00 PM CDT  

I'm not suggesting that Australia's Medicare combination of public and private health insurance with free public hospital treatment and accommodation is a perfect solution to the challenge of effective health care services delivery, but simply that it meets the fundamental objective of ensuring that nobody is denied necessary care, at an aggregate cost to the public purse that to date has been containable and sustainable. Moreover, it's by common consent a vast improvement on our previous system of voluntary insurance delivered mostly through mutuals called friendly societies and other 'not-for-profits' which left so large a proportion of the population for either catastrophically under-insured or without cover of any kind. And we're currently working towards major improvements in the system, as you'll find demonstrated in the very recent final report of our Hospitals and Health Reform Commission that's available for downloading at http://www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/Content/nhhrc-report

Louise Monday, August 10, 2009 at 9:07:00 PM CDT  

I can certainly say that I would be loathe to see any major changes in our medical care here in Australia, unless they were obviously an improvement. On the whole, the system works well.

Louise Monday, August 10, 2009 at 9:09:00 PM CDT  

Actaully, one change I would like to see is that abortions not be covered by medicare.

This is the one great evil in our system. Not sure if IVF is covered, but if it is, it shouldn't be.

Chris Campbell Tuesday, August 18, 2009 at 12:07:00 PM CDT  

One thing I think we are missing is this:
1.System is still an expensive solution, likely notto be sustainable for long
2. still ties to Hudge, if not gudge
3. relies on Govt, which historically, is largest evil, at times, necessary, but the biggest killer of people
4. What is to stop private insurers from saying "you are dumped, go the the Govt"? Many in USA reaching Medicare age are told that by private insurers. Or the good private insurnace becomes 2nd


Louise makes a good point, you have abortion covered and you have no choice but to fund it through your tax dollars, becoming an aider/abetter to evil....Insurance that is private can be dumped or pressure added far easier.....Gudge has a little more motivation to change.....

Roy F. Moore Monday, December 7, 2009 at 11:37:00 PM CST  

On the Fisheaters forum, this comment - dated 7th of December - was given in reply to Mr. Matthews article:

"two kinds of theft are lauded above...first the strong arm of thug govt stealing from a company...(a group of people who see fit to pool their talents to achieve synergy and a competitive advantage to be able to deliver products they love in an industry they feel important enough to work in). Second, stealing from one group of folks and giving to another."

The quote was from a supporter of Austrian School Libertarianism. God forgive him for being so.

Rebuttal to this, please and thank you.

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