Healthcare Issues In Australia

talaxandra · Oct 11, 2010

Australia has elective private health insurance, underpinned by Medicare, the government-supported universal health care program. 1% of taxable income is paid as a Medicare levy. Anyone who takes out private health insurance is entitled to a 30% rebate; anyone who earns over $50k a year and doesn't take out private health insurance is charged an additional 1.5% levy.

In 2004, to take the closest return I have to hand, I paid $AU1460 - I had substantial pre-gross deductions, and choose not to pay for health insurance I don't need, in favour of contributing to the universal health care I strongly believe in supporting.

For that money I have any medications I need heavily subsidised under the Pharmaceutical Benefit Scheme (most, but not all, medications are subsidised). If I had a chronic illness and my medical expenses exceeded the maximum payable, all my subsequent medications would be free. I have more than half the cost of every GP visit reimbursed, and the option of going to a bulk-billing facility, which costs me nothing. I have never paid for a blood test, an x-ray or a casualty visit.

On the two occasions I've had elective surgery (both dental), I chose to go private. The second of these was three years ago. Without insurance, I paid a total of just under three thousand dollars for oral surgery under a GA, with a night in hospital, IV hydration, three scripts on discharge, and a check up ten days later. I've also had two lots of emergency surgery, for hand fractures - I had outpatients appointments with the surgeons, ongoing hand therapy, splints, resistance putty, and analgesics. I only paid for the latter, getting 20 oxycodone tablets for $12.63.

I work in a world class public hospital, with the world's second largest lung transplant unit, the Southern hemisphere's largest hyperbaric unit, and Australia's largest intensive care unit. I never have more than four patients on a day shift, or eight overnight. My patients receive expert, round the clock care, from registered nurses (no patient attendants except as one-to-one carers for at-risk patients), with free rehabilitation if required.

Despite the fact that Australia's obesity statistics are seond only to the US, I have a current life expectancy of eighty-three, seventy nine if I was male. That would shamefully drop if I were indigenous). Australia's track record on indigenous health is appalling (life expectancy is fully twenty years lower than for non-indigenous Australians). But if we're reporting an infant mortality rate three times higher in Aboriginal and Torres Strait Island populations, I suspect we're not counting infant deaths differently than the US does.

That's one of the biggest issues in Australian health care presently - the gap between indigenous and non-indeigenous Australians, across prety much every facet of life.

You asked about funding concerns - in 2004 Australia spent $2,874 per capita, or 9.5% of the GDP, on health care. Canada? $2,989/9.9%. New Zealand spent $1.893 or 8.1%, while the UK spent $2.389 or 8.0% GDP. The US spent $5,711, or 15.2%. So we spend less, have better outcomes, and fewer cracks for people to fall through.

Like everywhere we have an aging population that increasingly have chronic illnesses, and that's going to be an increasingly significant problem in the next few years. Between hospital-in-the-home programs, increasing support systems, and increased throughput means that inpatients are more acute than ever before, and we're also expected to do more paperwork without decreasing patient care, so things are far from perfect.

To the best of my knowledge the only significant legislation at the moment around health is a failed members' bill trying to re-introduce euthanasia.