Health care’s better Down Under

Saturday, August 1, 2009 | 12:01 a.m. CDT; updated 12:19 p.m. CDT, Monday, June 21, 2010

I have one overarching life philosophy: When in doubt, do as the Australians do.

The Aussies have fashioned themselves a very nice, if not perfect, health care system.  It merges the benefits of a government-run universal insurance and care scheme with the flexibility and choice of private insurance rather successfully.

The news media on this side of the Pacific Ocean have obsessed over the process of passing American health care reform through Congress but not the details of the actual bill. President Barack Obama’s remarks of late have been platitudes about lowering costs, giving everyone preventative care and stopping insurance discrimination for preexisting conditions. These are not things to which anyone objects. But how we are to accomplish these things is left unsaid in the debate.

So I propose we look to the Southern Hemisphere. According to World Health Organization statistics, the total Australian health care cost in 2006 was $3,316* per capita. Comparatively, the U.S. spent $6,714 per capita on health care in 2007. Meanwhile, Australia also enjoys a lower per capita government expenditure on health care: $2,227 in 2007, as compared with $3,074 in the U.S.

Medicare Australia is the government universal health insurance program.  Australians enjoy this lower expense through a network of public hospitals, which are free for all Aussies. Australian Medicare also subsidizes medical specialists, general practitioners, and prescriptions, dentists and participating optometrists. This is paid for by a 1.5 percent income-tax levy.

Australian Medicare also strongly encourages those who can afford it to buy their own private health insurance. Anyone who buys private health insurance is entitled to a 30 percent rebate from the government. And then there is the Medicare levy surcharge, to encourage better-off Aussies to buy private hospital insurance. So singles who make more than about $58,100 per year or families that make more than $124,500 per year can either buy enough private insurance or pay a 1 percent additional tax for Medicare.

Conversely, Australians with an income of less than $14,800 don’t have to pay the Medicare tax, and those under $17,400 pay a reduced tax. There are also reductions for seniors and pensioners. But everyone gets basic Medicare, regardless of income.

And because everyone gets Medicare, private health insurers need to stay competitive. The largest private health insurer, Medibank Private, is actually owned by the government but is subjected to the same regulations as non-government owned health insurance companies. A few health insurance providers in Australia, such as GHMBA and HCF, are even nonprofit.

The private and public health insurance systems working in tandem provide cheaper health care that avoids many of the common complaints about “socialized” universal health care. Because the wealthy are so strongly encouraged to have private health insurance, there are rarely wait times for procedures. And since all Australians are in Medicare, it’s good, efficient and cost-effective health care. While the government won’t cover everything — the basics are taken care of and subsidies keep patients' costs down — what isn’t covered isn’t all that costly.

I have lived in Australia and used its health care system. I had to buy international student health insurance through Medibank Private. I needed doctors to re-issue my American prescriptions, to update my tetanus vaccination and to fix a dislocated knee. The system works, in practice, much like the American system for those who have good health insurance. Only, instead of just working that way for the insured, it works that way for everyone.

It’s a good system. I suspect it’s such a good one because with the jellyfish, crocodiles, sharks, funnel web spiders, dingoes, six of the ten most poisonous snakes in the world and a giant hole in the ozone layer, Australia is hazardous to your health. But our fair American congressmen and congresswomen should take a lesson from the Lucky Country: Health care is better there, and America would do well to emulate it.

*All dollar amounts have been converted to U.S. dollars.

Erin K. O'Neill is an assistant director of photography for the Missourian and a master's degree candidate at the Missouri School of Journalism. She has lived in Australia on two occasions, for a year as a Rotary Youth Exchange Student during high school and a semester abroad in college.

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John Schultz August 1, 2009 | 6:28 p.m.

While you were in Australia, did you also experience the Internet censorship ( that has been enacted? Seems to put the whole "do as the Aussies do" bit into something of a bind.

I'm confused by this paragraph as it seems to be contradictory:

"Because the wealthy are so strongly encouraged to have private health insurance, there are rarely wait times for procedures. And since all Australians are in Medicare, it’s good, efficient and cost-effective health care. While the government won’t cover everything — the basics are taken care of and subsidies keep patients' costs down — what isn’t covered isn’t all that costly"

If the Medicare system is so great, why are the "wealthy" urged to get private care? Is the system good because only those who can't afford private insurance use it?

(Report Comment)
Ray Shapiro August 1, 2009 | 10:18 p.m.

JS: When I visited Australia, they tried and convicted me of some violation of their internet censorship laws. I had posted on the Aussie Down Under Ground Daily Tribune Forum that Aborigine Tribal Music was influencing the behaviors of young, impressionable tweens resulting in boomerang drive-bys and outlandish make-up wearing. I was, of course, completely misunderstood and virtually innocent of any real wrong doing. Nevertheless, I was sentenced by a Kangaroo court.
Aussie prison is strange. There socialized prison system got so crowded that they're combining Koala Bear sanctuaries with minor infraction convicts. Let me tell you, it's not easy sharing a cell with a cute, but ornery critter. All he wanted to do was hug and cuddle while munching on these cough drop smelling leaves.
The people food wasn't too bad though. You get all the shrimp on the barbie you can eat and blooming onions. The food gives you heartburn but their socialized health care plan provides the Calcium Carbonate chasers.
After serving my time in Canberra, they banished back to the states because of my "funny" accent. (So now you know who to blame for me being here.)
Silly Aussies.
G'day mate.

(Report Comment)
Charles Dudley Jr August 2, 2009 | 4:44 a.m.

Ya there just is nobody around the world that might have the better ideas we should be looking at because our politicians are just so smart.

Then you have the Libertarians who think they are Gods yet are nothing more than the Homely Sister left sitting in the chair at the back of the room at the Sweet Heart Dance.

Yo nobody has the better ideas than our politicians and that is why our political parties are so full of complete fail across the board.

We need to start looking at other countries who are working harder than we do at how their systems are actually working instead of being so dam closed minded.

(Report Comment)
SANGRYUL HAN August 2, 2009 | 5:15 a.m.

No Rationing Is Required, from my standpoint.

In case you are a doctor, and your pay is dependent upon your patient's outcome, you will more likely strive to prescribe the best medicine for your patient, let alone avoiding unnecessary cares, and hope your patient will feel better as promptly as possible.

Studies have documented that nearly one half of physician care in the United States is not based on best practices and that at least 98,000 Americans die of a 'medical error' each year.

Under the new health care program, practitioners are expected to eagerly and voluntarily implement the 'recommendations', not 'rationing' , I think.

Nowadays, we can't imagine the society without IT SYSTEM, just to think of the bank that lacks it, presumably what we should fear most would be the medical institutes without A MUST. I think measurable savings in the transformative health program might be reached.

Thank So Much !

(Report Comment)
Stuart Snyder August 3, 2009 | 12:12 a.m.

I am an expat American who has lived in Australia for the last 16 years and I can confirm the comments made by Erin are true. While no health system is perfect and all western countries are facing issues with an aging population, the Australian system is about as good as any in that it covers everyone, is cost effective and affordable (about half the cost of the US system), and for those who are concerned about waiting list for elective surgery you can get private hospital insurance for about $2,500 a year for a family that allows you to choose a doctor and a private hospital if you need surgery and don't want to worry about a waiting list for elective surgery. My 76 year old mother in law needed a knee replacement and could have waited a year to have one in the public system but instead paid $1K for private insurance, waited 1 year because she had a pre existing condition and had her knee done in a private hospital by a doctor she chose. Anyone in Australia can see a general practitioner who gets reimbursed a standard fee although some doctors charge a bit extra for a visit and the patient picks this up.
Why so many American's are so in love with their hodge podge expensive health care system that doesn't cover 20% of the population is beyond me. I think it maybe because many don't know anything else.

(Report Comment)
Ray Shapiro August 3, 2009 | 1:24 a.m.

@Stuart Snyder: How many illegal aliens from Mexico live in Sydney?
Also consider this bit of nonsense and cultural dilemma:
("The teen birth rate in the United States remains the highest of any industrialized nation: four times higher than Germany, six times higher than France.
The negative social and economic impact of early teenage pregnancy is tremendous. It is estimated to cost the nation about $21 billion annually (in 1993 dollars). The long-term productive life prospects are also lower for teenage mothers and their offspring. Many programs have been utilized to reduce the incidence of teen pregnancy. While some have had modest success, no single or simple solution is on the horizon.")
MEDLINE Abstracts: Teen Pregnancy
America needs to clean up its act in many other ways as well, instead of allowing politicians to become landlords, new car salesmen, insurance brokers or heads of the medical community.)

(Report Comment)
John Schultz August 3, 2009 | 10:11 a.m.

Stuart, I'm pretty sure I could get a knee replacement a lot sooner than they year it took your mother-in-law and for that I would rather keep the system we have now (with some tweaks and real reform).

(Report Comment)

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