I invite you to visit also my literary blog: Journeys in Creative Writing where I post original fiction including short stories, poetry and 'Paternity', a full length mystery novel.

Monday, 13 July 2009

Health System for Everyone

A RAGING STORM about health systems has burst on Living on the Other Side of the Hill a blog run by mate Judy in Kentucky, US of A.

I'm sure that some of you have noticed that Americans are calling for big changes in their health system and hope President Obhama can do something about it.

I for one have looked over the Pacific and seen that many poor Americans die because they can't afford health care. We've all heard of people being ruined because of the costs when they needed even a short visit to hospital.

A big proportion of Americans just can't even contemplate calling for help because their bank balance isn't big enough. The smallest procedure can cost thousands of dollars.

Prescriptions are also incredibly expensive in a nation where the pharmaceutical companies are allowed to call the shots, unlike here in Australia where a government sponsored committee administers a PBS that bargains with the pharmas and keeps them in check.

This all makes me very grateful for our Australian system, warts and all.

Judy asked me to make a comment on her blog about Australian health, and I obliged.

This is what I wrote.

It is so good that you are having this discussion.

We in Australia have free hospitals and doctors, but have the option of insurance and private hospitals with the choice of doctors available then. We do pay a token amount to go to general practitioners of our choice and the remainder is government subsidy. Many GPs do 'bulk bill' with no cost to the patient.

Today I rely on a government pension through no fault of my own, having worked fifty years, but two divorces and conniving lawyers (one later gaoled for fraud) didn't help.

As an aged pensioner I pay only $A5 for any prescription and indeed am on three I will need for the rest of my life. People not on any benefit pay for their scripts but there is a government system which works to ensure that pharmaceutical companies cannot control prices absolutely as they do in your country. Our scripts are much cheaper as a result.

If I need hospital treatment and go public it costs nothing. I come home with no bills of any kind, and so does everyone else unless they have insurance, and then payments are made.

There can be a wait for non urgent surgery, but that too is being addressed. If your situation is life threatening a free ambulance takes you straight in.

Due to neglect for twelve years with a government seemingly hell bent on destroying our health system, the formerly highly esteemed public hospitals are in a deal of trouble, but that is being addressed now. The private ones with their profit motive have always been suspect anyway.

(By the way I have just been invited to join a committee to help implement these changes locally. I'm there as a community member alongside the doctors and other professionals, and respected for my point of view.)

Neither system is perfect amd people slip through gaps, but my goodness I cannot imagine the insecurity and horrors of living where I couldn't get help when I needed it.

In the midst of this global recession our Rudd Government (18 months old) has just put up the pension for seniors. They respect us for the contribution we have made.

This government is leaning on the States who actually run the system to fix up their health administrations and are gradually working to provide funding for improvements.

All of this during the global recession when Australia has so far avoided the big 'R' and is recognised as currently the best performing economy in the world.

It might seem a bit twee, but the Australian culture has always been caring of people in need. (Could it be our convict roots? We were also among the first to give votes to women and pioneered much of the union system.)

So far as I am concerned a good egalitarian health system is a matter of priorities. Why should good health depend on our bank balance?

The nation gains greatly when its working people are fit and happy.

America - if your administrators really care, a health system of equality is very much within your reach, even now. Priorities is the word.

We have been watching from afar, and aghast at the way you have done things in the past - perhaps it's time for a change?

I'll get off my caring soapbox now Judy ...
June in Oz'

Do you agree with what I have said?

We know there's a lot wrong in our system, but golly when you compare it to others ...

And do you think the Rudd Government has its priorities right on this? Should it do more? Can it do more right now?

If you live overseas, what is the health experience in your country?

It's a frank interview with a health insurance executive who woke up to what his industry was doing to the American people and decided to do something about it. This one blew me away ...

I'm adding this on 28th July:
A new report on reforms to our health system has begun a big debate here. The Federal Government wants to take over a huge slab of the system, particularly in primary care. It's far reaching and exciting. The Prime Minister has made positive noises about it and will lead six months of discussions with a national consultative tour to begin today. See the report and its recommendations HERE


  1. Sounds good to me June. Thanks so much for your comments and your post here. I will be checking back often. Sounds like your government is trying to help the people of Australia.

  2. Hi again Judy
    The more we all talk about these things the better I reckon ...

  3. Hi June, I live in Canada and we too have government run health care and its wonderful. I am diabetic and had Breast Cancer which included a year of treatment, surgery, chemo and radiation. The medication was very expensive and not once did I receive a bill but always received great care. A nurse came to my home twice a week to flush lines, and check vitals again no bill. I chose my own doctor and have been with him for years. If we can do it in Canada, it can be done anywhere. Its so good to know that all Canadians are covered, no, poor whatever. I did not have a long wait at all for treatment, they will treat a heart attack before a broken leg but that is the way is should be. I do hope US finds a way so that all Americans are covered regardless.
    Thanks for this post June......:-) Hugs, Bernie

  4. Onyer BERNIE
    I didn't make it clear that ALL people here in Australia are entitled to free public hospital treatment. No-one gets a bill unless they have health insurance, and then payments are made.

    The benefit is that private hospitals often have shorter waiting lists for non-urgent treatment which is not necessarily any better that public.

    Well done Canada.

  5. Unfortunately, the healthcare system in India (like many other social service sectors) is more absent than present. The govt does not provide any cover, except treatment at Govt-run hospitals, which are usually so poorly maintained and understaffed that people never opt for it if they can afford private treatment. And private doctors and clinics charge exorbitantly. The only rays of hope are the clinics/hospitals run by charitable trusts and religious associations, but these are simply not enough for our teeming population. As for health insurance schemes, they are helpful to a certain extent in providing for emergency medical expenditure, but the premiums are too high for the really poor people and the schemes are too flawed (for eg. cost of treatment for any existing disease at the time of taking the policy is not covered by insurance) to provide complete peace of mind.

  6. Sucharita
    I can imagine that being ill is very difficult indeed in India. We can only hope that as your economy grows government will spread the benefits to all. It will be up to the population to make sure that they do.

  7. I'll go along with the concensus here.

    I'm getting to the age where visits to the local doctor are getting more frequent.

    I have blood pressure, not serious, but needing medication and check ups.

    It's all free apart from prescription charges which are a known quantity and free for those in need.

    Having any kind of condition puts some kind of stress on the individual.

    It is a measure of a society's compassion for its citizens as to how it deals with them when faced with such thing.

    No system is perfect but a society has to make the effort to justify a claim to being civilised, in my view.

  8. Hi June,

    Is mental health covered under your system?

    As if our U.S. systems isn't bad enough, mental health coverage (so often overlooked as part of the whole person) is even more deplorable.

    My son (now 19 years old) has life-threatening physical AND mental health issues, both of which have been financially catastrophic as he has progressed from toddler (when he was first diagnosed with kidney disease) though to adulthood. So many years of dealing with this, and as a result, numerous, NUMEROUS insurance/access-related challenges we've had to deal with.

    At present, there's this: because he turned 19 this month, he is no longer covered on a state health insurance program for children. The delay in processing the application for transitional coverage means that next month he will be without insurance, thus without access to health care (due to the cost). He is on nine different medications that cost more than $5000US per month when paid for out of pocket. (He is a transplant recipient.) We have learned many ways to finagle the system and will get through his uncovered month... assuming he doesn't have any setbacks or episodes.

    We chose the state program when our private insurance premium rate exceeded $800 per month. At that time, we had to choose which members of our family would be covered. My husband and I went without health care for two years, hoping at all times that neither of us would become ill.

    In December 2007 I donated a kidney, which was covered entirely by the recipient's insurance. However, some of the potential complications as a result were NOT covered by her insurance. (There was one small complication. Otherwise it was an entirely positive experience.) Nonetheless, the fact that I chose to do the donation at a time when I had no coverage was met with many raised eyebrows.

    The stories of friends and family dealing with this issue are too numerous and unbelievable for one little comment section. I'm glad Judy and others who feel as passionately are part of the movement to bring about change. It's ridiculous that this problem has existed and worsened for as long as it has. I hope the change that needs to come will come soon.


  9. A very interesting blog post. Do you mind if I quote you and link to your blog? We need to learn more about healthcare in other countries so we can debunk some of the outrageous claims being made by our insurance and pharmaceutical companies, as they try to defeat any and all healthcare bills.

  10. Yes John of A WRITE BLOG - I agree that the availability of a quality health care system is a core measure of a nation's humaneness and maturity.

  11. ANANJI
    Knowing you as much as I do I'm not surprised that you are an organ donor - even without health insurance! Hugs for that you caring person you.

    And your stories of dealing with your son's health issues in such a hostile environment are heartbreaking.

    I'm thrilled that you guys are talking about these things as your President Obama needs help to get over the huge barriers to change. Good on Judy that's for sure, for her part.

    Mental health - last on the list as usual.It always will be, it seems to me, while there is so much stigma and general misunderstanding about it. People don't think that they could be next ... and that at least one in five people have a mental illness at some time in their lives (and the figure is rising).

    Again we must all talk about these issues to make a difference, I reckon.

    There is an ever so slight improvement in Australia's attitude to mental illness of late, and all treatment is free if you can get into hospital, and if there are enough community facilities in your area. Medication is free if you are on a benefit, and subsidised otherwise.

    Australia is a huge country with a small population, so services are uneven in areas distant from cities.

    There is a desperate need for support outside hospitals as big psychiatric institutions were closed 40 or so years ago, meaning that patients were cast into the community, supposedly to get support there. It didn't really happen.

    There are private facilities in most cities as well, but very few in rural areas.

    There is also an issue that many persons with mental illness do not recognise that they are ill, and resist treatment - thus missing out on services.

    One good thing - there is now a determined government effort to solve the plight of homeless people - with a long way to go. And community mental health support is being tackled, but very slowly.

    Thanks for widening the discussion INANJI - and good luck with those bills. No wonder people get depressed!

  12. BETTY
    I'd be most happy if you linked to mine ...
    I think you and Judy, Ananji et al have the right idea - start talking on the blogasphere to debunk the pharma myths.

    They're very powerful and greedy. However, a strong government can muzzle them (aka Australia) but my goodness they have a head start in the USA!

    It might be good to be aware that even some visiting bloggers could be pharma stooges - you can't believe everything you read.

    Good luck

  13. In the UK, healthcare is free - no charge at all... However, the queues are long so lots of people go private anway with private health care that they pay per month.

    Here in Sweden, we pay a small sum to vist the doctor while the rest is subsidized by the government.

    However, going to the dentist here is very very expensive and not everyone can afford, even though it is subsidized - but still incredibly expensive!

  14. Hi June,

    Wow girl you added to the controversy in this subject and you opened a hornet's nest with this GREAT VIDEO ! this is a subject which certainly needs airing... I am intending also to write comments re U.K. medical care after a Judy asked me about our care too. This video should be shown openly in courtries who act like the Americal Insurance agencies do... I feel so sorry for the folk who can't afford medical care there.... and pray that this country can manage to continue to have the benefit of medical care free at point of need !

    As you can see my holiday has helped my yakking muscle no end ....

    Cheers Pal, Kate x.

  15. LADYFI
    We have a similar problem here with dentists Ladyfi - it's been a very expensive business. However, the new Commonwealth Government has begun addressing this as well. Can't be soon enough for me!

  16. Hi KATE

    The video is amazing isn't it? Sheds so much light on the shadowing world of health insurance companies. And how about the thousands of people lining up for free care - with doctors in tents!

    I must say I pinched it from Judy's site - with her knowledge. Too good to ignore I think.

    Good to see the fish and chips on the pier did your heart good!

  17. Oh June, one of the reasons why I am scared to think about living in the U.S. again is precisely this issue!

    Japan's health insurance system isn't the best in the world but it is certainly much much better than America. It is so much cheaper to go to a hospital to cure a cold (and you heal faster) than to stock up on medicine bought from the pharmacy etc...

  18. Hi TULSA
    I can certainly see where you're coming from ...
    It must be such an emotional drain not to have a backstop in times of health crisis. I remember when our Medicare began in the 1970s - me a young mum of two.
    I recall so clearly walking into the fresh new office with its colour scheme of greens. I remember standing for a short while in a queue and the excitement of walking out with cash to replace the payment I had made to the doctor.
    It meant a lot.

  19. I have health insurance as part of a very small pension and retirement package. I have catastrophic coverage, meaning I cover the first $3000 dollars of medical expenses every year. If I exceed that amount of expense, the insurance will kick in and pay 80% of what they think is reasonable expense. So, for the most part I pay my own medical bills every year. It is a terrible system because I put off medical care until it is absolutely necessary. I have to choose between a mammogram or a bone density test (I have osteoporosis) because to get them both would cost me nearly $1000. The health care system in my country is an outrage. I believe a good single-payer system would go a very long way in civilizing us.

  20. Hi ROBYN
    I think you hit the nail on the head with the word 'civilize'. I'm one of those characters who can't see how a culture is mature unless it treats everyone equally and looks after its own when they can't look after themselves.

  21. Heard in the US, medical costs are hitting the roof. Pray Obama does something different

  22. I agree with what you have said June. I used to think New Zealand had a better system long ago, but there is no doubt that Australia's Medicare system is the best there is. We are very lucky, our GP's Bulk Bill, so we have no out of pocket cost for a visit. Like you we pay $5 per script. Our local Hospital leaves a lot to be desired, but having been there for two rather large surgeries, & one smaller, I have only praise for the staff & care I recieved, all free of charge.

  23. MEGGIE
    I'm pleased you agree with my comments.
    Our hospitals have their problems but generally they're great when you really need them!

    Bad luck about mental health though ... just not good enough when the institutions were closed down all those years ago with promised replacements in the community - that still hasn't happened.

  24. I agree with you. Health care should be a right not a measure of your bank account. Hopefully, here in the U.S. we will realize this and make the changes we need to so everyone can have affordable health care.

  25. Hi PAT
    Yes, it seems to be time ...

  26. I have lived in the U.S. for 26 years. coming from Europe. What I hate is that you either have to be dirt poor, or stinking rich here.
    So the majority, are paying way too much for healthcare. As you said, many go bankrupt due to ridiculous costs of surgeries etc. What incentive is there to pay for it, if you can get free healthcare by not having it? I would far prefer all humans to have the benefit of free healthcare, the problem is the abuse that goes on in such a system. I enjoyed your post very much.

    I think that a health system of inequality can't be good for anyone's health! Even the rich these days don't have certainty of their positions do they?
    Uncertainty about something so basic must be highly stressful, and therefore detrimental to one's wellbeing?
    We in Australia are having a big debate at the moment about a new health care system in which the Federal Government will take more control. This is hopefully in the cause of more efficiency.

  28. June,

    I am aussie living in the US who is about to move to the about differences in systems.

    No doubt it is exceedingly expensive here and as far as i am concerned, even with insurance here my standard of health has gone down while living in the US. Access is almost non-existent to those who cannot afford to pay large (and i mean large) sums out of pocket. I am not sure that it is remotely possible for the us to implement and australian style system. The infrastructure and the impetus is just not there. In Australia you must be registered with medicare to have a provider number to be a doctor - no such system exists in the US.

    Commentators and scaremongers consider the new proposals to be pushing the US towards a Candain or UK system, both of which aren't doing so well. In canada people have very little choice in the actual doctor they see. At least, where you can get into to a doctor in Australia you have some choice.

    I am grateful for the Aussie system too, just don't think it could be applied elsewhere.

    Thanks for this comment - it's so valuable to hear from a person who has seen both sides of the fence.
    Let's hope for your sake and that of all others in the US that Obama can get through this mess.


Thanks for your comment. It's good to know who's taking a peek! I will certainly reply to your message.
Maybe you'll also be interested in my other blog