Monday, January 19, 2015
Does Australia have the ideal healthcare system?
You might not think so from the news report below. The report covers just one episode of inaccessible healthcare but it is typical of what happens all the time in all states in Australia and in Britain. Both Australia and Britain have a system of "free" hospitals and local doctors but also (unlike Canada) allow private health services. And it is a testimony to how bad the "free" system is that 40% of Australians have private health insurance, which enables them to take advantage of Australia's large network of excellent private hospitals at little or no out-of-pocket cost.
Why would you pay for something if you can have it for free? The answer of course is that the "free" system is so bad as to be life threatening on occasions. As the various parts of Obamacare go live, Americans too will experience that. For many, health services will be "free" but unavailable.
Private health insurance is affordable in Australia. Many people on relatively low incomes have it. I pay $160 a month for mine. It is bought directly by the person covered rather than through an employer. So it is a significant budget item for many and the majority would rather spend their money on beer and cigarettes than on insurance. So they rely on the taxpayer for "free" health care. They rely on bureaucratic healthcare provision.
And the ineffectiveness of that gets steadily worse. Bureaucracies do not die overnight. They are like cancer, slowly growing but they will kill you eventually. They gradually choke themselves to death. And what we read below shows that process to be in an advanced state in Australia -- the State health services all go back many decades. And the services will get even worse in future.
So the present situation is in fact mostly fair. If you put your money into beer and cigarettes instead of health insurance you deserve only third-rate care and that is what you get. You are mainly raiding people who have already paid for their own care and asking them to pay for your care too.
Can that be improved? Do the improvident public have to be treated so badly? If you think improvement is needed the way to it would probably be to get the beer and cigarettes money redirected into private health insurance -- so that the government system is left to care for the few who cannot afford even beer and cigarettes. If that were done, much of the demand would be taken off the government service and the genuinely poor would get better service.
So if you see the situation described below as a problem, your rational response would be to mandate private health insurance for all but the very poor. But if you don't like the compulsion in that you can console yourself that the existing system may be rather horrible for many but it is at least fair for the great majority. Most of those being poorly treated could have chosen otherwise
I have a fairly average health insurance policy so my treatment in a recent health emergency is instructive. I had an attack of kidney stones. So I went straight to the Wesley private hospital here in Brisbane -- a church-run hospital named after two great Christians. Within less than two hours of the pain developing, I was given morphine as pain relief and within 6 hours I was on the operating table. The ideal is possible and readily available in Australia. It just isn't free
If America ever gets a rational Congress and President, I think they could learn something from Australia
A Sydney hospital left a patient in its emergency department for almost six days, prompting condemnation from an expert in emergency medicine.
Details about the incident are scarce. But a hospital source said the patient was admitted to Blacktown Hospital's emergency department on Wednesday evening the week before last.
The hospital confirmed the patient had been sitting in a recliner chair in its emergency department and was discharged at some time on Tuesday last week.
"This is absolutely extreme," said Clinical Associate Professor Paul Middleton from Sydney University. "In 25 years working in hospital emergency departments I've never seen anybody stay for that long.
"The lights are on all the time. It's noisy. There are wailing children, mental health patients, people pissed off with waiting and shouting; there's trauma; there's blood and there's vomiting. It's not a place to spend a long time. Patients don't do well [in emergency]."
The hospital, citing patient confidentiality, declined to provide details about the patient's illness. It said they had been treated while in the emergency department and been referred to hospital specialists.
Danny O'Connor, the CEO of the western Sydney local health district, said the patient was discharged after the hospital was satisfied with their progress.
Mr O'Connor also said the case "presented many social complexities" and that the hospital continued to care for patients who were unable to leave for "family or social reasons".
But Professor Middleton said a ward was the only place for a patient in hospital that long.
"There are also alternatives to staying in hospital [such as refuges]," he added.
The Health Minister, Jillian Skinner, declined to comment.
"Our members are sick of being abused by patients who are facing major delays," said Judith Kiedja from the nurses' and midwives' union.
The union advocates the government impose a ratio of one nurse for every three patients to maintain standards of care. Blacktown's emergency department has often run at twice that ratio of nurses this fortnight.
Tanya Whitehouse, from the Macarthur Domestic and Family Violence Service, said she found the case baffling.
"If the patient was facing domestic violence or homelessness, they should have seen a social worker and been found a refuge," she said.
A spokesman for the Family and Community Services Minister, Gabrielle Upton, said over the next three years the government would "invest a record half billion dollars to tackle homelessness across the state".
This latest case comes after a fortnight of major delays at Blacktown Hospital, where between 40 and 60 beds have been closed for the holidays.
A dozen patients, half aged over 80, were waiting more than two days in emergency two weeks ago.
There were further delays last week. Paramedics waited for 17 hours to hand one patient over to the care of the hospital.
"If they're closing that many beds it's a potential for disaster," Professor Middleton said.
Posted by John J. Ray (M.A.; Ph.D.).