Healthcare – why socialist funding fails
I live in Australia where we have a socialist part-government funded healthcare. This is slightly different from the debacle in the UK but we are not far behind when it comes to ending up with a total disaster.
The current system is known as Medicare. The way that this is funded is through a levy on income tax. Everyone who is earning any income pays the medicare levy. The reality of the system depends upon the State where one is living, and my own experiences are within Victoria, Queensland, New South Wales and the ACT. In the UK the doctors are employed by an area health service called a Trust. You do not have a choice of doctor, or at least that is my understanding. On top of that, in the UK you can end up being banned from a practice for no particular reason. That kind of thing does not apply in Australia, but if Gough Whitlam had his way when he introduced this debacle in the first place, then yes it could have ended up that bad. In recent years I have read a lot of stories regarding the problems with the UK Health System, and there are many problems, especially associated with the care of the elderly. This is also outside of my experience.
In the current Australian system I can go to my GP of choice. However, what I cannot do is choose to opt for direct payment via Medicare. My current GP charges $60 per 10 minutes in a visit. Go over that 10 minutes and it is even more expensive. At least in Sydney my GP accepted just the Medicare only payment, which suited my particular circumstances. The real problem as far as I am concerned is the scheduled fee which is determined by public servant who has no real experience of what it costs to run a private practice. The scheduled fee is something like $34.90. If I was attending a specialist, where the fees range from $110 to more than $240 I am expected to pay that money and then claim from Medicare. In my latest example, the fee is $240 for the initial visit, and the scheduled fee is $70. I will get back 85% of the scheduled fee. Something does not compute!!
On top of this, even with private health insurance, these costs are not covered, and the reason that it is not covered is in fact due to the government and its legislation. Private health funds are not allowed to insure for the difference between what the doctor charges and the scheduled fee. This leaves a patient with chronic illness very much out of pocket. Until the legislation is changed there is nothing that can be done about the situation.
There are other costs not covered by the government – physiotherapy is a prime example of something that is not covered under Medicare. To this you can add the cost of seeing a podiatrist and purchasing orthotics, the cost of visiting a dentist, and other associated costs, dietician, pyschologist etc. (although I think psychology now gets some cover). People with weight problems and who are Diabetic need to see a dietician but the cost is not covered. The health funds will only cover up to about 50% of the fee in some of these cases.
Prior to the interference by Gough Whitlam our system was not that bad, and it was not broken. People from the lower income brackets could still afford to see a doctor, and they were not turned away from the public hospitals. Here in Australia we have State run public hospitals such as the Victorian Women’s Hospital, or a more recent example of the Monash Medical Centre, and then there are the private hospitals. No one gets turned away from these hospitals. However, if one goes in as a private patient to a hospital, the bills will stack up!!! Over time government payments to the hospitals have been reduced leaving them quite often in crisis and unable to pay their bills on time. Some hospitals are good with their payments but others have a really bad history when it comes to paying suppliers. The situation has been getting worse and worse.
Why is this the case? First of all, when it comes to the hospital system, accident and emergency is overused for non-urgent cases. Yes, it is true, I have gone to the local hospital, on the weekends when my doctor is not available!! I have had legitimate reasons to seek that help when I have gone to the accident and emergency department of the local hospital. So yes, I plead guilty. However, this is not the case for people who turn up when they have colds or similar minor complaints. These people need to be seen in a different context – they need to be removed from the Accident and Emergency Departments of the hospital system. Perhaps they also need to pay a small fee for the visit, I do not know the right answer for this problem. Second, we have an ageing population requiring more in the way of what is considered “non urgent” operations and procedures. Third, we have an increasing number of women seeking expensive IVF treatments.
Let me address this last point: I do not believe that women should be entitled to receive IVF at public expense. It is not because I do not have sympathy for someone who has difficulty in getting pregnant, it is because in a number of cases, the women think that they have some right to this procedure even though they are: single, Lesbians, or mature-aged. Yet, this is so very wrong. A woman is only fertile for a certain length of time and then the ovaries and the eggs start to disintegrate or putting it another way, our hormone levels change over time so that we are no longer as fertile as we were when we are in the prime age (between 16 and 30) for giving birth. Over time we start producing fewer eggs. As women mature there is a greater propensity to have a baby with birth defects, especially Down’s Syndrome. However, more than that, giving birth at an age when most women have gone through menopause, means that any children who are born under such circumstances are less likely to have a mother as they mature into adulthood. Given these reasons, I certainly think that the public purse should not be used for such indulgences. IVF is an expensive procedure, and since the Medical budget is finite, not infinite, then this is taking money away from other areas, including taking away resources for cancer treatments.
The Socialist response, that is universal healthcare is not the panacea as claimed by its proponents. In fact it is a very flawed system, and it means that in the long run choices have to be made about rationing resources. Inevitably, this means that when rationing is applied, older people will miss out on necessary treatment for their ailments.