In a program on SBS about health care around the world the american presenter asked people in certain countries "If health care had ever sent anyone bankrupt."

The key component in these countries is that they had a universal health care scheme. Governments controlled costs and for example the health care funds were not for profit.

Something that is taking place in Australia at present is that private health care providers are positioning themselves to take advantage of the increasing health care expenditure of the ageing baby boomers.
http://www.uow.edu.au/arts/sts/bmartin/dissent/documents/health/path_rad_aus.html

Jeremy's ideas and beliefs are disturbing. Once a particular belief system about health takes root, and can cause enormous damage that will take decades to repair.

Take for example that the number of medical school training places was reduced as a cost saving measure in the 1990's and now there are insufficient numbers of doctors in Australia.

There have been failed experiments with privatising public hospitals or co-locating private hospitals with the public.

If Jeremy's idea takes root, health care in Australia will head down the same path as health care in America where the poor have about the same life expectancy and standard of health care as compared to those who live in third world countries.

Truly an ideological humbug.

It seems to me he’s forgotten that 2% of average wage taxation wouldn’t cover a family’s medical bills. Especially if there's a serious ilness or congenital problems. Private insurance doesn’t cover actual charges. Gap insurance? more expense. Medicine by insurance co look at the US disaster 30% without any cover.
Who amongst the average working family is going to be able to afford open heart surgery, organ transplants, AIDS medication, Long term dialysis, intensive neonatal care and survive? Oh yes, don’t get old the medication costs could kill you.

Wouldn’t it be nice if CIS could dump the failed rationalist ideology and simply tried to solve the problems from the people’s position?
Jerry, back to the drawing board.
And to think he gets paid to do this? (I hope it’s a lot or his old age will be miserable).

This is a disturbing proposition which ignores a few facts. People who have retired have paid their way in society. Many still pay - via superannuation (and GST) - to support our society. Their taxes have set up infrastructure (so much as governments have chosen to so do!), they have paid for the education of the coming generations and for the medical needs of their elders (and themselves).

The hucksterism promoted by Jeremy Sammut's article can have only adverse effects on those in most need. It is the kind of self-serving social-Darwinism which punishes the needy in the USA.

By all means express your individuality by ,say, buying an expensive car (like all the other hucksters), but please don't do it at the expense of those who have given and who have need.

Politicians already pork-barrel the “corporate vote”, and this expanding greedy constituency can be expected to vote in favour of tax and 'defence' spending policies that extract higher transfers from younger workers.

Due to Defence and Treasurys' open-ended commitment to provide “free” wealth care for a few Australians, if an ageing Australia continues to rely on pay-as-you-go tax contributions to fund the bulk of health spending, then governments will siphon off a considerably larger portion of the earnings of young generations as taxes to subsidise the greed-fuelled cost of 'Defence' and corporate welfare for the largely foreign owned weapons manufacturing industry, the failing motor vehicle industry, mining industry giants, Big Pharma and on and on.

James H., the self-importantly titled examinator, and LRAM, don't appear to be able to see out from their ideological blinkers.
The whole point of an opt out system is that if people prefer a universal system their free to stay in it. The argument that the poor will die in the streets if some people opt out is the real humbug - the public system will still be there for those in need. It’s the same for the elderly, LRAM, who incidentally have not pre-funded their own health care, have paid fare less for the health and pensions cost of a much smaller elderly population, and have not paid for the university education of the young (it’s called HECS.)
James H.: the private health system is 'taking advantage' of the elderly by providing them with the care they want in a much more timely manner than the public system, unless you want to wait months and years for knee and hip replacements and eye surgery.
Examinator has also bought the myth that the Medicare levy covers the
cost of Medicare. It covers around 15-17% at best of the cost of the public health system. Estimate what Medicare is really costing the average taxpayer, and then think whether you are getting value for your money.
I think that's what the defenders of Medicare are really worried out. That the alternative will turn out better than the status quo, and leave them bereft of even their ideological cover.
Sowat should follow the policy debate more closely: the CIS is a fierce critic of all government of subsidies to all kinds of individual and corporate recipients.

If we have universal health care and universal superannuation systems this should be cheaper and more efficient than

- multiple organisations competing for contributors each having the same organisational overheards

- private corporations pay profits to their shareholders and vastly inflated salaries to their management

Keep Medicare and lose all the employer based superannuation schemes run by the old life insurance companies and Gen X and Y would pay far less money to secure their old age than they do under the present system.

I read your extended article and I'm glad that the OLO editors cut out your spiteful rant.

Jeremy,

You write that by opting out of using the public health care system, people should pay less tax and get better health care.

Sure it is true that if we did not pay taxes which are suppose to pay for things like education and health, taxes would a lot less.

But then for people to be able to access health care or education it is going to be much much more expensive.

Even prior to the advent of medi-care(bank) governments funded(partly) public hospitals. Public hospitals treated both public and private patients and a significant part of a public hospitals finances was from treating private patients.

No particular health care system is perfect.

The american system is really really good, if you are wealthy and manage to stay wealthy.

Now as too TAXES, the taxation burden in this country has shifted to mainly middle income earners, those who earn high incomes are already able to reduce their taxation burden eg Kerry Packer famous quote about not pay more tax than was necessary.

Jeremy's idea had already been proposed in the 1990's along with co-payments and a few other ideas.

Australian governments Labor and Liberal are so far behind the eight ball in regards to health care in Australia, that is heading for a big melt down.

Jeremy you misquoted me!

I wrote, that private health care providers were positioning themselves to take advantage of the increased health care expenditure of the baby boomers.(this purely profit driven.)

<James H., the self-importantly titled examinator> thank you for the compliment. I have been studying health care systems since the 1990's, and what you are proposing will not solve the current problems and will perhaps even exacerbate the existing ones or even create new problems.

For example better treatment of chronic disease has increased the life expectancy of those with chronic disease, which results in increased health care costs.

Prior to 1950 if you developed renal failure you died, around 1970-80 people had to meet certain criteria to be able to be dialysed. such is the changing face of medicine.

James H. Though I doubt, you believe me, I really am not trying to be ideologically driven - nor advocate a US system - Medicare will still be there for those who choose to stay with it.

I agree with you about the unprecendented challenges we face in health because of the unprecendented effects of improved prevention and medical intervention, and the consequent lengthening of lifespans. We are going to need every health dollar into the future, and we are going to want to use every health dollar as effectively as possible to harness all the potential health benefits of modern medicine.

So why then are we content to stick with a public hospital system that takes our taxes and is better at funding bureacrats than it is at funding hospital beds?

That sounds like a cliche (and maybe it is cliched). But in NSW Health something like 20% (a conservative estimate) of employees are administrative or other. The Area Health Services are a standing joke with clinical staff - filled with people who never care for a patient and spend their time attending meetings and staring at computers. Meanwhile, there aren't enough hospital beds to admit emergency patients - hence we have chronic access block in not just NSW but in public hospitals Australia-wide. Invariably, it's frail and elderly patients who are forced to wait in ED corridors on trolleys for longer than 8 hours waiting for a free bed.

Examining this problem has convinced me that choice and competition need to play a bigger role in the health system. I think that breaking the public system's monopoly over taxpayer funded hospital care is the only way to reverse the process and try to re-allocate all the resources we waste each year to front-line services. I seriously doubt that the public system can do this, given its existing problems, and going by the long, failed history of the NHS. Do you think the Blair government got the bang of service delivery improvement it expected for pouring billions more pounds into the NHS

Jerry,
Are you saying that if I opt out to get more money in my tax and after I get sick I can then go into universal health system? The best of both worlds. Where’s the benefit for the govt (taxpayers)?
Those on Struggle Street will opt for more cash in pocket (short term perspective) but what happens when disaster hits the fan unexpectedly (as it does)?
Private insurance is more than the 2% tax credit. Or are you keeping the 30% subsidy. Fine but as I pointed out there is a gap between what is Govt recommended rate and what the health insurance covers, more money (gap insurance). More importantly who pays the difference between what is charged and the rebate? Where’s the savings to the average PAYE?

Isn’t part of the levy% calculation based on the amount received by the govt? Less $ the higher the levy must be (regardless of the % it pays for). That logically means the taxpayer has to pay more and so do the taxpayers (govt).

I was also under the mistaken belief that the govt 'bulk buy' power would get us more bang for our buck than if we sent it off to multiple private enterprises whose primary aim is to make profit (HMO’s). Without the same commercial power savings (profits) would have to be found elsewhere. The experience of HMO’s is that they have multi exclusions and limits on their coverage. Who picks up the rest?
By the way I am not ideologically bent quite the contrary.
I just think the starting premise of the CIS is somewhat biased and therfore questionable. As I have said before so is the Labor version. And I think your idea is ideologically biased to the well off.
Not wishing to be nasty but I bet you aren’t a struggler and you're a Gen X.
BTW the full name is Examinator ant.

Ok Jeremy,

for gen X & Y to save money by the reduction of taxation levels by having people opt out and pay for their health care.

For any substantial impact on public health care expenditure to be made would mean that more than fifty percent of baby boomers to opt out of the public system.

However there is no garantee that governments would return any taxation saving to the tax payer.

<

So why then are we content to stick with a public hospital system that takes our taxes and is better at funding bureacrats than it is at funding hospital beds? >

You say you don't support the american style of health care, yet here you are expressing the idea that our taxes are used to fund bureacrats which is true, in an ideal world there would be less funding for bureacrats and more funding for public hospitals.

<Examining this problem has convinced me that choice and competition need to play a bigger role in the health system. I think that breaking the public system's monopoly>

It might surprise you but in the ACT for example the numbers of private verses public hospital beds are about the same.

People tend not to notice that performance of the public hospital system had improved, the numbers of hospitals beds has been decreased, yet the number of episodes of care have increased. Many procedures that use to require lengthy hospitalisations are now short stay procedures.

It seems that you think that the private system provides better care. It doesn't, there are doctors and nurses who refuse to work in the private system.

I know of one doctor who is banned in performing procedures on public patients, yet is free to treat private patients, there are other things that I could inform you of, except I would get into severe trouble.