Hi Bushbasher.
I’d like to have a better understanding, too, why the US’ health insurance system is a disaster and the Dutch system a success, while both are based on market competition.

I can think of a few reasons: mainly lack of transparency and insufficient freedom of choice (but try telling Americans that they don’t have enough freedom!).

Realistically, we cannot expect insurance providers to care for the well-being of customers as their job is to make a profit. And the more care a customer needs, the more costs are involved.
That’s why, in the USA, providers reject people with pre-existing conditions or the elderly, or charge them a higher premium.
So, the Dutch Federal Govt set some basic rules/regulations. Insurance companies are obliged to accept anyone and are not allowed to charge higher premiums to people with pre-existing conditions and the elderly. But, because the government compensates them for people who are more expensive to care for, everybody is welcome.
This is called ‘risk solidarity’.

However, there are providers that give incentives to those with a healthy lifestyle. Buy a low-fat vegetarian meal at a restaurant and claim part of your bill! Approved products (such as low-fat, low-sugar) on supermarket shelves are also claimable.

Also, the US system is organised too locally, while the Dutch system is a federally regulated one.
In the US, people are not free to buy their health insurance from companies in other states, so there is no need for the states to compete with each other.
The Dutch system offers total freedom because customers can buy their insurance policies from anywhere they wish; they are not obliged to stay local.
And, insurance companies even pay out to people who have medical treatments outside the country.

Changing insurance providers is also easy in the Netherlands as their choices don’t necessarily have to be employer-connected like it is in the US, which is restrictive.

To be continued

Also, the costs for services in the US are not transparent enough.
This reduces freedom of choice also. Without adequate and easy to understand information about price and performance, one cannot truly have free choice.

There needs to be no artificial cap on doctors’ wages if customers are able to compare costs and have the freedom to find better prices/services elsewhere, even internationally.
Besides, wouldn’t a cap on wages lead to fewer practicing doctors or encourage them to work fewer hours, causing less competition, which means higher prices?
Doctors in Canada, who’ve reached their cap, simply go on holiday for the rest of the year.

Transparency of costs and services (e.g. patients’ rating system) will force doctors’ prices down, which will result in more reasonably priced health insurance policies, too, while maintaining and even improving quality.

Currently in Australia public health funding is provided through the taxation system, income tax and the medi-care levy and state taxation.

The next problem is that it is then funded by both the federal and state governments.

The state governments dish out the funding in a piece meal fashion, and use a carrot approach, where hospitals that meet bench marks recieve extra funding. Mind you the bench marks are set by the various health departments, and often are totally unrealistic and unachievable, because of years where funding has been kept below the inflation rate, and the decrease in available public hospital beds.

However what drives public hospital budgets into the red, it where they are funded to treat 1,000 patients for example, but wind up treating 1,100 patients.

The major costs of a patient are incurred within the first 24 to 72 hours of admission.

Decades ago, public hospitals had a small number of acutely ill patients and a high number of convalescening patients. Today this ratio has been reversed. Which increases costs, so improved effeciency increases costs.

A paradox occurs where the actual costs per patients decreases, because of shorter stays, yet the overall cost to the hospital increased because more patients are treated and the average daily cost per patient increases, because their stays are shorter.

Today both the Vic and NSW governments want public hospitals to make efficieny savings, this is after decades of attempts at cost reductions.

I guess both these governments think that you can get blood out of a stone.

cevilia, thanks very much for your posts. i don't have time to look carefully at this, but i'll make a few comments.

first, i have no doubt that the dutch system is better than the u.s. system: there's not much that is worse! i know there are many good health care systems around the world which have a private element, which avoid the free-market looniness of the american system. i take your word that the dutch system is highly successful and highly regarded, and take as good sense the safeguards you say the dutch system includes.

but, that is not an argument that the dutch system is preferable to the current australian system. it may be, but i don't accept it as true without someone making the argument. humphreys definitely doesn't make that argument, he simply assumes it, all the while chanting "competition". humphrey's failure to even recognise the argument needs to be made, the whole tone of his post, exposes him as a monotonic ideologue. he is not simply obtuse, he is totally untrustworthy.

i don't have time to dig up and review the arguments, but there are obvious ways in which free markets and competition do not apply well to health care. paul krugman is great on this stuff. Here, for example:

http://krugman.blogs.nytimes.com/2009/07/25/why-markets-cant-cure-healthcare/

i *like* australia's medicare (and i liked it more before howard and his thugs tried to destroy it). it seems to me to work extraordinarily well. that doesn't mean i'm not willing to consider improvements and alternative systems, that the private element is automatically bad. but it does mean i'm not going to pay much attention to anti-government ideologues like humphreys.

Agree with Bushbasher.
Notice the author didn't mention the US. That's because the US system proves that competition leads to higher costs, appalling service and a totally inhumane system.
This is typical right wing clpatrap from a typical right wing ideologue.

Having lost 18 days and nights total drugged up to vegetable state in an ICU ward of a local public hospital in February and December 2008 against my will, for 'asthma' of all things, I would suggest that the employment of casual agency 2nd yr nursing students who can barely speak English and are not yet capable of adjusting the dials on an oxygen meter might be quite adept at reducing the number of living specimens taking up hospital beds. More privatisation would no doubt help to free up more hospital resources to allow more efficient financial adjustments.

Although I have paid over $5,000 p/a for my so-called 'health' insurance by way of tobacco tax over these last three years on Newstart Allowance since struck down by that mosquito bite from Ross River, I don't consider the treatment I was provided in 2008 to be good value for my money, and hope that there might be an 'opt-out' option in this competitive solution, both for the provision of such deadly services and for the thousands of dollars I have paid for stuff all help and my two lucky escapes to survive that incompetence that pervades the private and public health sectors when I've been drugged up by force and stuck in a bed with unknown fools and mentally disturbed sicko's from the casual staffing pool roster playing school-yard games with my life.