James, thank you for reading my diatribe on p4. I neglected to mention the overall pattern I've noticed over four occasions in 2000, 2002, 2004, and 2008. The privatisation I noticed in 2008 where unqualified and careless casual staff from private agencies are left in charge of a patient's life was around throughout that period, according to one friend I knew in 2001 who was casually employed by her agency as a nurse at a local public hospital in Perth.

However I remember the first time I presented at the emergency ward during an asthma attack in 2000, and I felt lucky to be immediately led to a cubicle with a chair and an oxygen system, with a monitor attached to a little sensor that I attached to my finger to watch my blood/oxygen level rise from the mid-70s (dangerous) back up to the 90s (safe) over a few hours that night, and gratefully discharged myself before breakfast time that morning.

2002 was the same helpful and efficient experience. Then in 2004, I encountered a very obstinate nurse who tried to force me onto ventolin instead of oxygen. Once left alone in another cubicle that had an oxygen system in place, I was able to change to the oxy and recovered by morning once again.

In 2008, I called three different public hospitals to ask if I might utilise an oxygen tank at their premises during the asthma attack, and was told that they could not promise me anything unless I presented, so I got in the car and made it to emergency, on faith.

That was the last I remember. They drugged me sensless for five days, and held me captive in the ICU for another five. Luckily, I survived by bluffing my way out, threatening the registrar with legal action at one point.

More privatisation will save more dollars but IMHO after what happened twice in 2008, cost human lives. Not because I didn't have the money to pay for the hire of the oxygen tank, but because they were too stubborn to give it me.

I think the issues are not being contested at the foundation of the problem, and I note the propensity of some to want to steer the debate towards arguments of the mechanism of profiteering alone.

For those who allege a COMMUNIST agenda, I would say this. If the relevant scum continue to assert a right to deny appropriate access to medical and legal based on costs, then very likely there will always be trouble.

If Medicare is handed to the "private profiteers," on top of reasonable costs they will apply their own over inflated opinion of themselves plus their exorbitant lifestyles, and then still want big bonuses and a chunk of profit as well.

I am in favor of a hybrid system, with regulated salaries and regulated bonuses for those who use OUR money to make MORE money so that, EVERYONE gets full health care, not just those who can afford it.

In the 1st instance, I do not begrudge a talented hardworking doctor or financial services person making a quid above the norm, so long as their increased income does not come at the expense of say the Original Australians AND low income earners NOT receiving treatment like everyone else.

So, if the FAT CATS can make so much loot that everyone gets appropriate treatment, and currently they do NOT, and still make a surplus, then within reason they are deserving of their higher incomes and bonuses.

But that is not what is happening. The FAT CATS have become lazy, greedy and stupid, as evidenced by the global financial crisis, and again, from the outback, to dental, just to name a couple of sore points, people are suffering much as they do in the 3rd world.

Set the bar higher *Mr Wudd* and make them perform.

PeterHume and all
PH I don't think you were referring to me. If you were I have to ask
What part of "the absence of one extreme DOESN'T automatically presumes the other extreme" don't you follow?

The absence of feral Capitalism doesn't imply Communism/socialism or any other ism, just a need to focus on the objective, medical care for everyone including the poor.
Not like CIS ideological stance, Business profit first.
(just in case you missed it) Companies don't vote and not every one can own enough shares to make a difference.

I offered no alternative simply because privatization of medicare doesn't address the real issues i.e. medical care for every one.

Have you seen what a cockup the specialists market is? It serves those who can pay full stop.

Come to the wrong end of town and hear the majority. Public hospital waiting lists are ridiculous.

Been to a dentist lately? They charge substantially over the insurance rebate! Try the public health system for dental needs.

What ever the insurance co's pay the drs. will charge extra. This, currently can cost $100s-$1000s depending the service. Even with max private insurance two majors in any year can really screw the average man over badly.

Conclusion We need a new Medicare.

BTW There are other business models worth of consideration.

"There are other business models worth of consideration."
One maybe your local travel agent if you plan medical requirements ahead of time. Costs of overseas medical and dental services can accommodate the expense of return airfares if you know where to go, and the poor service of public hospital treatment in Australia may have lower probability of further damage, but there are risks in anything with health care. Buyer beware.

Beware to have it over and recovered before returning. The most memorable welcome home party I remember was in 2005 when I was medivacced back to Perth with fairly serious abdominal and head injuries after a traffic crash. Six stitches in my stomach from the overseas hospital starting to itch on the plane, and that Saturday afternoon I presented at the usual public hospital to ask for professional help in removing the 18 day old stitches.

Nobody would do anything at all until my records arrived from overseas, and from what I gather, the courier from the airport was off duty on weekends, and so they could do nothing for me until Monday. This was a Saturday. I accepted the admedistrivia, and said that I could probably remove the plastic stitches myself when I got home, and on hearing that they locked me up in a mental asylum for the night as my homecoming to Australia.

A week later, still with those blasted six stitches in my tummy, I went to another public hospital early one morning, waited until after lunch until a quack turned up with a 'student' and demonstrated on my abdomen the removal of plastic stitches, twice. I watched closely and pulled the remaining four out myself when I got home. There's still a small piece of plastic inside me around where the buckle on my belt would hitch up, but after blatant incompetence and negligence like that, I'd solemnly suggest to anyone who needs hospital care to visit your travel agent and fly to a civilised hospital.

To those who prefer the current system, under my proposal the worst possible outcome is that you stay on the current system. So no problem. If the government provider was the best, everybody could stay there, and they would be no worse off.

If somebody decides to move, surely they should have that right? The only reason to object is that you simply assume the bureaucratic approach will always be better, and then you assert your right to force others to follow your preferences.

To those referring to America, that is not relevant to my proposal. The American system is a world apart, and has many problems associated with the fact that their government encourages healthcare to be managed through employment contracts, and has many restrictions on competition. I don't think that is a good approach... but irrespective of that debate, it has nothing to do with my proposal.

To those who object to competition, under my proposal you can just stick with the government's "new Medicare" and be no worse off. If no other competitor provides better health care, then nobody will change and we'll still have the current system. If the government provider really is the *best* then you have nothing to fear from competition.

But the evidence in support of competition around the world & through history is so vast I find it strange that people are actually asking me to explain it. To start with, if nothing else competition allows greater diversity. The pro-bureaucracy types might hate diversity, but I think it's important to recognise that people are different and have different preferences/needs in life.

The link between competition, higher quality and lower price is unambiguous. When sectors are protected from competition the pro-bureaucracy types always insist they are doing things as well as possible, and oppose competition. When competition is introduced, outcomes improve. This is true for agriculture, for telecommunications, for heavy industry, for education, for airlines, for restaurants, for supermarkets, for bakeries, for shoe-makers, car-makers, hairdressers, etc, etc

BTW, competition does not mean radical free-market reform. A radical free-market position would have no government involvement... but my proposal includes massive government redistribution ($3000/year health subsidies) and a government provider. Some free-market people have attached my proposal as being too "soft". In any other sector, my proposal would be considered radical left-wing government intervention.

When people worry about the free-market approach their concern is usually with making sure poor people can afford the goods & services & ensuring a minimum standard. My proposal does that. The only reason to object to my proposal is if you have a ideological love of government monopoly.

To those who say that everybody should have infinite healthcare... once you invent an infinite money tree, then we'll take you seriously.

And to those who insist the solution to health policy (and every other policy) is simply for the government to spend more, that outcome simply isn't viable. Under the Howard government health spending increased by about 6% per year... and this explosion in costs is set to continue over the coming decades due to the aging population. If we do nothing to fix our health & pensions systems, by the middle of this century we will need a GST of 25%, just to pay for our current system. That includes no new initiatives. Just the current system. If you want to add new initiatives, then we would literally need taxes higher than communist East Europe had before they collapsed.

The "just spend more" approach does not work. We need to find ways to "spend smarter"... and allowing multiple providers to compete for our custom is a good way to encourage smarter thinking. Trusting bureaucrats & politicians to some day become perfect is not a good strategy.