Everyone in Australia is entitled to adequate hospital care. Every child in Australia is entitled to an adequate education. I believe that is true for people all over the world. We can’t pay for people all over the world, but we can pay for those in Australia. The money for public institutions comes in the form of taxes. We don’t get something for nothing so adequate public services conflict with the drive for lower taxes.

The strategy of both the government and the opposition to keep taxes low is to silence the voices of the more articulate and educated people who would protest if they were to have inadequate education for their children and inadequate hospitalisation for themselves. The strategy is carried out by subsidies to the middle class. I am part of the middle class and get a subsidy for my health insurance. My doctor has suggested a colonoscopy, and I will get it at a private facility where I don’t have to wait so long and the atmosphere is more pleasant as the staff is not as harassed. Everyone who needs that procedure should have the same treatment. If all we had to depend on were public hospitals there would be more protests and government would be impelled to provide better hospitalisation for all. I would prefer to pay the actual cost for my health insurance and have my subsidy go to the public hospitals to benefit those who have to use them. Better yet would simply be to have adequate public hospital care for everyone.

http://www.onlineopinion.com.au/view.asp?article=14913 points out the unfairness in our educational system where the level of aid to private education perpetuates and increases the inequality between public and private education. The same strategy keeps down protests for our inadequate public school system. The chattering classes in general send their children to private schools so many don’t have any experience with the inadequacies of the public schools.

To make Australia fairer eliminate subsidies for health insurance and private education, and tax enough to pay for adequate hospitalisation and education. All we need is the will.

Increase taxes so that fringe parties can blackmail a hung parliament into spending our money on your minority agenda?

Sounds like a democracy bypass to me.

Dear David F.,

My husband and I have always had private health cover
and ambulance cover for our family. Now that our children
have grown up - and have families of their own -
they pay for themselves.
We still maintain the cover for ourselves.
And we intend to continue doing so. I've been in and out of
hospitals, and as a matter of fact I'm due for a review
colonoscopy in a few months time.

I would willingly pay extra taxes - to help others in need
and to make this a fairer system all round. If increasing my
taxes by a little would mean a better education and better
health cover for everyone in this country - I'm willing to
do my part

Dear spindoc,

My compliments. You have chosen your pseudonym well. Calling adequate education and hospitalisation for all Australians a minority agenda is a triumph of spindoctoring.

David, you don't want "adequate", you want "more pleasant surroundings".

As the Grattan Institute report I cited in another thread points out, it is that expectation of people like yourself that is one of the largest contributors to a projected massive blowout in Government deficits over the next 10 years.

If you and those like you were prepared to settle for "adequate", the problem would be much more manageable.

What's adequate?

How long should people be forced to wait for non-life threatening procedures?

How many beds per room? Is privacy and comfort adequate? Is it more than adequate?

The way I see it there is so so so so so so so so sos os os oso sos os so sos os sossos so s

much waste in the whole Health sector.

I see it every time I visit the drs. I get bulk billed, people like me should have to pay. Drs do scans just to be sure, when I think it's unlikely there is any need, and they admit to such. They hand out scripts and offer medical certificates for however long I want for viral infections.

One doctor gave me antibiotics without even so much as looking in my throat.

Don't get me started on Obstetrics.

The private doctors schedule their payments to allow a higher net yearly medical expenses payout. They ask for constant ultrasounds that aren't really necessary, bi-monthly visits for the entire term of a normal pregnancy, send patients to private ultrasound facilities that somehow charge 4 times what the public one does, using 3D imaging and all sorts of stuff, encourage c-sections and induce mothers who have understandably had enough of being pregnant, and to ensure the birth fits into their personal schedule.

What is adequate?

The place up the road is giving free flu vaccines for all. Why?

We encourage people to expect free, limitless cost, zero wait medical facilities, when really they should look after their own health better in the first place for a start and then pay what they can afford each step of the way.

Why would people care about their health when they are told they can take a pill for free at the expense of the guvment for every little ailment, and have constant scans just to be sure that random pain they get every now and then isn't a tumor.

david f,

Here's an excellent article from a lecture by Tony Judt on social democracy.....looking at the willingness of people to pay more taxes for a more comprehensive system (like they do in Scandinavian countries)

I've posted it a few times before, but it's usually relevant to questions like yours.

http://www.nybooks.com/articles/archives/2009/dec/17/what-is-living-and-what-is-dead-in-social-democrac/

Poirot, a very good link, well worth a read.

Affordable health and education is not just a tax issue. Like any enterprise there is income and expense. The major issue with both systems is that the expense side is blowing out. There are not enough doctors and nurses. The oxymoron is they are paid too much and many (particularly interns) work excessive hours. There is way too much administration and bureaucracy and that costs a bomb. Health insurance 100% cost as it primary functions is a facilitator. Its prime purpose is to do the unpopular things that government find electorally difficult to do. Heath insurance companies focus is not on health but on the bottom line and shareholder dividends.

We as a country need to train more passionate indentured doctors and nurses pay them less but give them more time. We need more passionate indentured teachers but pay them less; however they get enough time off already. If people are not passionate about what they do money won’t make any difference. We need to reduce the amount of bureaucracy and administration. Communities need to be actively involved and take control of the health and education.

There are only two classes. They are the productive class and the parasite class. The productive class is self-explanatory. The parasite class is a little more complex as there are good parasites and bad parasites. For example there are probiotic bacteria and e-coli bacteria.

Our community has too much e-coli! It has infested our political, legal, health, education, business sectors, just to mention a few. E-coli bacteria are self-serving and have no interest outside self-interest and the holy dollar. They will destroy the host if they are not controlled. I believe without the good fortune of mining Australia would be Greece.

Yes we need to get rid of subsidies but we also have to have a DIY attitude and reduce parasitic activity.

I'm with you on this one Houellebecq. Only when they leave the druggies & drunken bums in the gutter where they have put themselves would you get any agreement from me. We need to stop treating these waste of space yobbos, in the hope their loss can improve the future gene pool.

I watched the Ambulance chase an old farmer, whose income, because of the drought, was less than the pension, for their charge, while they continued to pick up the no hoper bunch of drunks/druggies who had never paid.

A neighbour called for help. She was in agony with a gallstone attack, & had waited 30 minutes for a non appearing ambulance. This was her third. The hospital had sent her home previously as not sick enough.

My son & I carried her to a car & took her to hospital. The receptionist to her credit ushered us straight in to casualty when we carried her in. An hour later, with no attention, not even pain treatment, I exploded. A couple of staff were chatting, a couple were at their computers, & the rest were treating a bunch of drunken bums after a pub brawl.

Emergency staff were amazed when I asked for their names to include in my official complaint. Would you believe my neighbour suddenly got lots of attention, even from the ladies who had been too busy chatting about their holidays.

The Ambulance officer bringing in the next bloodied bum from the brawl explained my neighbour had not got an ambulance because all ambulances for miles around were at the brawl.

Yes everyone should get treatment for the simple things, if not self inflected. However when it comes to sticking hearts lungs & other spare parts, in clapped out old farts, forget it. The money is better spent elsewhere.

Us oldies have had our turn, look after the young, if they deserve it, & the oldies general health, but stop the grandiose transplant stuff on the public purse. The cost makes it simply not viable.

I wonder whether those whinging about the expense of 'too many tests' wouldn't be the first to sue the Health Dept or the doctors for not investigating their ultimately serious health complaints.

Who decides what is a 'legitimate use' for ambulance services Hasbeen?
The ambulance staff who are called to the scene?
Will they need to ask the crowd who hit who, and only take the supposedly 'innocent' injured to the hospitals?
What rubbish!

Where do we draw the line?

Houellebecq <"The place up the road is giving free flu vaccines for all. Why?"
Because it is much cheaper than treating them for influenza symptoms and complications, that's why.

Our country can afford to provide at least basic healthcare for everyone.
But I do agree that bulk billing should only be provided for health care card holders and welfare recipients.

Suse, you're right about the litigious aspect. Our society has become strongly self-entitled and the vast growth in ambulance-chasing lawyers of all types is largely to blame.

Industrial, family, professional malpractice, accident law practices are all based on finding someone to e a victim and trying to extort as much as possible, preferably arriving at an out of court settlement from which the ambulance-chaser takes his cut. Our esteemed sub-Prime Minister was one such ambulance-chaser in her earlier career, before deciding that ripping off the public generally is easier and more lucrative than dodging up spurious Associations to rip off companies.

A typical senior lawyer can charge over $500 an hour and be largely unaccountable for what was done. No wonder there's an incentive to settle!

All that doesn't change the fact that we are hugely overserviced when it comes to "heroic" medical interventions. Nor does it change the fact that some people expect others to pay for "pleasant surroundings" rather than simple good care.

When I was a boy, the school sickbay was made deliberately uninviting, because it was intended to be a place that kids didn't want to be. That meant that it didn't get used unless there was genuine need.

I reckon they had the right idea at school. Medical services are not something that should be marketed like a Westfield shopping centre, they are an essential and costly public service that should be provided as needed and that need should be both carefully assessed and reduced as much as it can be consistent with good health.

Dear Poirot,

Tony Judt left out two big factors in his otherwise excellent essay. One is the effort to roll back what was the beginning of the welfare state in the United States. Franklin Roosevelt spoke of the United States in the thirties as “1/3 of a nation ill-fed, ill-clothed and ill-housed” and sought to bring social justice to all Americans. Business interests dug in to prevent this by establishing the American Enterprise Association in 1938 which became the American Enterprise Institute.

(http://en.wikipedia.org/wiki/American_Enterprise_Institute)

They couldn’t compete with Roosevelt’s immense popularity, but they were in it for the long haul. Their propaganda against social justice was successful, and they succeeded in 1980 in electing Reagan as president after eliminating most of the moderate elements from the Republican Party. The Republican Party originally was for civil rights, promoted the first antitrust legislation to control corporate interests, the first national park and was a force for conservation. The AEI changed all that. Please read about AEI.

The second big factor is the damage done by Karl Marx and the communist tyrannies.

http://www.nybooks.com/articles/archives/2013/may/09/real-karl-marx/?pagination=false

is a review of a book that places Marx in the nineteenth century where he belongs. If it hadn’t been for the Leninist takeover in Russia and the resulting horrors Marx would have probably sunk into obscurity. In my opinion the horrors were a logical consequence of some of the Marxist ideas. As the review points out Marx was inconsistent and advocated contradictory positions at different times.

http://www.onlineopinion.com.au/view.asp?article=12693 is my essay which argues that the Leninist-Stalinist-Maoist horrors are a logical consequence of some of Marx’s ideas expressed in the Communist Manifesto.

The often effective response to such a thread as mine is to point out the horrors of the Marxist-Leninist variety of socialism.

I believe that one can have a just and socialist society in a democratic context. Two things that are necessary to this end is to jettison Marxism and publicise the activities of the American Enterprise Institute in promoting reaction

David, this is Australia, not the US, you might be surprised to learn.

The AEI may be a big deal over there, but over here there are more influential groups and those groups are promoting featherbedding and subsidy of every aspect of life. It is their influence which has lead to the problem of debt expansion, both public and private. Weak populist politicians have allowed those very vocal organisations to scare them into producing bad policy, while wiser heads have been kept quiet behind the scenes, unable or unwilling to risk the public opprobrium that suggesting a reduction in subsidy would inevitably invoke from those who have come to see such subsidy as a natural right and to depend on it to fund their lifestyle.

As I said in another thread, the problem for Australia is that the median income family is now a net consumer of government spending rather than a net provider of such funds. That means the majority of people now have a vested short-term interest in ensuring the money keeps flowing to them. We don't allow children free access to the bikkie tin for a very good reason - they are going to consume what is in it until it is gone, then demand that Mum makes some more. Mum has a competing interest - she wants the bikkies to last - so she limits the child's ability to access the tin, even when the child throws a tantrum.

That is just simple common sense.

Dear Antiseptic,

I agree that basic should not mean luxurious. However, basic should mean that there is not a long waiting time for necessary medical intervention. Pleasant surroundings as well as optional procedures should be paid for by those who want them.

One reason that there are not enough doctors and nurses is that the number of places are restricted by the doctor’s union (AMA). Often having a medical degree and a specialist qualification is simply a license to make big bucks.

Medical costs have blown out, and a large proportion of it is spent in giving an old fart like me (87) a few more months of agony. I would appreciate legal means by which I could end it if I am faced with months or years of agony with only one possible end. I would rather the end be sooner. The Northern Territory had Rights of the Terminally Ill (ROTI) which allowed sufferers of terminal disease to end their lives peacefully. Unfortunately parliament in a bill introduced by Kevin Andrews and supported by Howard and Beazley succeeded in overturning the Northern Territory Law.

My wife and I belong to the Voluntary Euthanasia Society of Queensland which would like to see the legislation reinstated and passed in other places.

I agree with hasbeen that somebody my age should not be entitled to a transplant of a major organ although I wouldn’t sticking in a few teeth to replace those that have gone.

As long as parliament is mainly composed of lawyers we will continue to have a litigious society. Lawyers are not allowed to serve on juries. I think this is because they get too involved in the mechanics of procedure rather than in trying to ascertain the facts of the case. Perhaps lawyers should be barred from serving as members of parliament and should only be retained as technicians to ensure proposed legislation is in the proper format.

Dear Antiseptic,

Perhaps you are unaware of how much influence the US has on Australia. Megachurches have been set up in Australia with American seed money. Hillsong is an example.

The American Enterprise Institute has financed groups in Australia. To a great extent Australia is a US subsidiary. I will try to find the reference. I don’t have it at hand at the moment, but it told how AEI has organised Australian think tanks.

I agree with you on the position of the middle class in Australia.

' Everyone in Australia is entitled to adequate hospital care. Every child in Australia is entitled to an adequate education '

wrong premise Davidf

we should view these as a great blessing and be thankful for them instead of demanding entitlements. Otherwise your premise is racist. You could easily write
Everyone in Pakistan is entitled to adequate hospital care. Every child in Pakistan is entitled to an adequate educatio

Dear runner,

I wish you would read my posts before you argue with me.

My first three sentences were: Everyone in Australia is entitled to adequate hospital care. Every child in Australia is entitled to an adequate education. I believe that is true for people all over the world.

That obviously includes people in Pakistan and everywhere else on the planet.

Weren't you able to get to the third sentence?

david f

fair point David f my apologies. I do however view things as a blessing rather than 'entitlement'. That creates a myriad of wrong attitude.

I think Nurses need much support and get paid at the same level as Doctors. There will be much more productivity and a lot more people to do the job. We provide the same service as Doctors so shouldn't we get paid the same. I've been working as a nurse for many years now in sydney and it's a very demanding job. It took be years to complete my university degree and it was very challenging just like a medical degree would be. I think education is important and it should be spread to potential nurses out there.

Contact me with Genuinely@yahoo.com.au to put your name down to support this further. It's all about humanity.

Sennur Goktas
Sydney NSW

Sennur – I have a better suggestion. What say we pay doctors less and get more of them? It will make the system more affordable and increase services.

Who put up the cash for your degree?

It might be news to you there is a lot of very demanding jobs just as important out there and they don’t get anywhere near as much as you do now.

It’s all about the cash, humanity is not purchased.

David, there are three problems for the medical workforce in Australia, neither of which is related to an inadequate number of doctors.

The first is poor distribution of doctors across specialties. Some specialisations have far too many practitioners, while some have difficulty attracting enough.

The second is the poor geographical distribution of practitioners of all kinds. Capital cities are more attractive locations to practise than regional areas; welthy parts of town are more attractive than the fringe and low-SES areas.

The third is that about half of the doctors we train are women and they will, on average, work for fewer hours in a week than their male peers (about 80% as many, on average) and work for fewer years in their lifetime (about 65% as many FTE years, on average). They will also choose general practise over specialisation much more frequently and be less flexible in where they practise.

If you're interested, look up the Australian Medical Workforce Advisory Committee and Australian Health Workforce Advisory Committee reports. They're interesting, if somewhat depressing reading.

The AMA doesn't have much to do with it.

I'll have a look at the AEI involvement in Australia, but at first blush I think you're taking a US-centric view that reflects your own heritage rather more than is strictly justified.

I second your motion davidf, though I also have a problem with "adequate". What's wrong with "equal"?
Australians should be privy to equal education and healthcare. There should be no private option, unless the well-to-do are willing to provide their own infrastructure, research and practitioners. But private privilege rides on the back of public investment.
If all we had was public education and healthcare, the taxes would be gladly provided to make it world's best practice.

Dear Squeers,

What's wrong with equal is that it could mean inadequate for everybody.

so be it!