posted on Sep, 7 2009 @ 07:41 AM
I know the US government has considered the Australian public health system as an option on several occasions but every option has its problems. In
the Oz example, the scheme is funded by a levy which is 1.5% of taxable annual income added to your payable tax at the annual assessment in July. The
levy is means tested so that the lowest income earners are exempt at the bottom end of a sliding scale. High income earners are penalised with an
increased levy if they don't have full private cover for hospital expenses.
The concept of increased taxation is the hardest pill to swallow for US residents, especially those with very high incomes.
The public health system is essentially free eg. you could be hospitalised with a life threatening problem for virtually any length of time and not
pay any hospital costs. Most medications are government subsidised which doesn't make them free, just considerably less out of pocket costs but
there are some notable exceptions like some specialised drugs for rare diseases which haven't been covered as yet and those are hideously expensive
for those unfortunate enough to need them.
Where private insurance comes into its own (I have always had full private cover) is for what's called 'elective' surgery which is basically
anything non-life threatening. On the public system there are huge waiting lists for such surgery, things like hernias, arthroscopy for arthritic
conditions etc. With private cover I can see the local doc who 'bulkbills', meaning he only charges what the health system rebate is for
consultations which means I only need to swipe my health card when I see him. He gives me a referal to a specialist and I get into a private hospital
and fixed up ASAP, like in days usually. Without private cover I'd get the same standard of care but might wait my turn for anything up to years to
get the necessary surgery.
My private cover allows me to go to the private hospital emergency dept and I all I need pay is a small excess fee and ANY length of hospitalisiation
is fully paid for, including all expenses incurred while an in-patient (doctors, surgeons, anaesthetists, theatre fees, medication. bed fees etc etc).
It's something you hope you don't ever need but you're thankful you have it when it's needed.
Cosmetic type surgery is definitely not covered by either the public or private system and for that, you pay the big bucks which is why a lot of Oz
patients take their chances getting it done cheaper in places like Thailand these days (breast implants, nose jobs for example).
Oz tourists travelling to certain places (the US in particular) are heavily advised to take out fully comprehensive traveller's health insurance
against the chance of suffering a serious injury/illness while over there. We've heard many horror stories of the cost of treatment for let's say,
a serious accidental fracture in the US virtually sending families bankrupt like having to sell the family home to pay the bill and get the patient
back home again.
The US health system is in desperate need of reform and it's not going to be cheap but it should be a lot fairer for all citizens regardless of
income. Basically those at the top of the income pyramid need to be helping those lower down but that doesn't exactly fit the concept of totally
free enterprise and low taxation. It wouldn't hurt for your medicos to take a serious pay cut also and that will never get a popular vote.
[edit on 7/9/2009 by Pilgrum]