Health care’s better Down Under

BY ERIN K. O'NEILL

I have one overarching life philosophy: When in doubt, do as the Australians do.

The Aussies have fashioned themselves a very nice, if not perfect, health care system.  It merges the benefits of a government-run universal insurance and care scheme with the flexibility and choice of private insurance rather successfully.

The news media on this side of the Pacific Ocean have obsessed over the process of passing American health care reform through Congress but not the details of the actual bill. President Barack Obama’s remarks of late have been platitudes about lowering costs, giving everyone preventative care and stopping insurance discrimination for preexisting conditions. These are not things to which anyone objects. But how we are to accomplish these things is left unsaid in the debate.

So I propose we look to the Southern Hemisphere. According to World Health Organization statistics, the total Australian health care cost in 2006 was $3,316* per capita. Comparatively, the U.S. spent $6,714 per capita on health care in 2007. Meanwhile, Australia also enjoys a lower per capita government expenditure on health care: $2,227 in 2007, as compared with $3,074 in the U.S.

Medicare Australia is the government universal health insurance program.  Australians enjoy this lower expense through a network of public hospitals, which are free for all Aussies. Australian Medicare also subsidizes medical specialists, general practitioners, and prescriptions, dentists and participating optometrists. This is paid for by a 1.5 percent income-tax levy.

Australian Medicare also strongly encourages those who can afford it to buy their own private health insurance. Anyone who buys private health insurance is entitled to a 30 percent rebate from the government. And then there is the Medicare levy surcharge, to encourage better-off Aussies to buy private hospital insurance. So singles who make more than about $58,100 per year or families that make more than $124,500 per year can either buy enough private insurance or pay a 1 percent additional tax for Medicare.

Conversely, Australians with an income of less than $14,800 don’t have to pay the Medicare tax, and those under $17,400 pay a reduced tax. There are also reductions for seniors and pensioners. But everyone gets basic Medicare, regardless of income.

And because everyone gets Medicare, private health insurers need to stay competitive. The largest private health insurer, Medibank Private, is actually owned by the government but is subjected to the same regulations as non-government owned health insurance companies. A few health insurance providers in Australia, such as GHMBA and HCF, are even nonprofit.

The private and public health insurance systems working in tandem provide cheaper health care that avoids many of the common complaints about “socialized” universal health care. Because the wealthy are so strongly encouraged to have private health insurance, there are rarely wait times for procedures. And since all Australians are in Medicare, it’s good, efficient and cost-effective health care. While the government won’t cover everything — the basics are taken care of and subsidies keep patients' costs down — what isn’t covered isn’t all that costly.

I have lived in Australia and used its health care system. I had to buy international student health insurance through Medibank Private. I needed doctors to re-issue my American prescriptions, to update my tetanus vaccination and to fix a dislocated knee. The system works, in practice, much like the American system for those who have good health insurance. Only, instead of just working that way for the insured, it works that way for everyone.

It’s a good system. I suspect it’s such a good one because with the jellyfish, crocodiles, sharks, funnel web spiders, dingoes, six of the ten most poisonous snakes in the world and a giant hole in the ozone layer, Australia is hazardous to your health. But our fair American congressmen and congresswomen should take a lesson from the Lucky Country: Health care is better there, and America would do well to emulate it.

*All dollar amounts have been converted to U.S. dollars.

Erin K. O'Neill is an assistant director of photography for the Missourian and a master's degree candidate at the Missouri School of Journalism. She has lived in Australia on two occasions, for a year as a Rotary Youth Exchange Student during high school and a semester abroad in college.

Published in the Columbia Missourian on Saturday, August 1, 2009.