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The Health of Nations (and Don't Forget Australia)

I just got around to reading Ezra Klein's Health of Nations article in The American Prospect. It's a wonderfully clear description of how the health care systems of Canada, France, Germany and our own Veterans' Administration work (Ezra's verdict: better than the private U.S. system).

It's fine work, marred only by Ezra's egregious failure to mention the great nation of Australia (that man's anti-Antipodean bias will be his downfall, I say). Happily, though, several Aussies commented on my Wednesday post about health care, one of them (Marcus by name) offering this description of how things work down there:

Everyone pays a levy that guarantees a basic level of service. The basic costs of visits to doctors (Physicians and some specialists), accident and emergency care, and elective surgency etc are all covered as part of that package based on a set fee structure. Pharmaceuticals are bought in bulk through the government and the price to consumers is reduced and subsidised as a result.

The problems with the system are that there are long waiting lists for elective surgery, and at times there is limited choice (some doctors charge over and above the fee structure and therefore there is a "gap"). For those who are concerned enough about that, private health insurance is widely available (about 30% of Australians have it) and is also supported by tax incentives, etc etc.

It is not a perfect system, but i'd take it over yours any day...

Update: On the bright side, things are much worse in China.

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  • 1

    "The basic costs of visits to doctors (Physicians and some specialists), accident and emergency care, and elective surgency etc are all covered as part of that package based on a set fee structure"

    I'm not sure that this guy understands what "elective" surgery means i.e. medically unnecessary.

    Basically, operations can be broken down into three categories, emergency (immediately medically necessary), non-elective (medically necessary but not an 'emergency') and elective (not medically necessary).

    My guess is that what he meant to say is that there were delays in non-elective surgery.

    (btw, is there something going on at swampland? You and the James over at Tuned-In have each produced more posts than the entire Swampland team the last couple of days....)

  • 2

    Re: Australian elective surgery - from the Australian government:

    Elective surgery is surgery that a doctor believes to be necessary but which can be delayed for at least 24 hours. It does not cover emergency surgery or treatment, nor does it cover medical treatment. Patients are generally treated in a timely manner. However those with less urgent conditions are usually required to wait for a time and are placed on a waiting list.

    http://www.health.sa.gov.au/electivesurgery/

    What is elective surgery?
    Outside of medical circles, many people find the term ‘elective surgery' confusing. They think that it means ‘electing' or choosing to undergo a non-essential or optional surgical procedure. This is not the case. Much of the elective surgery undertaken in Australia's hospitals is urgent and critical, such as coronary bypass operations and hip replacements, which are clearly necessary and often fundamental for a person's wellbeing. Elective surgery is any form of surgery that your doctor or health professional believes to be necessary but which can be delayed for at least 24 hours.
    http://www.aodgp.gov.au/internet/wcms/Publishing.nsf/Content/health-ahca-sooph05-ins_elective.htm

  • 3

    Wow. Thanks James, for your high-quality research.

  • 4

    Heh. The Google. Elective surgery Australia. Search. Click.

    But gee, Maybe I can get a job at Time Mag.

    The Google. Gonzales US Attorney firing. Search. Click.

  • 5

    "Outside of medical circles, many people find the term ‘elective surgery' confusing. They think that it means ‘electing' or choosing to undergo a non-essential or optional surgical procedure. "

    um...I stand corrected...in Brisbane! ;)

  • 6

    Of course, elective surgery in the US can be unduly delayed as well. For insured persons, it is often delayed, and even denied, in the approval process at the health management orgs, some being notorious for not approving medically necessary surgery and other treatment, including cancer treatment. Uninsured persons, of course, generally don't *have* elective surgery, instead waiting until it becomes non-elective, driving them into bankruptcy and/or chained to a massive medical debt for years.

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