Monday, July 27, 2009

Medicine down under

Australia has national health insurance (called "Medicare," but unlike US Medicare, it's for everybody, not just old folks).

Australia also has private healthcare and insurance; if you don't like the service you get from Medicare, and you've got the cash, then you can pay for treatment or private insurance. That's different from Canada, where doctors aren't allowed to accept payment from anybody besides the government.

How well does the Australian system work?

Well, if you believe the newspapers, not terribly well. I picked up a copy of "The Australian" newspaper today-- it's the equivalent of the New York Times down here. Headline on the front page: "After five visits to the hospital, family asks why did our little girl have to die?"

It's a heartbreaking story of a four-year-old girl who died in a tiny little town in North Australia. But maybe that was an unpreventable tragedy that even the most perfect health care system wouldn't have prevented.

Page 2 story: "Billions 'wasted' in health system"
If you've been listening to the debate over healthcare in America, then this will sound very familiar:
The commission... will warn that healthcare services, already under strain, will be swamped by the rising tide of chronic illness, an ageing population and costly new health technologies. ... The current system is "unlikely to be sustainable without reform"...

And on Page 4, on the same page as the continuation of the front-page, dead 4-year-old story: "Medicare system failing indigenous"
It the data-driven version of the "pulls at your heartstrings" front-page story: "In 2008-2009, less than $8 million out of a total Medicare budget of $14.3 billion went towards rebates specifically for indigenous people, who have shorter life spans and almost three times the infant mortality rate of other Australians."

Sigh. It's nice to think that if America just had "Medicare for All," it would correct longstanding social injustices, improve health outcomes for our minority populations, save us money, and prevent oodles of tragic deaths.

But politics, even honest, no-bribery-or-scandal politics, is a market. The rich, privileged majorities who elect the politicians have the most influence on policy, so guess who ends up getting the most from just about any political deal? If healthcare reform happens in America, the people most likely to benefit are people like you and me-- relatively well-off, well-educated people who don't really need any more government handouts (I still feel a little dirty over the 4.5% interest rate I got on my mortgage refinance a couple of months ago; thank you, I guess, Federal Reserve).

Which brings me to this Page 3 story: "Beautiful lure for tourists packages cosmetic surgery, IVF"
Cairns, the tourism hub of tropical north Queensland, is reinventing itself as the cosmetic surgery and IVF (in-vitro fertilization) mecca of Australia-- targeting US defence personell in Guam.
I can see the ads now: Cairns: not just Bikinis any more, now with affordable Babies and Boob Jobs!


Anonymous said...

Earth to Gavin: We have a problem here that is choking our economy and our government budgets to death. No one in favor of reform believes that all of our problems will dry up in one fell swoop. You are giving us one of the great perennial phony arguments against any kind of reform: that it won't whiten my teeth and cure cancer. But we're simply looking to move the ball up the field. It's called progress.

You are not back here listening to the insufferable propaganda offensive from the right wing on health care reform, so your post is just more of the same stuff for us here.

"Politics is a market": Wow, I guess this is some sort of Down Under Profundity for you. It's all very pat. But what does it mean?

If you were here, I trust that your contrarian self would kick in and you would be posting something other than the same old skeptical defeatist stuff we're already getting: calling any plan "socialism" and threatening "death panels" in which government officials decide who dies and who does not.

From where you sit, this may seem like insight to you, but it's just part of the shit storm for us for the past few weeks. In short, you (unusually) have nothing new or insightful to say (yet) on this topic.

Gavin Andresen said...

C'mon, you've ALWAYS gotta filter out the insufferable propaganda, from all sides of any political debate.

You claim that the reform proposals "move the ball forward."

I don't see it. According to the Congressional Budget Office (who're supposed to be non-partisan), the democratic proposals don't "bend the cost curve."

If that's true, and they won't address the issues that are choking our economy and budgets, then how are they moving the ball forward?

It sounds to me like the typical politician logic: "Something must be done. This is something. Therefore, this must be done."

RE: what does it mean "politics is a market" : it's the lesson of public choice economics. Politicians and the people who vote for them (or lobby them or donate money to their campaigns) are self-interested individuals, they are NOT selfless beings interested in creating a Greater Good for All Mankind. It's an obvious but usually forgotten truth.

(President Obama is an exception, of course; he couldn't possibly be motivated by personal loyalties or concern for getting re-elected or being seen as a great and heroic president...)