Like most people, during my 20s and 30s my experience with the health system was largely routine – GP visits, the occasional emergency ward appearance for a broken leg (mixed indoor netball is a tough sport). I was healthy and so didn’t really think much about the workings of the health system until something unexpected occurred – the birth of our second child, who has Down’s syndrome.
The first week after her birth as we waited for test results and confirmation of the diagnosis was as stressful a time my wife and I have ever experienced.
Fortunately our daughter Emma lay peacefully in her humidicrib in the Canberra hospital neonatal ICU (and as an aside, if there are any true heroes walking among us it is the nurses who work in those wards).
So small and in need of warmth was she that I was rarely able to hold her, and I felt utterly useless and disconnected. As we had named her after one of our favourite literary characters, my way to bond with her was to spend nights in the dimly lit ICU sitting next to her humidicrib, tearfully and softly reading the Jane Austen novel to her.
So yeah. I was pretty much a wreck. And among the worries I had about her future was the wonder of how we were going to pay for it all.
In retrospect it was a slightly dopey thought – perhaps stemming from too much infiltration of US TV into my system where I was reacting like someone who, after witnessing a crime, thinks to dial 911.
I had little understanding of what Down’s syndrome was: what care would be required, what operations would be needed (we were very lucky, in that she did not require any surgery to repair her heart or intestines which can often be the case for babies with DS)? But above it all I kept thinking, cripes, how are we going to pay for it?
I guess I can be excused due to the stress, but it didn’t occur to me until later that the very place in which I was having those worries and where my daughter was receiving amazing care was a public hospital – and that we of course do not live in the US – we have Medicare.
And let us all pause and give thanks that we do.
Now sure, there have in the 13 years since been numerous private medical expenses – mostly specialists – ophthalmologists, ear, nose and throat specialists and the like. And there have of course been out-of-pocket expenses.
But mostly the public system has been there – either firstly through TherapyACT, or then the NDIS.
And when things went bad – such as in her first two years when she was hospitalised each winter with bronchiolitis and had be put on a respirator to keep her oxygen levels up – there we were once again in the Canberra hospital getting great care.
In the 2016 election the big issue was the supposed desire of the Liberal party to privatise Medicare. It was never a stated policy, and the ALP had to face a lot of questioning over how truthful they were being. There were suggestions that it could never happen but the scare campaign was enough to get the ALP very close to winning government.
Australians overwhelmingly love Medicare. And they should. And they overwhelmingly hate private health insurance. And they are right to.
Mostly private health care is now a thing taken out to avoid paying the Medicare levy surcharge. And more and more what is being offered is insurance with a myriad of exclusions and excess co-payments.
Little wonder that young people are leaving the private health system.
Bizarrely though as well this week came the suggestion from the managing director of private health insurer NIB, Mark Fitzgibbon, in an opinion piece in the AFR that the government should scrap Medicare and “make private health insurance compulsory for all Australians with taxation devoted to subsidising the premiums for those who would otherwise be left behind.”
Ahh yes, privatising Medicare. Welcome back.
Is there any policy issue that the business sector doesn’t believe can be solved by privatisation? Especially when that privatisation will most benefit the business run by the person promoting it?
There actually has already been a recent quasi-privatising of the health system. The NDIS saw the end of the very good care people received from public health groups such as TherapyACT and a switch to having to find private therapists (often those who had worked for organisations like TherapyACT) who are then paid by through the NDIS.
I am sure many have benefited from the NDIS, but I have not found too many benefits that I would not have been as efficiently delivered by just providing the public health sector with the extra money that now goes into the NDIS.
But this is the heart of the argument – the belief that the private sector delivers things better. And yet we know this is a belief better observed in economic textbooks from the 1980s than from reality.
The US’s largely privatised health system is inefficient and so disgracefully costly that sickness in the US is almost a synonym for bankruptcy.
We know the current government is committed to reducing expenditure and this of course will have to hit the health system.
I suspect this will manifest itself in a push for more NDIS style “voucher systems” which is essentially a privatisation by stealth and for ever-more “incentives” for people to join private health insurance.
What is also clear is that the 2016 “Mediscare” campaign might have lacked substance but the implicit desire to prefer the private sector over the public sector is a feature of conservative governments either in nations with strong public system like Australia and the UK, or those without like the US.
And it is a desire that always needs to be fought against by all of us for whom the public health system is so treasured.
• Greg Jericho writes on economics for Guardian Australia
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