The NIB Boss Is Wrong, Scrapping Medicare Would Be A Disaster
As a doctor, I take pride in the fact that when my patients walk out of hospital, the only piece of paper they get is a letter detailing what happened while under our care.
In fact, they leave not only without paying a cent, they leave with a bag of medications also given to them for free.
The Australian healthcare system was set up in 1975 under then-Prime Minister Gough Whitlam who saw that many Australians struggled with affordable healthcare. What we now have is a federal and state funded program -- Medicare -- which covers the costs of hospital treatment, with arms that also cover some medications and some community care. It is supplemented by our private healthcare industry, which allows us to choose to pay for insurance and be treated in a private hospital.
The private health sector is currently experiencing a downturn, with concerns over the number of young people dropping insurance because of rising premiums and minimal return on investment. With healthcare costs rising, due to more and more ageing Australians as well as the rise of complex illnesses and the resultant treatment required, health funds are feeling the pinch as people drop their private cover.
So, when I read that chief of a private insurance company wants to abolish Medicare, my first thought was that this is either a decidedly stupid idea or a desperate grab for business -- or both.
I work in both public and private health. And for my whole career, I have been beholden to the pros and cons of both systems. As someone deeply embedded in healthcare, as a surgeon and a consumer, I strongly believe that our dual model care is important as both models bring something to the table.
In the public sector, the ability to provide healthcare for all who need it is an important moral imperative and as such, any moves to abolish it are in my opinion, unconscionable.
While public healthcare has some significant limitation, such as the failure of Medicare rebates to keep pace with the actual costs of providing care, leading to underpayments of providers, poor workplace culture, or a stretched and under-resourced system, we should always take care of those who need it most. And at any time, any one of us could be in that position.
The public healthcare system in Australia provides care that is world-class and should any of us need it, we will be grateful for it.
The private sector also has an important role to play. For one thing, it can provide some breathing room for the over-stretched public sector, which is never to be underestimated. Private medicine may conjure up notions of minor illness or cosmetic procedures, but that is not the case. Every year, thousands of Australians get care for major illnesses in the private sector. I operate on people with life-threatening heart and lung problems in the private sector, just as I do in public.
The costs to patients in the private sector rightly come under scrutiny when it becomes clear just how large the gaps patients must pay are. But for the vast majority, the costs reflect the care and many of my colleagues, myself included, provide life-saving or life-changing care without a gap.
Private healthcare is also an increasingly important way of providing education and training to doctors and nursing students -- the next generation of people who will be providing care to us all down the track.
Is our healthcare system perfect? No way, not even close. There are literally dozens of things that I would change. Better resourcing and efficiency of the public sector, cracking down on excessive fees are just a few that come to mind. But what we have is something worth fighting for.
For a lot of us, our biggest fear is replicating an American-style health system, where people even close to death are afraid to turn up to a hospital for fear of an unpayable bill. In the US, medical costs are cited a significant reason people file for bankruptcy. Private health insurance providers dictate the treatments that people can be provided, not doctors, arguably the people best placed to make such calls.
I will fight for the existence of both our private and public healthcare systems because they are both outstanding and important. But I will also keep fighting for them to be better, and against letting private health insurers dictate in any way shape or form what that looks like.