Healthcare reform- Aussie’s Keys to Heaven

Readers have seen how hard the Finnish government has tried to improve the efficiency of our rather public good health system. After 10 more years of trying, the Finnish Parliamentary Constitutional Law Committee threw out the government’s proposal that they brought before Parliament! It will take months of amendments before they can come back, and new general elections are only 10 months away.

At this stage it is worth taking a look on what the Aussies are doing with their healthcare system – it is a very interesting story that works for those with money but not too well if the pension is small, or if you are not employed…

Australians have a big lovely country with plenty of hot weather most of the year, long sandy beaches, mountains, lakes, high hills, tropical and subtropical forests, never-ending bush, animals galore, fish and millions of sea creatures, and the strangest birds singing all year round.

The Australian population is as diverse as the landscape, with fiercely independent immigrants from Europe and newer ones from Asia and South America. They complement the original native (aboriginal) population who also remain fiercely independent after the abuse from the colonial arrivals.

No nanny government. Australians want to live in their own stand-alone houses, and definitely not in “shared” apartment buildings. This reflects their wish to avoid a nanny government. Basic services should be provided by private as well as publicly-owned companies.

Your Forum correspondent has spent a few weeks in Australia, during which one of the talking points has been the organization and cost of healthcare. You cannot miss the half-page advertisements in every newspaper offering “great” healthcare insurance and “Australia’s best medical benefits”. Nor can you look past the tempting photographs of good-looking, smiling doctors offering every private service under the sun. Even more noticeable are the huge discount pharmacies that offer low-cost healthcare products and competitively priced medical services.

Images can be deceiving. Dozens of interviews with young and old, as well as some careful research with healthcare professionals, produce a very different picture of what locals think about healthcare in Australia.

Most people in Sydney and in Gold Coast, Queensland, say that the basic public healthcare system is fine. Everybody has to enroll in the government’s Medicare system which helps pay for most, but not all, of the costs of public healthcare. The waiting times on average are between 1 month and 1 year, but there is a lot of divergence and patients can end up waiting years in pain for hip or knee replacements. Even then, the patients will be responsible, depending on age and income, for funding the cost gap – the costs of the medical procedure exceeding the limit set by Medicare.

Pay as you go. Patients who have the money can follow two paths: either take out private healthcare insurance, or go to a private hospital and pay whatever it costs for the surgery. In the first case, the insurance company will only help with the part of the costs if the treatment proves to be expensive. This leaves the insured client economically exposed if the takes the private route, not wanting to wait.

Health insurance in Australia is expensive and complex – so complex that many who were interviewed have no real idea about what was covered. They just have faith in the “competitive markets” which is a strong Australian characteristic handed down from father to son or mother to daughter.

Pure PR. Many say that it would take a week with lawyer and doctor to understand each contract. The adverts in the newspapers and the websites are full of legal jargon, and when you pressed the next “NEXT” button you were presented with another mind-shattering promise that this was the best deal in the world. Press “Next” again until you reach the end when, none the wiser, you are asked for your phone number and email address so the salesman will call you with more details.

It appears that young people take out the basic insurance scheme for simple doctor visits, accidents and ambulance. When you get married, and if you can afford it, you take out a full insurance policy that will cost each adult some 4 000 euros per year – with the insurance company holding the right to increase insurance payments each year and reduce the ailments covered by the scheme.

Lottery. The contracts are long and written with small print, and it becomes clear that few patients have any idea of what is covered – until you one day end up in a hospital bed and the invoice is placed under your nose…

The best description was given by one lady: “this is a lottery – if you get the right disease with the right insurance contract you will go to heaven happily, but if you have the wrong ailment without insurance get ready to meet with St. Peter at the pearly gates.”

Knowledge is power. And clients are at a structural disadvantage. So you can see why health insurance companies like OP Group and If are licking their lips with the future of SOTE and private care. It will be a gold mine like the Australian Klondike.

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