Monday 27 June 2022

Of Public Health

 Greetings,

I have seen a lot on social media about the public health systems of various countries, especially in the wake of the decisions made in the United States in regard to abortion and so forth. There has been much touting about the Australian Public Health system and how wonderful it is. There are wonderful things about it, and there are also things which are not so wonderful about it, so lets have an examination, at least from my perspective.

You can go to an Australian hospital, as an Australian citizen, carrying a Medicare card and get emergency medical care without having to pay for the medical care you receive. You can attend any of the outpatient clinics at Australian hospitals without having to pay for them, so long as you hold a Medicare card, and a Health Care card. The second being issued to those with a low income, or those who are on government payments.

The problem with this, if General Practitioners out in the community refuse to bulk-bill their patients, even those on Health Care cards. Then the same individuals go to the hospital for non-emergency reasons and the lines extend out the doors at emergency departments. The other choice for these individuals is to choose between eating and getting non-emergency medical assistance. This is only the state for the physical medical needs.

It is near to impossible to find a bulk-billing Psychiatrist, or a bulk-billing Psychologist, forcing people to either remain untreated for mental health problems, or wait until they are so bad they need crisis help services. Once again, for low income earners or those on government payments it comes down to seeking mental health treatment or eating in many instances. This means that such crisis help services, or outpatient services at hospitals are also hemorrhaging patients, or resulting in long wait periods for help.

At the hospitals, even with the outpatient services, which were mentioned before, there is a triage process, meaning that the people who need the services get them first. This is a good thing. In this case they go by Category, with Category 1 (Cat. 1) being the first to be seen and Cat. 3 being seen at the end because they are considered least on the triage scale. A person on Cat. 3 has a wait of anywhere up to 365 days to be seen by a an outpatient service. In some instances, unless you keep track of it, you can occasionally "fall off" the waiting list, and have to start the process all over again. 

So, there are some wonderful things about the Australian Public Health system, there are also some not so great things. Some people can afford Private Health, and thus can afford to pay for medical and mental care, there are others who cannot. The Public Health system was built for those who cannot afford to pay for such services. There is a limit, however to where the Public system simply cannot support the load and the Private system has to bear some of it.

If the Medicare rebate was increased to make it affordable for professionals, medical and mental, then they might be more available in the Private system, and this would take some of the pressure off the Public Health system. Another alternative would be to increase the government payments to reflect the current state of affordability of such medical systems, to make such payments actually livable. Of course, it would seem that the government has other priorities (paying off their campaign supporters, for one), focusing on other projects other than Public Health.

Cutting into the soft underbelly of society is much easier than taking from the top where there is much more to spare, but they might not get funding for their next campaign. Maybe if the governments actually focused on running the country rather than winning the next election, or staying popular with "important" people, things might actually get somewhere and society might actually improve as a whole. Of course, such a radical move would take a brave set of politicians, and there don't seem to be any of those out there anymore.

Cheers,

Henry.