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Fragmentation in Australian health care

Discussion in 'Other Health News and Research' started by MeSci, Aug 21, 2015.

  1. MeSci

    MeSci ME/CFS since 1995; activity level 6?

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    Cornwall, UK
    another article from NEJM:

    Australian Health Care — The Challenge of Reform in a Fragmented System
    Jane Hall, Ph.D.

    N Engl J Med 2015; 373:493-497 August 6, 2015

    The Australian health care system appears remarkably successful in delivering good health outcomes with reasonable cost control. Australians enjoy one of the longest life expectancies and a long healthy life expectancy, while costs as a proportion of the gross domestic product remain around the median among countries in the Organization for Economic Cooperation and Development (OECD; see table and case histories; to compare this country with others, see the interactive graphic).1 Universal, tax-financed comprehensive health insurance, Australian Medicare, has been largely stable for three decades. Yet this performance has been achieved through, or despite, the interplay of public and private financing, public and private service provision, and a division of responsibilities between the federal and state governments. The main political parties clash over the role of government and whether national health insurance in its current form should continue.

    More at http://www.nejm.org/doi/full/10.1056/NEJMp1410737?query=TOC

    It looks horrendously complicated. How can sick people be expected to negotiate a system like that? The US one looks bad enough to me, to have to figure out insurance issues as well as health issues.
     
  2. ahmo

    ahmo Senior Member

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    Northcoast NSW, Australia
    Where's the complexity? My experience is that you go to GP, then, if necessary, to specialist. The one thing I have experienced, as someone at the bottom of the pile (live out of metropolitan area, no private insurance), is the wait for surgeries. My husband had a recurrence of an infection that had necessitated brain surgery for an abscess 5 years earlier. He was unable to be booked for surgery in this 2nd episode until it became an emergency, and then the care is immaculate. As is the follow-up, including daily visiting nurses to deal with take-home IV. Private insurance presumably pushes people up on waiting lists, as well as classier hospital stays. Most of the people I know don't have it.
     
  3. alex3619

    alex3619 Senior Member

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    Logan, Queensland, Australia
    The Australian system is complicated at a political and managerial level, not at a patient level. At a patient level its a lot like the UK but with more freedom of choice, and more non-public options if you can afford them. We do have a national problem of huge waiting times for some specialist services, including surgery. In my local area a lot of surgical options were removed when operating rooms were closed, increasing wait times even further.

    I would still argue its far simpler than the US system at a managerial level, though the politics is probably just as messy. It takes an army of clerks to process paperwork in the US, and doctors have to spend a lot of time navigating insurance waters there. We are much more standardized as far as insurance goes, so far as I am aware, which means the system requires far fewer people to keep the paperwork moving.

    Like all medical systems globally there are still major issues though. Mental health issues, for example, are massively ignored here, just like elsewhere. People seem to think it saves money, rather than just being fancy accounting methods to pretend the costs are elsewhere. Someone pays in the end.
     
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