Single-Payer Health Care – It’s Working in Australia


Political acceptance is very high. The conservatives have (totally) made their peace with the system as proposing to remove it is electoral suicide. The support of the populace is almost total.

There is so much misinformation floating around about the satisfaction with health care in U.K., Canada, France, Australia, etc. When I talk to people I know who live in those places or are from there, I hear a much different story than what we hear in our own media.

I don’t know a lot of Australians, just a handful. But those I know say they are definitely happy with both the health care they receive and the cost to them. One of them posted a link to this TPM article that provides a pretty good explanation of how the system works. What I wonder is why are we trying to re-invent the wheel? The U.K. has been at this for 60 years, Australia over 20. Why don’t we study their plans carefully and see what works, what doesn’t, and learn from their experience?

I know the answer: we are so caught up in the politics of it, we can’t get down to practical matters.

I hope you’ll read the entire article as it’s very informative.

The way I think about it is that the US has a fundamentally broken market system. We know it is fundamentally broken because it costs a lot and produces fairly poor outcomes in aggregate. Stories about failure of insurance companies to honour their promises are legion. Many people have conditions that make them uninsurable. America spends a greater proportion of GDP on health (and greater dollars) for worse outcomes almost no matter how you measure it. If you do not agree with that statement you simply refuse to acknowledge clear facts on the ground. Health coverage is one of the major issues for middle America and many are unsatisfied. By contrast political and general population satisfaction with the Australian system is high and has by-and-large been rising.

Australia has a system whereby primary medical care (general practice doctors), much specialist health care (for example a cardiologist) and almost all important pharmaceuticals are covered by the government but with a copayment by patient. Most the copayments are large enough to be annoying (the service is not free) but do not cover anything like the costs. The copayments differ sometimes due to your income status. For instance most people have a copayment for pharmaceuticals of about $20 – but for (low income) pensioners the copayment is $5.

There are also government run public hospitals – run by State Governments – but where the funding almost entirely ultimately comes from the Federal Government through transfer payments to the States. These hospitals have a public emergency room which rations via triage. [Turn up with a sprained ankle and you might wait twelve hours, turn up with chest pains and the waters part for you.]

[snip]Still – on most measures – the Australian system is a resounding success. The cost (proportion of GDP, dollars) is about half the USA – but the outcomes are better across the board. And that is not diet or lifestyle related. Australians are almost as fat as Americans.

Surprisingly the outcomes are as good or better for the rich too. The only exception is Australia’s chronically disadvantaged native (aboriginal) population.

The author of the article explains how the system is paid for as well as both pros and cons of the system. Bottom line is, health care is affordable and available to all, costs are controlled, and people have options with public and private health insurance both existing and working well together in the same system.

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  1. #1 by brewski on August 24, 2009 - 11:50 am

    Sign me up!

  2. #2 by Richard Warnick on August 24, 2009 - 12:03 pm

    Rep. Anthony Weiner (D-NY) engineered a House vote recently to offer Republicans an opportunity to support the abolition of Medicare (a single-payer government health plan). None of them took the bait.

    Yet we are told that a single-payer solution to the health care crisis is politically impossible. Even though a majority of Americans is in favor of it.

    • #3 by brewski on August 24, 2009 - 9:32 pm

      Yet we are told that a single-payer solution to the health care crisis is politically impossible

      Because the drug companies, insurance companies, AMA and tort lawyers have bought the Democratic Party, so they don’t care what the polls say.

  3. #4 by Ken on August 24, 2009 - 7:39 pm

    In Australia it’s not exactly “single payer”. They have both a public and private system. For those who can afford private insurance they do because the quality is much higher. In fact the Australian government will subsidize private insurance because it is cheaper and the quality is higher in the private sector.

    On my mission I experienced socialized medicine. Spent three hours just to pick a number then another 2 hours to see a doctor for 5 minutes.


    • #5 by Cliff Lyon on August 25, 2009 - 9:11 am

      I imagine you are exaggerating a bit or that was an exception and thus anecdotal.

      Any KEN. How much did it cost you?

      • #6 by Ken on August 25, 2009 - 10:17 am

        I admit it was free except for the loss of a P-day because my companion had the flu. Australia does have one of the better implementations of nationalized medicine because it is not compulsory and private insurance is still available and popular, but it does create a 2 tier system where those who can afford it get quality care and those who can’t get adequate but certainly lower quality care.

        However there is a huge difference. There are only around 20 million Australians versus 300 million Americans. The cost to the Average Australian is minimal compared to the enormous cost if the United States was to adopt the same type of system.

  4. #7 by Becky Stauffer on August 24, 2009 - 8:49 pm

    Ken, if you would click the link and read the article, you’ll see that was well-explained. But thanks for the Wikipedia link too. As the author in the article explained, those who opt for private insurance get a tax break, and they can still take advantage of the government-run hospitals, and many do. Isn’t it nice to have options — and to know the two can co-exist?

    As to waiting two hours, if the doctor only saw you for five minutes, we can assume it was not an emergency? I have waited longer than that in American emergency rooms with kids with serious cuts needing stitches, broken bones and serious sprains. As long as the bleeding is controlled, they don’t worry how long you’ve been waiting. Have you ever had to take a kid to the emergency room? Especially in the middle of the night?

  5. #8 by Ken on August 25, 2009 - 12:36 am

    Actually I have waited very long at the emergency room at Primary Children’s hospital. But we are not talking emergency rooms here but a public clinic. It would be like going to see your general practitioner and waiting for 5 hours.

    Even in Australia if it is a real emergency life or death situation then you won’t have to wait, but many do have to wait months for surgeries that would happen in weeks or days here.

  6. #9 by Cliff Lyon on August 25, 2009 - 8:46 am

    This is just toooo funny. Bill Maher is the Truth Teller.

  7. #10 by brewski on August 25, 2009 - 9:33 am

    It is a universal truth that when someone hears someone else who parrots back to them what they already believe, the reaction is “ooooh that person is so smart, so perceptive, such a truth teller.”

    Cliff you are the flip side of the same coin as Rush listeners.

    Although, I did like Maher’s quote which you did not include about each party (I am paraphrasing from memory): “One party is the stooge of Wall Street, Credit Card Companies and Food Processors…and that’s the Democrats, and the Republicans are religious nuts and civil war re-enactors.”

    I would call that fair and balanced.

  8. #11 by evil is evil on August 25, 2009 - 12:57 pm

    RE: Australian health care.

    When I lived in Hawaii, I met a surfer, not good but he enjoyed it.

    Told me that in the late 1960s, he received a large amount of money and decided to tour the world. He was robbed of passport and money in eastern Turkey. Then he had to rely on the “kindness of strangers.” He would come staggering into a dirt poor village and some villager would take him to get food. Maybe a small mound of rice that would be divided 5 ways instead of 4.

    He went through India, Burma, Thailand, Malaysia, and Indonesia with NO passport and NO money.

    Some Indonesian fishermen took him to Darwin in Australia and dropped him off. He said he had every known ailment known to mankind. They shipped him to Brisbane or Sydney and he spent a year or two in hospital.

    When he was finally released, he asked how much he owed. The people that he was talking to started dying away laughing and told him that he could NEVER pay the cost of the medical care, that it was so enormous that they were going to forget about it.

    He said something like “I would leave one village and go to the next.” The first village would tell him that the people in the next village would kill him. When he got the second village, they would tell him how lucky he was not to have been killed in the village he just left.

    He told me and I quote exactly, “xxxx, don’t ever let anyone tell you that there are not good people everywhere.”

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