Health care for all! Wishful thinking or the only thing that makes any sense at all? What we seem never to hear is what it is really like to live in a country that cares about its people enough to maintain universal or 'single-payer' health care – for everyone. For everyone: think about it. Not 45 million people who have no doctor and cannot get anything but band-aid care from emergency rooms. Not 16,000,000 children who are not 'worthy' of health services, because their parents happen to be too poor to pay $500 a month to insure their families.
As Michael Moore's film, Sicko!, forced into many Americans' awareness, every other developed nation has universal health care, except for America. The US is the richest national culture in the world. We all know that. And if these two facts are understood: 1) that other countries have solved what Americans feel is an insurmountable problem and 2) that we have more wealth and resources than any other country, then how can you go to sleep at night, all wrapped in your American Pride and self-satisfaction, knowing that millions upon millions of children, teenagers, adults and the aged are going to sleep hungry, ill and with no hope of even basic medical treatment in their future?
This is a story of real, family life in Australia – protected life, life with health care for every individual, health care that the government takes as a solemn duty to provide. I understand that as Americans, it is often difficult to get our minds around the possibility that a national government might regard the well-being of its people as its first priority, especially when we live within a governmental context that serves (at the federal level, at least) only Big Corporate interests
However, this story is true. It is based upon my family's experience of living in Australia for fourteen of sixteen years, between 1978 and 1994 (we will notice the significance of these dates later). Why everyone reading this does not already understand that national health care for everyone is working well in countries which have cared enough to build a universal healthcare system, is absolutely incredible to me! Socialized medicine, universal healthcare or single payer health care (by any name) is people's medicine. If any person needs health care under these systems, then it is provided. The immediate costs are borne by the state (i.e., the 'single payer'). That means that you can get treatment for any genuine medical need for Free.
For most Americans, steeped as we are in the outrageous claims of our medical establishment that our medical care is 'the best in the world,' it is hard to comprehend any other situation... until you get to experience it firsthand, when you have a child in need, when you are far from the enormous pomp and glitz of the American medical system.
Let's have a look at how is works in Australia. Later, we will deal with that terrible threat of, "How could we ever pay for everyone to be treated for free?"
Let's say that you live in a small to medium sized Australian town. One day your child wakes up with a severe headache. You don't know what it is. So you call your local doctor. You talk to the receptionist and tell him/her what is wrong. Depending on the symptoms, often whoever answers the phone will go and ask the doctor how urgently you should be seen. If the doctor is with another patient, the receptionist may well conduct a brief discussion with the doctor in the doorway. Or over the phone. I have never been put on long 'hold' as so often happens in the U.S.
Perhaps the current patient waits a minute and when the doctor returns, his/her full attention is immediately returned to the patient in the office. Doesn't this sound strange? You see, the doctor has not been notified that you are very concerned about your child and is not then expected to wait until s/he finishes with a current patient before even being able to judge the importance of the incoming need. S/he already knows. It is so simple. Why can't we do it that way? Because a doctor in this country would not dare to say anything about another patient that might be overheard – you know, liability issues and all that. Gotta be very careful. At every moment in America, every doctor's practice and lifework are on the line, hanging by a single legal thread. One careless act and....
So it has already begun: peace of mind. For in Australia, there is already less drama when needing medical help. You don't have to provide checks and rechecks of your identity and be grilled on every personal detail of your lives before you are on track to get some help. A name usually does it. Recognition greets your call. The doctor's staff knows you and your children. It all contributes to peace of mind.
When you first call, and the reasons for the call have been explained – and maybe the doctor consulted – you are then asked (no, not told). "When can you come in today?" And an appointment is made, right on the spot. Even with the needs of several kids to deal with, our family was never kept waiting to see our doctor, even overnight. Think of it. An hour or two later, you are in the doctor's office. Maybe there is a short wait. You are asked for your Medicare card (not an original name, perhaps, but a more accurate use of the word over there). The card is swiped and you sit down. Relax. Really. Everything is in hand. Tea, coffee, perhaps, maybe a neighbor to chat with.
The appointment itself is just as you'd imagine it should be. Privacy, but not manic, overdriven, frightened privacy. Just effective respect for privacy. The doctor talks with your child, asks what the child can reveal about whatever hurts. In time (and there will be time) the doctor gets around to asking the parent what's happening. Then there is some looking around. You know, touching the patient, patting the kid on the shoulder, providing a little reassurance – the things that would come natural to anyone who had chosen to devote their life to really helping others. Like your own doctor here in the U.S., only here, there is always the pressure of having to justify every minute spent with a patient – and having to generate enough income to support the 4-6 staff whose income is directly tied to the doctor's billing.
True, in Australia, if x-rays are needed, you might have to go a few blocks away to the radiography clinic. Ours was built into an old house with a wheelchair ramp up to the back door. But inside, the equipment and the professionalism of the staff was as good as what happens here in our mega-million dollar 'diagnostic imaging' facilities. Believe it or not. Wasted servicing is kept to a minimum throughout the entire Australian medical system. At a bureaucratic level, when the government – Medicare – is paying for everything, wasting system resources at any level is not benefiting anyone! Because waste would mean that fewer people could get proper treatment. In the US, systematic waste – over-prescribing, ordering extra tests, sending patients off to specialists – protects the medical profession from liability and generates extra income. Medicine for profit vs. medicine for health. The two simply cannot be interchanged without changing everything about how the system operates.
So there's your kid, and her doctor is smiling and talking to her - easily making time to be genuinely involved. Perhaps there is a rare medical condition that should be considered. No, not for every simple headache, nor for every migraine. But maybe there's something.... Maybe some blood is drawn; maybe you go off for an x-ray or an MRI. Hey! Sometimes MRI's more than a day or two to schedule. Ah well... those machines don't grow on trees and they are allocated very carefully throughout the system
Perhaps your child does need an MRI. Then you are about to meet one of the amazing attributes of the Australian medical system: the Base Hospital. In every area there is one hospital (more in larger cities of course) which houses perhaps 90% of all possible medical services, technology and specialist services . Base hospitals serve their entire regions, providing a locus for specialized services of all kinds. This means that your local GP (and your family) has constant access to local specialist diagnostics and treatment. The base hospital is the hub of the wheel of the medical system. For your daughter's needs today, the MRI will be done at the base hospital, and the specialist who will read the resulting images will likely have a practice within a block or two of the hospital. Accessible: peace of mind. Did you ever wonder who read your daughter's x-rays or MRI scans? And have you ever tried to talk to 'your' radiologist? Good luck!
MRI's are very expensive: usually well over $1200 in the US, often closer to $2000 (and maybe more where higher local incomes can be tapped for additional profit). But in Australia, you offer your card and that's it. No co-pays: peace of mind. It does not matter whether you are getting an MRI or a heart-lung transplant. It is all covered. No surprises and 'no worries.' Aussies (and, if only out of courtesy, practice saying 'Auzzies' instead of 'Aussies") say this a lot: "No worries, Mate!" And they really mean it. You also hear them say, "Not a problem," and "no dramas," and they really aim at this in every aspect of life. "No worries. She'll be right! Just leave her to us!"
If your daughter didn't need any special diagnostic scans, then your office appointment with the doctor is likely to end with, "Bring her back tomorrow if things don't seem to be improving." Did I hear right? "Tomorrow?" Of course! "And when would you like to bring her in...?"