A PERSONAL NOTE

I thought I might make brief mention of my own encounter with Australian medical services a couple of days ago. As a fair-skinned person who grew up in the tropics, I do in my later years (I am 61) get a lot of skin cancer. In Australia's public hospital system, a wait of at least six months to have skin cancers removed by surgery seems common. Australia does however also have an excellent private medical sector and affordable health insurance premiums to give access to it. I am, of course, privately insured.

Last week, I noticed a small skin lump pop up on my leg. Being by now experienced in such matters, I decided on Sunday that it was probably an SCC (squamous cell carcinoma) -- a form of cancer that can be dangerous. So on Monday morning I rang around the local plastic surgeons in order to arange an appointment for its removal. I could have got a GP to cut it out but lesions on legs do not heal well so I wanted the more expert job that plastic surgeons do. On my second try I found that a very skillful and highly qualified surgeon whom I have used before did have an appointment available. When? For six months' time? No. For the next day! So I went in to his private operating theatre yesterday at 9am and was out again with the job done by 10am. And it was such a good job that I have had no pain since!

And the total cost? A totally trivial $180.00 (That's $125 in U.S. dollars). Lots of gamblers would spend that much in 10 minutes. And for the $180 I got the very politely-rendered services of a man with double qualifications -- in dermatology and plastic surgery. And I will get some of the $180 back out of insurance anyway.

There is absolutely no reason why all medicine cannot be like that. Only socialism prevents it.






DECKCHAIR SHUFFLING IN AUSTRALIA

They think that a bigger bureaucracy is the answer to problems!

"It's not every day that health industry leaders publicly agree with a politician about how hospitals should be run. But it should perhaps have been no surprise that a medical industry desperate for reform last week overwhelmingly backed NSW Premier Bob Carr's offer to hand responsibility for public hospitals to the federal government.

Australia's fragmented and unnecessarily complex health system is at a crossroads. It is hemorrhaging money while waiting lists grow longer and patients struggle to gain access to hospitals, nursing homes and medical specialists.

This week the idea of shifting the responsibility for hospitals to the federal government gained momentum when the Productivity Commission called for an independent public review of the health system. "It is now generally accepted that Australia's health system is beset by structural problems that require nationally co-ordinated action," commission chairman Gary Banks said.

Economists estimate between $1 billion and $4 billion a year could be saved by cutting the substantial amount of bureaucratic duplication between the state and federal governments.

The cost of running the health system is outstripping inflation by 3 per cent a year and one of the fastest growing expense items is hospital administration. In 2001-2002 public hospitals spent $992m on administration - the third biggest expenditure item behind wages and medical/surgical supplies.

Since the plan was floated, industry commentators, while backing commonwealth control of hospitals, have stressed now is the time for a widespread restructure of health services. Australia's health system is impossibly complicated and attempts to analyse the quality of the health care are hampered by excessive bureaucracy. The federal government funds nursing homes, private health insurance and the Pharmaceutical Benefits Scheme while the states also fund hospitals and are ultimately responsible for hospitals meeting their budgets.....

In July this year NSW Health Minister Morris Iemma announced 650 administration jobs would be cut over two years and the 17 area health services in NSW would be reduced to eight as part of plan to save $100 million a year.....

The lack of national standards and uniformity among the states is one of the reasons that the Australian Healthcare Association's executive director Prue Power prefers the model of the federal government taking control of hospitals. "Something has to be done to end the cost-shifting and blame casting that characterises our health system today."........

Without universal reporting of hospital standards, Woodruff says services will not improve. "We need universality to make it easier to assess what's working or not. "The moves to address adverse event management, for example, are incredibly slow. We've known since 1995 that adverse events in hospitals are a major source of morbidity and mortality throughout Australia but the speed of implementation of changes has been so slow. Most physicians in public hospitals I've asked are not aware of any moves to improve adverse event reporting. "It's laughable how slow it's going but hospitals don't have any resources to throw at that because they're busy dealing with the patients who are on the trolleys." "

More here.

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For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation.

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