No, the government should not pay for all medical care for every person in a nation. They certainly should ensure that everybody has access to essential and good quality health care – and that nobody is excluded due to their personal circumstances. However, there are many people who are able to contribute significantly to their own medical costs – and as such, they should be taking at least a certain degree of responsibility for it.
Without the majority of people in a society bearing a reasonable portion of their health expenses, the system cannot work long-term and ultimately nobody’s best interests will be served. Most particularly, those who are most vulnerable of all will suffer. Of course, that is also the case when the government does not take enough responsibility for the health care of its citizens – and even ignores them altogether when they are in dire need. So there should be a balance, with those who are able to afford private health insurance being required to cover themselves up to a point.
Here in Australia we have had a Medicare system in place for many years now. Its goal is to provide good quality basic health care for every citizen. This means that everybody has access to public hospital care without having to meet any expenses from their own health insurance. It also means that every citizen is subsidized for the cost of consultations with a general practitioner or specialist. Some other health care is included as well. Some examples are: consultations with an optometrist; tests and examinations required by doctors in their treatment of an illness (including x-rays and pathology tests); and most surgical and other therapeutic procedures performed by doctors outside of the hospital system. Many pharmaceutical prescriptions are also subsidized by the government’s Pharmaceutical Benefits Scheme.
All of this applies to the general population. For those who are on very limited incomes – such as those on pensions of various kinds – there are other health expenses met by Medicare as well. These services are not covered for others. They include ambulance services, dental examinations and treatment, home nursing and provision of basic glasses, hearing aids, etc. To receive these extra benefits a person must qualify for a Health Care Card, according to their income status and other criteria.
There is also extra subsidization of families and individuals who are in a position where they have to spend an excessive amount of money on services provided by Medicare in the course of a year. The extra subsidies kick in when they have made enough claims to reach what is know as the “safety net”. The same principle applies to the Pharmaceutical Benefits Scheme as well.
Ours is undoubtedly one of the best systems in the world. However, it has its faults and failings and ultimately it’s still the most needy members of our society that suffer the consequences. Waiting lists for non-urgent surgery can be atrociously long and people can languish on these lists for years.
Many of the procedures that fall into the category of so-called “elective surgery” may be far more vital than the term suggests and have a significantly negative effect on quality of life. Furthermore, they can ultimately impact so much on a person’s overall health and well-being that they can develop other problems before they make it to the top of the waiting list. Sometimes it’s multiple problems – as their system breaks down in many areas – often due to immobility. There can be no doubt that this even leads to a person’s premature death – when they may well have lived for much longer if they could have had the appropriate surgery at an early stage.
This happened to my mother, who passed away when she was not quite 71. Of course that’s not young – but by today’s standards, neither is it exactly old. We could potentially have had her to share our lives – and enjoy watching her grandchildren grow and develop – for a few more years.
There has been a lot of negative publicity in the media in the past few years too because so many people cannot get satisfactorily prompt access to the dental care they desperately need. Indeed there have been people waiting for a decade to receive dental treatment. Obviously this is far from good enough and this issue urgently needs to be addressed by the government.
Running a nation’s health care system is undoubtedly very complex indeed. There is so much the government needs to take responsibility for doing on behalf of all its people to make it work efficiently. But there’s also the need for those who are financially able, to take pressure off the public coffers through consistently paying premiums for private health insurance policies.
In the past decade the Australian government has introduced new laws which do require people to take some responsibility for their own health care if they are in a position to do so. Failure to have at least basic private health cover results in higher taxes for the individuals involved, as well as higher premiums for those who leave it till they are over 40 to sign up for private health insurance. I believe this is a fair and reasonable approach to helping deal with the problem – as long as people don’t end up paying higher and higher premiums. Always the needs and rights of both sides should be kept in balance.
Before these laws were introduced, the general public were deserting the private health funds in droves. Many didn’t feel they were getting value for the money they were paying out. If they were young and relatively healthy they just saw no need to have it. They could get most of their needs met by the public health system. However, it wasn’t long before this prevailing attitude began to take its toll on that health system, which was taking too much of the pressure of the nation’s health care needs.
Now that a greater percentage of the population are taking some responsibility for their own health care, at least some of the pressure will have been taken off the waiting lists for elective surgery. After all, if you have private health insurance and you need surgery, you are not going to put up with waiting for years in a long public queue. It only makes sense that you will take advantage of your private health insurance and have your problem dealt with in a fraction of the time.
It also means that many who would go into public hospitals for various reasons – including maternity – will choose to go into a private hospital instead. Of course, this also takes a considerable degree of pressure off the public health system.
These are just some of the ways in which the public health system is improved for everybody’s sake when those who are financially able, have private health cover. This means that we can all receive help from the government with many essential services – and those who are most needy can receive a greater level of assistance.
A decent, honourable nation will always make sure that its children, senior citizens, chronically sick and disabled individuals and those who are unemployed, under-employed or receiving a very low income are not neglected. In a society with Christian and/or philanthropic values, it is the responsibility of those who are privileged and fortunate enough to be able to care for themselves to subsidize those who are not so blessed. Nobody knows what their own circumstances will be in the future or when they will be dependent on their society’s provision for their needs.
Of course this may mean that some people will be given assistance who just don’t try to help themselves at all. That is another issue though. The needs of the many who do try, and who are genuinely vulnerable, must not be jeopardized because of the minority who maybe don’t deserve as much help as they get.
Ultimately the government is responsible to see that all these things work together for the overall benefit of its citizens. It is their task to look after everybody – but some will need more help than others. Only the weakest and most needy should have all their medical needs met by the government.