Is Medicare finished?

[Julia]

So you are saying the solution is to limit people's choices? We could become "the sheltered nation"

Nothing wrong with people eating fatty quarter pounders. I eat them occasionally, and love them, but I also spend 10-12 hours per week in the gym. People should have the choice to eat like crap/chain smoke/take drugs, whatever. But they also need to face the consequences of their own actions. If some dude weighs 200kg because all he eats is Macca's, has a heart attack, then he should pay his own medical expenses, not leech of the taxpayer.

Becoming a sheltered nation, as you seem to be suggesting, is the fastest way to becoming a nation of bludgers with no drive to get the best from themselves. Why strive for more when you can free-ride?

OK, so let's say we put your suggestion into practice.
Bill Bloggs weighs 200kg because of factors you quote above.

People who have such low self respect as to let themselves get into this condition are unlikely to have bothered to take out private health insurance.

So Bill has the inevitable heart attack. What are you going to do with him?
He rings 000 and the ambulance arrives. Do the paramedics say "oh sorry, mate, you don't have private cover. We're off now. You just have to die by yourself"?
Of course it would never happen. So a pointless suggestion really.

I think telling Maccas, KFC and Hungry Jacks to up the quality of their food is hardly sheltering and limiting choices... Maybe I'd be A customer of theirs because right now but I don't see anything worth my while... Their food doesn't really classify as food but more like confectionery... If this is what is affordable and available to people then that's what they will end up eating... The choice should be made before hand... Isn't prevention better than the cure?

No, it's not about dictating to businesses what they should sell.
The responsibility is entirely on the consumer. Perfectly sensible, healthy people will very occasionally buy a hamburger.
I'm not at all overweight, eat healthy food 95% of the time. But I occasionally enjoy icecream, cream etc. Are you saying I should not be able to access these?

Oh that's right the Medical Industry is exactly that... An industry there to make money... That's why they will never cure anything major for years to come... They make money on the Medicine... That's what you're about yeah... Money!!!

Yes the medical industry is a business. But that's not to say they do not produce profoundly useful medicines for which we should all be grateful.
If you ever doubt this, just consider the fragility of life e.g. before antibiotics.

A survey showed that overweight people make $5,000 a year more than slim people... So on average they pay more in taxes... Do you classify them as bludgers now? Hell it might be their work that's killing them

Really? That sounds like a rather extraordinary claim. Could you please provide a link to this survey.

i don't want to live in country where the first thing you get asked on the emergency door is "do you have health insurance" or Pay first or die system which some countries have.

You might be surprised to know that this has actually happened to me here in Australia. It was when I was living in NZ and was over here at a work conference on the Gold Coast. Became acutely ill late one night, hotel called ambulance, and before they would take me to the hospital demanded details of my insurance policy.
Less than impressive, frankly.

And yes, i had a mate inside. He made one stupid decision, spent 18 months in jail, and now has to spend the rest of his life living with the fact that that one bad decision killed his best friend. Im not condoning it, im just saying that there are plenty of people within the prison system that are not 'hardened criminals' they are just repaying their debt to society

PPrawn, yes that's a really important reminder. There are people who are in jail simply because of being unable to pay a fine.

Green, I don't think it's possible to make life as black and white as you seem to see it. Mostly it's a great variety of shades of grey.

 

[Green08]

People will generally find the money to pay lawyers, architect, stock broker, financial planner, though when it comes to medical attention they just expect it to be free.

"AUSTRALIANS are so obese the NSW Ambulance Service could be forced to spend more than $60 million on extra large planes to transport patients weighing more than a quarter of a tonne.

All stretchers on new planes for the air ambulance are required to handle patients weighing up to a massive 260kg. The new limit is almost double the existing 140kg and equivalent to the weight of a light aircraft or a child elephant.

The news comes as it was revealed more than 7.5 million Australian adults are overweight or obese, costing the health system $8 billion a year, The Daily Telegraph reports."

http://www.news.com.au/story/0,27574,24867894-421,00.html

You need your health to live but people put such a low priority on it.

 

[Julia]

That's pretty disgusting.

Though on the subject of healthcare being free, don't we have an expectation that healthcare is something we receive in exchange for paying our taxes?
The medicare levy?

 

[Green08]

Health care in exchange for taxes could be a worse can of worms to open. Does the person paying more taxes get to jump the line for treatment? How do you make that a 'fair' system? Those that don't pay tax and don't have private health insurance - what do you do with them?

 

[Green08]

New fees From 1 July 2008 NSW residents requiring road, fixed wing aircraft or helicopter or a combination of these, from the scene of an accident, illness or injury to a public hospital or other destination nominated by the Ambulance Service of NSW will be required to charged a call out fee of $290 plus an additional charge of $2.62 per kilometre or part thereof.

Road Fixed Wing Helicopter​

Emergency Non-Emergency Emergency Emergency​

Call Out

$290 $228 $290 $290​

rate (p/km)

$2.62 $1.41 $2.62 $2.62​

Max Charge

$4,752 $4,752 $4,752 $4,752​

Sorry about the drastic layout don't know how to C and P a table. Under Road is Emergency and non- Emergency next Fixed Wing next Helicopter

 

[Trevor_S]

Health care in exchange for taxes could be a worse can of worms to open.

Hows that any different to any other situation in regards taxation ? I pay more tax then the median salary for example... should I get better roads to where I live ?

I don't think the Health system can be fixed, people have diametrically differing opinions on 1. what it is they want from the health system and 2. how much they are prepared to pay to get it. I think it will just lurch from one crisis to another ad infinitum.

I can see the welfare system going down the same hopeless road.

 

[Julia]

Health care in exchange for taxes could be a worse can of worms to open. Does the person paying more taxes get to jump the line for treatment?

No, of course not. It's just simply part of living in a civilised society.
Those who have the capacity to do so need to look after those less able etc etc.

How do you make that a 'fair' system? Those that don't pay tax and don't have private health insurance - what do you do with them?

It's not necessarily about just being what is 'fair' in purely monetary terms.
It's about decency also.
I get annoyed and frustrated with people who fail to take care of their own health and then end up using more than their share of the health dollar, but I don't see how it would be possible to change this and retain any sort of humanity.

What exactly would you like to see happen, Green?
Would you find it good if someone who hasn't paid tax and who likewise hasn't taken out private cover is refused treatment when they need it?

 

[Green08]

No, of course not. It's just simply part of living in a civilised society.

That unfortuantely is what they would like us to think. Decency is a matter of scale.

What exactly would you like to see happen, Green?
Would you find it good if someone who hasn't paid tax and who likewise hasn't taken out private cover is refused treatment when they need it?

I would like to see Private Hospitals have their own Emergency Wards and staff for Private paying patients. The excess would probably go up but I would pay it.

I don't know if it is a matter of good refusing someone treatment.

People who don't pay tax, don't have some sort of private cover and neglect themselves should wait.

This is a discussion where you are either viewed as supporting 'human rights' and political ideals. Or you are the evil self centered being.

The world is not a fair place. As adults, we want to have freedom and choices, entitlements but easily succumb to blame and poor me when it doesn't work out.

It is about taking responsibility for all your actions to ensure you have health and healthcare you can live with.

The Ambulance system is heavily indebted. Those that don't, won't, can't pay for the trip - we pick up the tab.

If you are only aware of the cost of transport then isn't private cover at a basic level worth the money than the costly bill? Priorities. I can see the smoker gasping for breath carted off in the ambulance, admitted, attended to and released only to go back and get another smoke and somehow can't pay the bill. Is it fair my tax pays for their stupidity and lack of self control?

Personally private insurance is the only month direct debt in our lives.

 

[Julia]

That unfortuantely is what they would like us to think. Decency is a matter of scale.



I would like to see Private Hospitals have their own Emergency Wards and staff for Private paying patients. The excess would probably go up but I would pay it.

This just wouldn't be practical. If you have an emergency, i.e. a cardiac event, you will have to go to a public hospital where all the equipment is available. Private hospitals are great for elective surgery but it really wouldn't make sense for them to be brought up to the same emergency standard as public facilities unless the cost of private cover were to become beyond the reach of much of the population.

I don't know if it is a matter of good refusing someone treatment.

Green, can you say this some other way? I don't understand what the above sentence actually means.

People who don't pay tax, don't have some sort of private cover and neglect themselves should wait.

Well, they do, don't they? That's why there are long waiting lists in the public system for elective procedures but if you have private cover you can get it done immediately with the doctor of your choice.

That's all fine. But what are you going to do with the hypothetical heart attack patient I postulated in my earlier post?

This is a discussion where you are either viewed as supporting 'human rights' and political ideals. Or you are the evil self centered being.

Yes, it does seem like that. And I know absolutely how you feel and largely agree with you. Just that in practice it's not realistic to carry such ideas through.

The world is not a fair place. As adults, we want to have freedom and choices, entitlements but easily succumb to blame and poor me when it doesn't work out.

Yes, true.

It is about taking responsibility for all your actions to ensure you have health and healthcare you can live with.

Ideally, yes, of course it is. But if you have health problems which have not occurred because of your own irresponsibility, can't work, shouldn't you be able to expect the wider society to care for you?

The Ambulance system is heavily indebted. Those that don't, won't, can't pay for the trip - we pick up the tab.

I think pensioners have the ambulance levy picked up by State govt in Qld.

So, Green, if you were given the opportunity to completely redesign Medicare how would you like to see it function?

 

[Green08]

Private hospitals are great for elective surgery but it really wouldn't make sense for them to be brought up to the same emergency standard as public facilities unless the cost of private cover were to become beyond the reach of much of the population.

Why not try, even just a few Private Major Hospitals - North Shore Private, Strathfield Private, Armidale Private. The monetary risk would more than likely pay off, if you offer it the clients that value it will turn up - not deliberately of course.

That's all fine. But what are you going to do with the hypothetical heart attack patient I postulated in my earlier post?

I can only answer as a regular human - CPR. Depends where it happens. In the country even the public system is strained, there of quite a few deaths out here for simple reasons. Can't get a blood transfusion in time. Delivering baby's in the Flying Doctors breach - still birth.

Ideally, yes, of course it is. But if you have health problems which have not occurred because of your own irresponsibility, can't work, shouldn't you be able to expect the wider society to care for you?

You may expect it but don't count on it.

I think pensioners have the ambulance levy picked up by State govt in Qld.

True there are certain consessions.

So, Green, if you were given the opportunity to completely redesign Medicare how would you like to see it function?

Julia, I'm just a mum and forum member. As you would know I have no Medical Degree or Political Aspiration to change the system. I just live in it and extract the best I can for my family.

My opinions are just that - opinions. You have more experience with the medical profession what would you do? This is not a perfect world but what would you try?

 

[Julia]

I can only answer as a regular human - CPR. Depends where it happens. In the country even the public system is strained, there of quite a few deaths out here for simple reasons. Can't get a blood transfusion in time. Delivering baby's in the Flying Doctors breach - still birth.

What I was trying to get at was would you send an ambulance and take him to hospital? The question was asked in response to your feeling that people who don't contribute shouldn't be able to use the system.

Julia, I'm just a mum and forum member. As you would know I have no Medical Degree or Political Aspiration to change the system. I just live in it and extract the best I can for my family.

Yes, of course you do, and so do we all. But I thought you did want to change the system because you don't approve of how it's currently run, i.e. you feel it's unfair that people who don't contribute get the same level of attention as those who pay the tax/medicare levy etc.

What would I change? Well, I think compared to many countries it's a pretty good healthcare system especially if you live in a capital city where there is a teaching hospital. I'm in a regional area and the hospital is a place I would hope to avoid at all costs, but if they feel they can't deal with something then in no time at all a helicopter or the Flying Doctor whisks the patient off to Brisbane.

What I would change if had the power is to halve the bureaucracy, have the health system run by medical professionals rather than bureaucrats, and put the saved funds into employing more nurses and better qualified doctors.

Would also find a way to stop the Colleges restricting numbers of trainee specialists so that in time there were enough specialist physicians and surgeons to make them available in the regions as well as the main centres.
(The money would have to be pretty good, though, to get them away from the city.)

 

[Green08]

What I was trying to get at was would you send an ambulance and take him to hospital? The question was asked in response to your feeling that people who don't contribute shouldn't be able to use the system.

Depends on the long term economic health of the system and peoples ability to take responsibility of their life. Sure, the 'ideal' situation would be to save and give perfect care to everyone but that simply is not feasible.

I take the view that if I die then I die. No celestical being or procedure is going to save me unless I happen to be paying for it or just damn lucky.

The heart attack person may die anyway on the route to hospital. Would I jump in as a medical professional to save them, I would be commited by oat to do so. Would I support the survival of humans who couldn't give a damn about their lives and expect others to wipe their *ss. No. Let them go.

That is opposed to do I support the Westmead Children's Hospital - Yes I do.

I gave my main project to be changed and implemented. Nothing is impossible.

I would insist that any minister in charge of the medical portfolio state or federal be a practicing, well acknowledged, experienced in theory and practice, and hopefully be putting the medical profession forward.

have the health system run by medical professionals

This we agree on.

I would encourage more Doctors into the country health system. As far as referring patients they would be given a list. Any Doctor is appreciated.

I would give all fully completed Medical Degrees of 6 years a refund on their study if they achieve over 95%.

I would give a full refund to an Medical student who went on to specialise in an area of need so long as they made the commitment to stay in Australia for and next 5 years.

I would give nurses a break by refunding their tuition if they pass at 90%, stay in the system of Australia for 5 years minimum and exhibit a capacity to increase their skills.

The current UAI for nursing is 55

Well, I think compared to many countries it's a pretty good healthcare system especially if you live in a capital city where there is a teaching hospital.

Yes, I could be transported from the country by Helicopter or Plane under private insurance with no problem. Though the costs, even as a minimum, as stated previous, is weighty to most individuals and when you consider the lack of resources in the country, lack of specialist. i.e. - the only fully trained immunologist comes from Sydney to Armidale once every 2 months for a 2 day stint.

I would give producers of agriculture not just free medical attention but free private care. Look after what you’ve got as the next generation is not there.

My limited experience from living in the Mosman area to the country in terms of human quality is impressive. Dedicated farmers love their job, they put up with less value for product, high input costs, struggle through the red tape. My understanding of how difficult it is has been humbling and rewarding. If you want an agriculture community you need to look after it. Kids move away or become delinquents, few care out here. OK for the city ones to want want. I've seen it many times. You don't need Australian racism you have a big enough disparage between city and country, sheer ignorance.

I do not regret my move. It has been a massive change for many reasons. Sure some of the country folk are questionable and bogans who don't give a toss beyond the next drink.

In the latest AMA presidential election a Coonabarabran GP, Aniello Iannuzzi, 38, stood as one or three for the position this month - "a lot of city doctors felt is was just impossible for somebody from a small town to hold a political position despite the fact we live in an age where transport and communication are better than ever."

The few city Doctors / Specialist I've met from the city love the change but are frustrated with lack of funding and being ignored.

“The blood bank stopped its mobile service e to most western NSW towns due to admin and cost constrains”. The Land June 4 2009

 

[johenmo]

I haven't read anything here about the technology advancement adding to the cost. CT SCans, MRIs etc all add tremendously to the capital and running costs. Anyone have costs per head of population in real terms comparing say 25 years ago? Or any idea how much the newer technology costs?

I will get minor shoulder surgery soon and will about $1000 out of pocket despite health insurance. Health companies nto allowed to cover this difference I'm told. The alternative is to go public and wait months if not years for my condition - stuff that!!

I used the Canadian system years ago - had to pay upfront $500 at the hospital. That was the total cost and they did blood tests as well. If you travel without medical insurance, you're an idiot.

Haven't met anyone from the US who's proud of their healthcare system as a whole. Parts of it, yes. Having a US system is a step backwards.

 

[Green08]

I haven't read anything here about the technology advancement adding to the cost. CT SCans, MRIs etc all add tremendously to the capital and running costs.

Technology increases in cost as does the effeciency, it all adds up. Maybe the companies could be a little humble and 'donate' equipment? and pigs fly.
Or you can be lucky and have a person like Kerry Packer give money for cardiac equipment installation in ambulances. How offend does that happen? Sure they give money to charity what about direct cash injection or direct buying and handing it over to remove the middle man.

No easy answer. As most things everyone one wants a piece of the pie.

I will get minor shoulder surgery soon and will about $1000 out of pocket despite health insurance.

I'd pay it your shoulder is worth far more, hope your operation goes well.

If you travel without medical insurance, you're an idiot.

Should be mandatory to purchasing an international ticket.

 

[johenmo]

Or you can be lucky and have a person like Kerry Packer give money for cardiac equipment installation in ambulances.

I'd pay it your shoulder is worth far more, hope your operation goes well.

Should be mandatory to purchasing an international ticket.

Packer's life was saved by a "packer whacker" as they dubbed it at the time. That was in gratitude, I guess.

Tks re op. It's removing bone spurs from arthritis and is only 3/4 hour - which I thought was really short.

I agree - make the insurance mandatory to force idiots to protect themselves. BUt if you emigrate out then you probably won't want it.

 

[Wysiwyg]

Would I support the survival of humans who couldn't give a damn about their lives and expect others to wipe their *ss. No. Let them go.

What are your opinions about our failing health care system?

Well Medicare is well and truly alive and increasing from July 2014 to 2% from 1.5%. On top of that is the added financial burden of a Medicare Levy Surcharge.

In the last 3 years I have been earning above the Medicare Levy Surcharge (MLS) threshold. I maintain my body and mind so health expenses are very low and I pay for them as needed. Due to maintaining my body and mind I vehemently object to paying the surcharge so am now seeking out (today) private hospital cover that costs less than the surcharge per year simply so I do not pay the MLS. Where does it stop 1.5%, 2%, 2.5%?

The problem is this.

People do not maintain their health. Take a look in the local mall and count how many people are over-weight, smoking, eating rubbish, drugged, mentally agonised or stressed. Can we force people to change their economically bad habits. Socially I don't care what they do with their bodies and mind as long as it does not infringe on my self or property. Some solutions are make them suffer the consequences of their own behaviour OR education via media.

 

[Julia]

People do not maintain their health. Take a look in the local mall and count how many people are over-weight, smoking, eating rubbish, drugged, mentally agonised or stressed. Can we force people to change their economically bad habits. Socially I don't care what they do with their bodies and mind as long as it does not infringe on my self or property. Some solutions are make them suffer the consequences of their own behaviour OR education via media.

I share your frustration. How do you think it would be possible to make people 'suffer the consequences of their behaviour"?

I don't think lack of education is the problem. There is plenty of sound nutritional information available. It seems people just don't care and this will probably increase as obese becomes the new 'normal'.

Ambulances are having to be modified to accommodate fat people, as are hospital beds and gurneys. Coffins are being made ever larger and crematoria are having to increase the size of their ovens (apologies if there's a more polite word). Meantime obese people continue to load their supermarket trolleys with cartons of Coke, cakes, fried food, sausages, everything except fresh fruit and vegetables/lean meat/fish etc.

 

[Wysiwyg]

I share your frustration. How do you think it would be possible to make people 'suffer the consequences of their behaviour"?

Oh well I would target the repeat offenders. Those that have a history of lining up at the clinics every Monday with self caused problems, hypochondria or addiction would have to pay more/get less. Either charge them more for the service or cut the service for repeat offenders. I know these issues stem from the mind and it does seem harsh to make them pay more/get less if only as a deterrent. Together with GP's making a living off the regulars and general society compassion, it will never happen.

The psychology is that if you harm yourself then the welfare system will pick you up again and again.

 

[Wysiwyg]

Another thing is that we have gone from looking after the immediate family to looking after every Tom, Dick, Harry and Jill in the world.