Wednesday, May 14, 2008

Universal Heath Care

Universal health care is health care coverage which is extended to all citizens.

The Medicare website proudly announces:

Welcome to Medicare - Australia’s universal health care system. Medicare ensures that all Australians have access to free or low-cost medical, optometrical and hospital care while being free to choose private health services and in special circumstances allied health services.

Universal Health care is back in the media. The National Health and Hospitals Reform Commission (NHHRC) is talking about universal health care. The Prime Minister has been quoted as saying that Australia's 40-year-old universal healthcare system is failing to deal with new developments, most notably in mental health and dental care. There is some suggestion that the NHHRC is considering enhancing the Australian Health Care Agreements to reflect the whole health needs of the person, including mental and dental health. There is also significant international discussion on universal health care.

There is an issue of how we can fund this. As consumers we understand that the public purse is limited and Medicare can only provide so much, and we have moved beyond a publicly funded universal health coverage. Instead we have a health system that is delivered through a mix of public and private funding arrangements, including out of pocket payments by individual consumers. The services are provides by the Commonwealth, states and territories, non government organisations and private providers.

The Commonwealth Fund has an article on how to achieve universal health coverage while lowering health spending. They present an overview of a new health reform framework, built on the current U.S. mixed private–public system that "provides a pathway to universal coverage with a minimal increase in total national spending and relatively modest net federal budget costs." There is a range of views posted in the comments to this article that demonstrate the difficulties in meeting the needs of all.

The Commonwealth Fund also draws attention to changes in the Netherlands, with the launch of a sweeping national health care initiative in 2006 to provide universal health care coverage for its population. The Health Insurance Act 2006 requires all people who legally live or work in the Netherlands to buy health insurance from a private insurance company. Consumer can choose from 14 insurers.

The Commonwealth Fund says that this model “succeeds in providing quality insurance coverage, at affordable cost, to nearly all its citizens--while continuing to have private insurers play a leading role."

We are not alone in trying to provide health services for all citizens and find the right combination of public, private and NGO providers.

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