Monday, November 19, 2012
Socialized medicine fails in Australia too
"Free" public hospitals, tax rebates for having private insurance and refunds for private health expenditures are all in place but are still insufficient for many people with expensive illnesses. Governments just can't afford to look after everyone. They should confine their help to the seriously ill only but that would now be politically impossible. The Left's new "disability" scheme will make things worse -- unless someone invents a money tree
FAMILIES are being forced to sell their homes or raid their superannuation to pay medical bills, with some going bankrupt as Medicare rebates [sometimes only a third of the actual cost] fail to keep pace with inflation and health funds fail to cover all medical charges.
The financial nightmare has exposed the growing inadequacy of Medicare and health fund rebates and the crippling health costs to those with multiple or serious illnesses.
Battling breast cancer, chemotherapy and a life-threatening infection, Leonie Havnen's biggest challenge was not her health but the $31,300 in medical bills not covered by Medicare.
This year the 52-year-old Sydney mother of two was forced to raid her superannuation nest egg to cover her treatment costs.
"As a taxpayer for the past 36 years who pays around $30,000.00 a year in tax, $2,500 health insurance and the Medicare levy, to have to pay out of pocket for life saving medical treatment, just screams to me the 'the system is broken'," she said.
"Why did I have to access my superannuation to pay for my life saving medical treatment? We aren't a third world country."
Since being diagnosed with breast cancer a year ago Ms Havnen has had surgery six times, first to remove both breasts and then to deal with the consequences of a golden staph infection. She spent time in hospital when one of her kidneys collapsed. A statement from her health fund for the 2011-2012 financial year shows her private hospital treatment cost $77,732 and she received rebates of just $59,400 from Medicare and her health fund leaving her $18,331 out of pocket.
On top of these hospital expenses, Ms Havnen had another $12,000 in bills for specialist appointments, scans, health fund excess payment, and medication. Her health fund reviewed her case after being contacted by The Sunday Telegraph and have since refunded her a further $6000.
While our Medicare and health fund systems are praised as among the best in the world, there is emerging evidence they are leaving hundreds of thousands of Australians in poverty.
A Menzies Centre for Health Policy study has found 250,000 Australians spend more than 20 per cent of their income on health costs. Doctors and anaesthetists who charge large out-of-pocket gap fees, poor health insurance cover, Medicare rebates that haven't kept pace with inflation and the $35.40 copayment for medicines are at fault. As well, many treatments and medicines are not covered by either subsidy schemes.
A recent Health Consumers NSW survey has found families were being forced to sell their homes or skip doctors' appointments or medicines because of the cost.
"Due to the combination of suddenly not being able to work, and the high out of pocket costs of my illness, we had to sell our family home," one respondent told the survey. "Have not attended a cardiologist since February 2011. Cannot afford to," another said.
The government's Private Health Insurance Administration Council said health fund members paid $4.3 billion in out of pocket expenses last financial year.
Research by the George Institute found 11 per cent or 28, 665 bankruptcies in 2009 cited ill health or absence of health insurance as the primary reason.
A recent survey of 3000 National Seniors members found one in five Australians aged 50 to 64 are skipping doses of their prescription medicines because of cost.
Gaps fees for plastic and reconstructive surgeons averaged $1588, for orthopaedic surgery $1485, the gap for scans averaged $88 and for specialists $56.
A spokesman for Health Minister Tanya Plibersek said gaps came about when doctors charged more than the scheduled fee.
Australian Institute of Health and Welfare figures show Australians spend an average $1075 a year in out-of-pocket health expenses.
"The issue is whilst we say we have a universal system, the reality is many people are struggling," Consumers Health Forum chief Carol Bennett said. "The cumulative costs of a chronic illness mean you have multiple scripts and scans and appointments and you've got to make the difficult choice of whether you see your doctor or put food on the table."
Injured toddler's two-night wait a sign of casualty crisis
A TWO-YEAR-OLD boy who needed stitches to a gashed lip had not been seen by a doctor more than a day after being taken to The Children's Hospital at Westmead by his father, the former rugby league star Frank Puletua.
Puletua has spoken out about his emergency room nightmare on behalf of other parents he saw enduring long waits at Westmead.
A senior emergency physician at Royal North Shore Hospital, Tony Joseph, described the Puletuas' experience as "totally unacceptable".
He said: "What has happened in the Westmead children's ward is reflective of a broader problem across NSW where there is a lack of senior physicians in emergency departments."
Unpublished figures obtained by Fairfax Media show NSW has the lowest proportion of senior doctors in emergency departments in the country, apart from the ACT, the state government failing over the past six months to hit reduced waiting time targets.
On the front line, in the state's 95 hospitals, that translates into times when patient demand swamps medical manpower.
After two nights and a total of nine hours in the Westmead waiting room, Puletua was forced to call on his former team doctor at the Penrith Panthers, Norm Southern.
By then, the wound had healed too much for stitches and the ragged scar inside Noah's mouth might require future plastic surgery, the family has been told.
When Puletua arrived with Noah on a week night after a trike accident at home three weeks ago, he was told there were 27 patients in front of him but, due to the two-year-old's bleeding and agitated state, the triage nurse said she would put the child on the "injuries list" for faster treatment. By 10.30pm, Puletua was told it was unlikely that his son would be seen before morning and he took Noah home.
The next day a GP put plastic stirrups on the wound but they came off quickly and Puletua was back at Westmead that night. This time, there were more than 30 on the list but Noah was put on an injuries list of just three. "I lost track of how many SpongeBob shows we watched but I changed his nappy and managed to get him off to sleep," he said.
"By 10.30pm, I was wondering what was going on. I waited politely and asked the nurse, to be told that the injuries list finishes at 9.30pm and we were back behind other patients on the normal list. "I'm not a fiery person off the footy field but it was at that point that I lost it."
Puletua was told to "write a letter to the government". He did write a long letter about his experience, which found its way to Fairfax Media. He said: "Westmead was specially built for kids but it is not a special experience for those parents I saw waiting around. The place was packed. I just wanted to speak out."
A spokeswoman for The Sydney Children's Hospitals Network said: "On occasion, children with less urgent health complaints may need to wait to be seen by a doctor … We trust parents understand the need to care first for children who may present with life-threatening conditions."
The government recently increased the number of senior doctors in triage at Westmead to reduce waiting times. But hospital physicians, GPs and health experts said emergency rooms were at times "overwhelmed" over the past six months during a winter in which the flu bug and several viruses affecting children spiked.
Arrivals in emergency have grown nearly 8 per cent in a year to 2.3 million. At the same time, the Health Minister, Jillian Skinner, is about to cut $775 million from the state health budget over the next four years and implement $2.2 billion in efficiency savings. Dr Joseph said that it was "very unlikely" the NSW government would meet the national target of treating 90 per cent of patients within four hours by December 2015.
NSW hospitals achieved 58 per cent in the latest three-month period reported, which was from April to June.
In Perth, hospitals are regularly achieving 85 per cent, he said. "In NSW, there is a lack of senior physicians. The government needs to get serious and think about how it will meet national emergency targets," he said.
Richard Paoloni, an emergency physician at Concord Hospital, said: "The number of people presenting in ER continues to grow but the number of emergency physicians has slowed and then plateaued over the past few years. "We are falling behind other states, particularly Queensland and Victoria."
Dr Paoloni said it was not uncommon for people to be forced to endure long waits. "There are incidences in which numbers peak and overwhelm the number of staff present," he said.
According to Australian College for Emergency Medicine figures, there is a higher proportion of foreign doctors in the NSW system who require more oversight and instruction.
Paramedics still complain of "trolley block", the long wait for patients arriving in ambulances to be transferred to a hospital bed.
Wayne Flint of the Emergency Medical Service Protection Association, representing ambulance staff, said: "Some days and nights emergency is an absolute nightmare with people queuing up everywhere to be seen.
"We had a spike in winter but, with Christmas coming, we're going to see the peripheral and regional hospitals under pressure from holidaymakers having accidents."
A spokesman for Ms Skinner said: "Local health districts are focusing on implementing new models of care that are helping to deal with an unprecedented increase in emergency department presentation".
Labor's spokesman on health, Andrew McDonald, a paediatrician who works one day a week in hospitals in western Sydney, said the government has little hope of achieving its national emergency access target of 69 per cent of people being seen and treated within four hours.
The figures for April to June, finding 58 per cent had been treated within that timeframe, were attributed by the government to an "unseasonal increase" of more than 6000 patients.
Dr McDonald said it was obvious the flu bug and child viruses were coming and the government had left the state's hospitals underprepared. "The whole system went into meltdown, unable to treat patients."
"Discrimination" to fire the medically unfit?
PUBLIC servants have won the right to challenge unfair forced medical and psychiatric examinations, after a landmark court decision.
In what has been described as "a victory for the little people", the State Government has lost an appeal that was fought by the Anti-Discrimination Commissioner and a public servant.
"This is a great win for civil rights in Queensland," said Susan Moriarty, who represented Peta Attrill, a former probation and parole worker who was medically retired after a psychiatric examination. Ms Attrill, 39, will now seek reinstatement.
Ms Moriarty said compulsory medical examinations were very common in the public service and often were used as a means of forcing people with illness or disabilities out of their government jobs.
The November 2 Court of Appeal decision means that government employees who are made to have medical or psychiatric examinations can object on the grounds of discrimination.
Ms Attrill, who had worked for Corrective Services for 51/2 years, last year lodged an impairment discrimination complaint.
A court heard that she had suffered from depression since losing sight in her left eye at the age of 21, but she claimed she managed it with medication and counselling.
But Queensland's Civil and Administrative Tribunal ruled that part of the Public Service Act, allowing the compulsory examination and ill-health retirement decision, was not subject to provisions of the Anti-Discrimination Act.
The Anti-Discrimination Commissioner then joined in Ms Attrill's appeal against that decision, which was successful.
It meant that public servants who were directed to attend a medical assessment could get an injunction stopping the process, until their discrimination complaint was resolved.
The State Government's subsequent appeal was unanimously rejected this month, with the Court of Appeal awarding costs against the Government, represented by Solicitor-General Walter Sofronoff, QC.
Litany of major pledges axed to keep surplus
The Gillard government's year of "decision and delivery" has been followed by 12 months of what could best be described as "decision to dump".
An obsession with maintaining the budget surplus means many of Labor's key promises have been watered down, delayed or pushed off the table.
A Fairfax Media analysis of Labor's policy agenda for 2012 reveals the big-ticket items that failed to make the grade.
A casualty of the last budget, the long-promised "tick and flick tax returns" were scrapped as the Treasurer, Wayne Swan, scrambled to deliver the $1.5 billion surplus.
The reform of the tax return system - which frequently involves expensive trips to the accountant and excess paperwork - was a Rudd government proposal that would let people simply tick a box and send back a standard form that had already worked out their deduction.
The baby bonus fell to the razor in the mini-budget last month. The $5000 payment will be reduced to $3000 for the second and subsequent children - a decision unpopular with families but embraced by key independents Rob Oakeshott and Tony Windsor, who call for the scrapping of middle-class welfare.
And the government's plan to end the influx of asylum-seeker boats - the Malaysia solution - appears becalmed. The Coalition and the Greens are opposed to the people-swap deal, which proposed Australia sending to Malaysia 800 asylum seekers who arrived by boat. In exchange, Malaysia would send 4000 UN-approved refugees to Australia over a four-year period.
The Immigration Minister, Chris Bowen, has conceded his policy may never make it into law - a reversal of his previous statements.
The hard-fought mining tax has not lived up to expectations and is a large black spot on the government's scorecard, raising almost no revenue in its first three months.
Mr Swan responded to the revelations his tax has failed to fill the coffers by saying it was unfair to judge on just one quarter.
A referendum to implement the constitutional recognition of indigenous people was shelved for three years in September, despite it being a key part of the power-sharing deal with the independents and Greens.
Instead, Labor has proposed an "act of recognition" as an interim measure to build for a future referendum, and a new joint select committee to look at constitutional recognition.