Doctors Reform Society of Australia
			supporting health care reforms to ensure justice, equity and quality care for all
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By the prevailing standards of the Coalition parties, and Labor politicians of a rationalist bent, the private health insurance business just doesn't deserve to survive. It patently cannot compete with the generally excellent public health scheme and is shrivelling up and dying in the face of overwhelming public disdain.

It seems to have eluded government but Australians are fast coming to the fairly simple conclusion that, by and large, private health insurance just doesn't offer value for money. Yet the industry is generously subsidised by government rebate, encouraged by an arm-twisting surcharge on high-income earners and largely insulated from even more massive claims on its funds by the public preference for bulk-billing Medicare. It is the recipient of misdirected government largesse unrivalled since the heyday of rural socialism under Black Jack McEwen. If it were the steel industry or any other enterprise thrown into the deregulated and competitive ring, it would be put to rest with a torrent of crocodile tears and the usual political platitudes.

It's been a long illness but the simple fact is its days were numbered the minute the Federal Government accepted the then quite extraordinary proposition that it was responsible for the health of the people. The need for private insurance was debated even then but it was drowned in the uproar that surrounded the quite disgraceful efforts of the medical profession and the funds to derail Bill Hayden's original Medibank scheme.

Only yesterday a doctor wrote ruing the fact that the Government no longer listens to the profession. There are many who believe it has listened to the medical profession for too long. Had it not been for the disproportionate influence of the profession, the private insurance industry might well have lost its special place in government affections during that first flush of universal health care.

Its demise would not have been greatly mourned by millions of Australians for whom it had long been an unavoidable and highly resented impost on tightly stretched family purses. The regular visitation from the man from the health fund was about as welcome as the rent-collector in a British kitchen-sink drama.  And not even insurance insulated families from the harsh realities of government indifference and medical elitism or offered any prospect of relief.

Insurance just didn't build or equip hospitals. As late as 1956, my much younger brother survived only because of a humidicrib purchased thanks to a pit-top whip-around by ny father's workmates. In my early adulthood I neither had, nor could afford, medical insurance and didn't give a damn until we began to have children. In between that blissful state of bachelor indifference and fatherhood along came Medibank.

All too soon, former prime minister Malcolm Fraser arrived and began to dismantle Medibank, thankfully dissuaded by public rage from delivering the coup de grace. By that time we were with children and signed on for private coverage, quite a burden with two young mouths to feed and all the other encumbrances that go with marriage.

Slowly the realisation dawned that every time one of the kids fell over and split her fool head (or whatever), the first stop was the local hospital casualty department where insurance counted for nought but the service was just as good.

The next stage in our odyssey was the ascendancy of Bob Hawke and the introduction of Medicare, which has cared for us rather well. Then, maybe eight years ago, an acquaintance landed in hospital as a consequence of a life-long love affair with the bottle. The treatment was first class. The accommodation was appalling. He lay on an enclosed verandah surrounded by people in various stages of dying.  The only thing missing was the lady with the lamp.

Approaching that age when tickers start to falter and other things begin to wear out, it seemed a good idea to sign on for private insurance. The odd thing is we didn't sign on for better medical care or access to more whizbang gadgetry. We signed on for a private room, a television and a telephone. And, people tell me, even these little luxuries are unavailable, or unwanted, when faced with open-heart surgery or other major procedures.

Then. there is the dreaded gap, the extras that are free to the uninsured yet can bankrupt a fund member. Gap insurance is the easy answer but, as hospital bills are currently compiled, that would just be a pipeline to the bank for highly paid specialists. Membership doesn't even let you jump the queue when it comes to entering the closed-shop of specialist consultation. The cost just keeps going up and up, reaching a level where both government rebate and Medicare surcharge are unrealistic and irrelevant by comparison.

The fact is that, from a consumer's viewpoint, the Government scheme is a much more effective way to distribute the health dollar. Private insurance costs so much and delivers so little, that even a greatly increased levy on higher-income earners would give better value. It's taken a quarter of a century of universal care but Australians are realising that the health insurance industry is about as relevant as schools of arts and mechanics' institutes.

Only 31.4 percent of Australians belonged to private health funds in March. If and when I can pluck up the courage to write off thousands of dollars that have been contributed over the years, that figure will decline by two more. Then again, maybe I'll hang around in the faint hope that my fund will do a Patrick, go into receivership or administration and declare a dividend for the faithful few.

by Terry Sweetman
reprinted with permission from The Courier Mail 28 May 1998 Brisbane.

.		.	The Doctors Reform Society of Australia, Box 14, 4 Goulburn Street, Sydney 2000. Phone 02 9264-9084 Fax 02 9267-4393.	.
			This page was last updated on 29th January, 2003.
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