I’ve seen a few things this last week or so which have made me very pleased that we live in the Lucky Country. The first of them was the news that the UK Conservative government has sold off to venture capitalists the state-owned company which provides plasma products to the NHS. The more shrill commentators who claimed that UK blood donors were enriching American fat cats with their donations are not accurate, but this is still an unprecedented development which has many serious people waiting for deeper inroads to be made by private equity in the NHS. Already assessments of disability for pension purposes have been privatised to a number of companies, and Richard Branson’s Virgin Group has successfully bid to provide general practice services within the NHS in some regions. The current Tory government seems determined to push ahead with further privatisations. There is nothing inherently wrong with public-private partnerships as long as they don’t become just a risk-free vehicle for businesses to profit from a captive market. Much of what is necessary within our public healthcare system is not at all cost-effective if it is to be appropriately done. Services such as stroke rehabilitation and diabetes care are good examples of this. You have to wonder if this massive experiment in selling off the farm will improve services on the ground or not.
The issues with the UK system go all the way to the top. The next King of Australia has been deep in conversation with the current Health Secretary. Both are believers in alternative health treatments. Their private meetings have apparently canvassed how to preserve such anachronistic barmy nonsense as the NHS homeopathic hospitals and advance the cause of non-scientific treatments within the NHS. Needless to say, Prince Charles is stepping well outside his constitutional duties if the reports are accurate.
Denizens of the US are hardly better off. I was stunned as well last week to read that medical bills are the leading cause of personal bankruptcy in the US, responsible for 2 million unfortunate cases a year (fully 60% of all people who file). Having insurance is not a guarantee against losing your shirt either, with 10 million insured Americans unable to fully pay off medical bills a year. An extraordinary one in five of all adults in the US will have a medical bill which causes them financial hardship this year.
We may have our problems with Federal-State cost-shifting, PBS restrictions and Medicare rebates which haven’t kept pace with inflation, let alone the CPI, since legwarmers and mullets were all the rage. But spare a thought for our overseas cousins who have to contend with ideologues who flop from supporting fantasy-based therapies to handing out access to unique and valuable markets to privateers.
We’re lucky to have a country where you can get sick or injured without losing all your money, dignity and hope for the future. Keeping an effective and affordable health system should not come down to luck in the future but to responsible stewardship by health professionals and the willingness of Australians to put long-range health policy decisions above short-term political aims.