‘Celebrity surgeon’ Charlie Teo has made headlines after he defended charging up to $120,000 for brain cancer surgery. In doing so Teo inadvertently exposed the enormous problem with Australia’s healthcare system. Many are now asking if we are heading towards US-style healthcare.
In one case, Teo waited until $160,000 was fundraised before he would even consider operating on a 12-year-old girl’s brain tumour. Thanks to the fundraising efforts of her parents she had the operation and it saved her life. Teo however quickly found himself under attack, including from the Australian Medical Association (AMA).
The AMA, and some in the media, have largely taken to attacking Teo personally. While no doubt his actions say something about his outlook, he is only an example of the problems that exists with Australia’s healthcare system.
The foundations of Medicare, a system designed to equitably cover healthcare costs, have been slowly but surely eroded since it commenced in 1975. Everything from supposedly ‘elective’ surgery (which includes things like coronary artery bypass graft surgery) to seeing a GP, now either has a wait list or out of pocket expenses. In many cases it’s both.
Consider the case of Samantha*, a 41 year old mother of one who was diagnosed with stage 4 non-Hodgkin’s lymphoma. After months of painful and gruelling chemotherapy she was told by doctors that conventional treatment had failed.
Samantha was told her only option was to travel to the US where a treatment called Car-T cell therapy was available. But the treatment would cost up to $1 million dollars, with flights and accommodation extra.
Samantha’s family, and the close-knit community where she lives, managed to raise over $150,000 but it wasn’t until pressure was heaped on the federal government that the health minister agreed that the government would fund the treatment. Now back in Australia, Samantha is cancer free.
In another case Dianne*, a mother of three in her 40s, was diagnosed with lung cancer. She is a non-smoker. The cancer had already spread to her lymph nodes when it was diagnosed. She wasn’t given a good prognosis but was accepted for a trial medication.
This medication would normally cost between $6000 – $10,000 a month! While the drug worked for a time, it stopped being effective after a year. She was given compassionate access (meaning she does not have to pay for it) to another drug which is keeping the cancer at bay.
But because of the exorbitant costs, thousands of others cannot access the treatments that Samantha and Dianne have received.
While the means to save lives exists it is often big pharmaceutical companies that control access to treatments and the prices. Successive governments have done nothing to address this.
In the US today it is not only these specialised treatments but all healthcare that comes at a cost to the patient. Medicaid offers some free care to some low-income earners in some states, but for most healthcare is paid ‘out of pocket’.
In the US there is a heavy reliance on health insurance. If you’ve got insurance you might get some, or most, of your treatment paid for, but more than 28 million people don’t, or can’t, get insurance. This means you pay in full.
Depending on the issue, you could expect to pay between $150 – $3000 to visit an emergency department in the US, but if you need critical care the cost can be up to $20,000! Ongoing care, like what Samantha received, can cost a lot more.
In Australia we are now hounded to buy health insurance. We’re told if we don’t, we won’t get the care that we need. But health insurance in Australia is expensive and offers little coverage in many areas. In addition to what the insurance companies receive in premiums, governments pay them millions more in subsidies.
In many ways we already have elements of a US-style system in Australia. We need a push to reverse this situation and a fight for a truly free universal healthcare system for all. Plenty of wealth exists to pay for this. Millions could be saved by ending public subsidies to private insurance and pharmaceutical companies, while billions more could be freed up if we removed the profit motive from the sector entirely.
A publicly owned and democratically run healthcare and pharmaceutical sector would allow us to deliver care and treatment to everyone regardless of their ability to pay.
*Not their real names
By Denise Dudley