National Nurses United

In their most recent elections, Aussie RNs Brett Holmes, Coral Australians failed to reelect the Levett, and Judith Kiejda head up Labor Party's Kevin Rudd and the New South Wales Nurses and instead installed Liberal Party Midwives Association, which has challenger Tony Abbott as their energetically fought against privaPrime Minister. In Australia, the tization of services. Liberal Party is what we in the United States would think of as conservatives, and the issues are much the same in terms of struggles to protect the rights of workers and average citizens. The stakes were high not only for the healthcare system and increasing moves to more privatization, but also for unions like NSWNMA and its members. The political climate is also similar in other ways to ours in that Kevin Rudd and other Labor Party allies haven't always been as forceful as they should have been in recent years to protect unionized workers or preserve the integrity of the robust public health system Australia has enjoyed for many years. Now Australians must fight back against an even more aggressive agenda aimed at protecting private interests rather than the public good. Australia spends less than half per capita on healthcare than the United States. In the most recent studies, the United States logs approximately $8,000 per person on healthcare while Australia spends just over $3,400 per person. These figures come from a study of healthcare spending around the world done by The Commonwealth Fund in 2012. Australia's healthcare is anchored by its public health insurance system, which has been in place since 1984. According to The Commonwealth Fund, "Australia achieves universal coverage through Medicare, a tax-funded public insurance program that covers most medical care, including physician and hospital services and prescription drugs. Most health services are financed and regulated by the federal government, although the states and territories have responsibility for public hospital care. Besides Medicare, roughly half of Australians receive additional coverage through private insurance, which the government subsidizes and which covers such services as dental care and private hospitals. Most doctors operate in private practice and are paid on a fee-for-service basis, and [general practitioners] act as gatekeepers to specialized care. Roughly two-thirds of hospital beds are in public hospitals and the rest in private, although private patients can be treated in public hospitals. Physicians in public hospitals either earn a salary and can receive DECEMBER 2013 additional fees for seeing private patients, or are in private practice and receive hourly compensation for treating public patients." It's hard for most Americans to conceptualize how very differently this kind of public investment in health operates and what a difference it makes in the lives of working-class citizens. No one is compelled to carry private insurance, and many people refuse to do so as they want to maintain their healthy personal support for and commitment to the public system and all the benefits it has provided Australians over the years. As I traveled through the country during my weeks there, I met several people for whom the public system had performed brilliantly even though they had also purchased private coverage. One such person was a 63-year-old cab driver in Brisbane, who preferred I just use his first name, Rick. Rick told me about how surprised he was that when he recently felt chest pain and was fairly certain he was suffering a heart attack, he was able to have the ambulance ride to the closest hospital (a public one), three days in hospital care, an angiogram to study the status of his arteries, and his follow-up care—spending only about $500 in out-of-pocket costs that related mainly to the ambulance fee. He didn't need his private insurance. He was surprised because often, even in countries like Australia where a public system has been in place for years, people are led to believe that relying on a public system alone will not be sufficient to access high-quality care. Rick found out for himself that just wasn't true, and now he chats up the Aussie system at every opportunity and planned to join with other citizens to help fight to protect it. It seems that the private, for-profit interests in healthcare use the same tactics globally to frighten people into thinking a private insurance plan or system simply has to be better than a public one. Many Australians like Rick spend years paying a private insurance plan only to discover in times of health crisis that their public coverage and system works just fine. What is it, then, about the U.S. system's intense privatization that pushes costs so high and, if exported to other countries around the world, will also accelerate the costs for those countries? The United State's national healthcare expenditure has reached $3 trillion a year (or 3,000 billion if that helps you visualize things more accurately), and the drivers of that spending all are made more expensive through privatization. Private profit-making interests all W W W. N A T I O N A L N U R S E S U N I T E D . O R G N AT I O N A L N U R S E 13

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