National Nurses United

I could hear audible gasps every time I mentioned that I pay $803 per month for my private health insurance that still carries a huge deductible and high co-pays and other out-of-pocket costs. push aggressive usage of drugs, medical technologies, and medical equipment because the more we use it, the more they make. There is no collective goal of good public health or cost-efficacy. "Prices for selected health services and products [are] higher in the U.S.—far higher, in some cases—than in the other study countries," reports another Commonwealth Fund paper. "According to an analysis by Gerard Anderson of IMS Health data, U.S. prices for the 30 mostcommonly prescribed drugs are one-third higher than in Canada and Germany, and more than double the prices in Australia, France, Netherlands, New Zealand, and the U.K." While some in the United States may wish to lay the blame for increasing healthcare costs on public programs and too many Americans taking advantage of social safety net programs like Medicare for those 65 and over and the disabled, or Medicaid for the economically disadvantaged, the reality is that the major driver of healthcare cost escalation is coming from the private interests in America. "While the United States has had above-average total spending, its public expenditures are in line with other countries," said a report issued by the Kaiser Family Foundation. Where we are really out of line is in spending driven by private, profit-making interests. Countries wishing to move more in the direction of a U.S.-based model must understand that the economic impacts of privatization will likely be to increase health expenditures overall and create pressures within the system that will be detrimental to the health of their people. It seemed much of the time I spent with Australian audiences provided something like shock value for them to hear about the real costs and experience of accessing healthcare in the United States. I could hear audible gasps every time I mentioned that I pay $803 per month for my private health insurance that still carries a huge deductible and high co-pays and other out-of-pocket costs. And I brought other stories from the United States that other people wanted me to share, like 14 N AT I O N A L N U R S E the one we heard on NNU's 2012 Medicare-for-all bus tour through California when Carolyn Trovao, a Fresno woman, stood up and told us that she had waited 16 hours to seek care for a heart attack because she feared being bankrupted by the costs but knew she had mortgage insurance to pay off her home if she died. Australians, like Rick, cannot conceive of such barbarism in their healthcare system. Unfortunately, many Australians mistakenly assumed that passage of the Patient Protection and Affordable Care Act (ACA) in the United States meant that we Americans finally were joining the rest of the civilized world in achieving universal healthcare for our citizens. I burst many bubbles when I talked about the realities of reform under the ACA and how private interests have been so well protected by this legislation. Why any nation like Australian that performs better in terms of health outcomes for its citizens at a more reasonable cost per capita would want to move toward a more privatized U.S.-style model is mind boggling. In yet another report issued by the World Health Organization, Australia ranks five full positions better than the United States in overall system efficiency. It's clear that corporations and the international forces of privatization have done a thorough job in brainwashing people everywhere to swallow the myth that privately owned and run systems are better systems. The attempts to privatize Australia's healthcare system are not only limited to an erosion of coverage offered under Medicare and the push to carry private insurance, but also to privatize more healthcare services and the providers of those services, whether they be entire hospitals, clinics, departments within hospitals, etc. It's this shift toward privatization that the New South Wales and Queensland nurses and other health professionals are furiously fighting. In some places, like the new children's hospital being built in Brisbane, the call for efficiency is being used to sell the public on the 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 DECEMBER 2013

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