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Changes in Latitude: Comparing Health Care Systems with Nurses Down Under

October 26, 2011

By Peggy McDaniel, BSN, RN, who writes the occasional post for this blog and currently works as a clinical liaison support manager of infusion in Australia, New Zealand, and Asia Pacific.

latitude lines/ wikimedia commons

I recently found myself sitting on a boat, enjoying a “sausage sizzle,” dressed as a pirate no less. In Australia, a party that includes barbecued meat usually includes sausage; thus the name. The pirate theme was an added bonus. As an American and a nurse, I was pleasantly surprised to find myself seated at the same table as two Australian nurses. What were the chances of that? The conversation that evening gave me some insight into the Australian health care system, which I am just getting familiar with.

Comparing health care systems. Once we all realized we were experienced nurses and shared the belief that quality patient care should always be the primary focus of health care, the conversation turned to cost. In Australia, there is a public health option that all Australians can access. It is paid for by taxes. If you choose to do so, you can also purchase a private plan to supplement this public option. I have yet to determine what part, if any, employers play in paying for health care or private insurance. However, a sick Australian will always get care and not incur a lifetime of debt for that care within their public health care system.

My fellow nurses were amazed to hear that in the U.S., you may not have health insurance for a variety of reasons. One of the nurses purchases private insurance as a “backup” to public care. She used this coverage for an elective procedure, chose her own surgeon and private hospital, and was able to schedule the procedure in a timely manner. This same nurse admitted that if you need a new hip or knee and you only have public coverage, you may have to wait for up to a year. However, if you have cancer and need treatment, it will start promptly after diagnosis, whether or not you have private insurance or not.

Both nurses asserted that the care for acute and emergent issues is of high quality in the public hospitals. They were able to give me examples of how the system works, from a personal and work perspective.

As in the U.S., hospitals here in Australia are struggling with the rising costs of health care. The public hospitals in each state utilize their group buying power to purchase supplies and equipment, which helps keep costs down. The private hospitals often have a bit more polish and shine, but all the hospitals strive to give Australians high quality care and the nurses I’ve met are passionate about that goal.

Imitate the American system? One of the nurses I chatted with exclaimed, “Our politicians keep telling us that we should be more like the American system, but I think that’s a mistake. What do you think?” Admittedly, I have much to learn about Australian health care, but so far I have to agree with her. As an American who has gone without health insurance because I was rejected due to preexisting conditions and was not employed full-time, I thought this system sounded pretty reasonable. The Australian nurses certainly felt that anything less would be unacceptable.

I’ve been lucky enough to work in hospitals all across the U.S. and in the U.S. Virgin Islands, as well as visiting hospitals in various countries, including China, Malaysia, Kenya, Honduras, and elsewhere. Are American hospitals clean and full of high quality equipment? Are our medical professionals trained to the highest standards? Are we often treated to a private room with our own TV and bathroom? If you are an American and have been in the hospital, you can answer these questions based on your own experience, which may vary fairly widely based on the hospital you went to as well as your income level…

The common denominator. Are all hospitals the same around the world? I am sure you can guess what I’ve seen and the answer is an emphatic no. But I can tell you that nurses are the common denominator. They work hard every day to care for their patients in a variety of settings. I’ve seen everything from state-of-the-art facilities and equipment to open air shacks with the bare minimum of supplies, multiple patients in a room (maybe to a bed), and family members bringing in food, linens, and soap.

The pirate theme has been a part of my life since about 1992, when I was lucky enough to spend time living on a sailboat in the Caribbean. During that time I listened to a lot of Jimmy Buffett. It’s pretty much nonnegotiable—he is as much a part of that culture as fish are to the sea. One of my favourite songs remains “Changes in Latitudes, Changes in Attitudes.”

After criss-crossing quite a few of these lines on our globe, I’ve learned that wherever I find myself, nurses and their attitude towards providing quality patient care are as constant as the stars that have guided sailors for generations. This is inspiring to me and always reminds me how proud I am to be part of the global nursing family.

Editor’s note: here’s a Wikipedia page giving an overview of the Australian health care system. We can’t vouch for its accuracy, but it appears to give a good basic overview of how public and private plans function in relation to each other, who pays for health care, etc.

44 comments

  1. In my studies concerning Global Health, we have come across and number of lower cost alternatives for basic health care needs. Health care costs continue to rise despite our best efforts to keep costs down, and all we hear from government officials concerns raising taxes to continue to fund a bottomless pit of rising healthcare costs. For example, there is a $25 incubator used with only hot water, a $30 centrifuge that is hand powered (yes, no electricity), and a 3 cent biodegradable toilet. If we can charge our college stduents with alternatives for lower cost, basic health care needs, why can’t we charge our graduates working in the private sector with the same task?
    In our current system, all eyes are on the Affordable Care Act, which attempts to remedy our healthcare problems. However, I unfortunately, do not see my job changing in any way, shape or form. I am employed in an Emergency Room where the populationo includes a majority of impoverished, uninsured, and immigrant patients who seek all medical care in the Emergency Department. Even with the Affordable Care Act (which does not cover immigrants), we will continue to serve the exact same population.
    It is interesting to note that the population of Australia is happy with their healthcare system, which is not surprising since when emergency care is sought, it is available to them. However, the United States has a daunting task ahead of them until they can perfect the healthcare system.

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  2. I believe most Americans agree that a healthcare reform is necessary. There is something wrong with a system in which a cancer patient is bounced from hospital to hospital because he does not have health insurance. Or a 22-year-old patient found to have a brain tumor has to wait six to eight months to be seen by a specialist at the local teaching hospital because of the same reason (no insurance). The healthcare reform that will take in effect next year will not be available to a large amount of people who need it. For example, due to income restrictions, a family of four with a total income of $40,000 will not be eligible to purchase the insurance offered by the government. Federal poverty level for a family of four is $22,050. Who can live on that in this economy? Also, it will still be cheaper for employers to pay a $2000 fine per worker annually, than to spend thousands more covering the employee and his/her family. Meanwhile, my family’s insurance premiums are going up next year because this “government insurance,” is being funded in part, by imposing a 40% tax on “high-end” insurance plans. So, the Australian healthcare system, as well as the French and many other overseas nations’ healthcare systems sound like an improvement. I don’t believe this has to necessarily be funded through additional taxes. It is simply a matter of allocation of funds and resources.

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  3. Thanks for posting about your experiences in global health and the system in Australia. I agree with you that the United States should be more like the Australian system. I take the global health stance of access to healthcare being a right rather than a privilege. It’s still shocking to me that the U.S. is one of the few, if not the only, developed nation in the world that doesn’t have universal healthcare. Yet, it ranked #1 out of 193 countries in total health expenditure as a percent of GDP.
    I believe that installing state-run insurance exchanges and closing gaps in coverage will help curb costs and expand coverage to nearly 50 million currently uninsured Americans. Like many, I will be waiting to evaluate the effects once the changes take effect.

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  4. I found this article very refreshing. As a nurse, I find it a little surprising that other nurses are so opposed to the Health Care Reform and what it would mean for the millions of uninsured individuals in our country. I agree with McDaniel when she says that the goal of nurses around the world is to provide quality care to their patients; that can be difficult to do when the patient never makes it to a hospital room.
    The healthcare system in Australia seems to be similar to the European and Canadian standards, and it seems that the U.S. should imitate them, not the other way around. It was enlightening to hear her account of the nurses’ stories, and to know that emergency and critical situations are dealt with in a timely manner.

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  5. I am happy to see that nurses around the world, whether they are from a wealthy nation or the poorest country in the world, understand the common goal of this career, the patient. The more I read articles from the web, the more I feel part of a global family of caring individuals. As for the health care system of this nation, it is time to step up and ensure that the right of every human being to have access to universal health care is protected. It is impressive to see how other nations with a smaller GDP than the U.S are able to provide care for their citizens. I think that we as nurses should cease this important moment in our nation’s history and push collectively in a manner never seen before to ensure that legislators stop working only for those who only seek wealth on the backs of the people and work for the people ensuring that universal care is provided to every man, woman and child of this great nation.

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  6. It is pretty interesting to read about an experienced nurse’s perspective of how our health care system works; this is even more amazing during this era of “Obamacare” and other governmental solutions to fix or break our health care system. A lot of disagreement has been shown among health care workers about what is the right way to go, but there is something that everybody agrees on: our health care professionals are educated with the highest standards and high quality patient care is always a priority. It is true that receiving medical attention without health insurance could become very difficult, even impossible, and government-funded plans usually do not provided enough coverage or it limits your choice of doctors or hospitals; the decision of who and where you should received medical care should not be made by plans or numbers, it should be made by those suffering the disease or condition.

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  7. The past few months have been quite eye opening for me in regards to global health care. It amazes me every time I learn of yet another country ‘s healthcare system that put US healthcare system to shame. It greatly saddens me to hear that Australia has leaders that want their healthcare to be more like US healthcare!

    It seems as though healthcare facilities, pharmaceutical and insurance companies in the US are more interested in “making a dollar” than truly providing “health care” to its clients. If the government truly wants to reform healthcare in the US, they should start by placing a monetary cap on the amount that can be charged for healthcare services and tests, as they do in Japan. This would make healthcare more affordable for everyone right off the bat.

    The US needs to take a good look around the world at successful healthcare systems in other countries. While I agree that something needs to be done (and done quickly) I fear that they are quick to offer out insurance on the front end, while they have little solid planning in place on the back end.

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  8. Being a nurse in a diverse metropolitan community like Miami, Fl. it is a sobering reality that America’s healthcare system, while progressive in terms of technology and techniques, is draconian when we consider how its funded and who is covered. The average American citizen believes that healthcare is important for them to have, but debates whether it should be extended to everyone else.

    Our priorities are convoluted because of a false perception that by extending healthcare to every person in America, we will somehow create a welfare state. Americans pay more for healthcare that is less proactive to health and well-being relative to othe comparable industrialized countries.

    Many of our legislative leaders are too easily influenced by the economic and coercive power of insurance and pharmaceutical companies to listen to the pleas of their fragmented constituencies. While current healthcare reform is attempting to correct some inequities, the change is slow and people are still suffering and/or dying.

    I am a healthy male nurse and a father but cannot afford health insurance for myself or my family!

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  9. Changes in Latitude: After reading this entry, I find myself thinking about the different types of health care insurances globally. The simplicity of Australia’s health care makes me wonder how ours can be so complicated. I found it fascinating that Australian’s have health care that is paid for through taxpayers. I also thought that it was interesting to see that if they wanted extra or supplemental that you could purchase private insurance. I also agreed with the writer (a nurse, of course) that it was truly amazing how the health care insurance providers had nothing to do with employers. So, why in the United States, have we adopted this concept? My personal opinion……money! We are a greedy population. Instead of focusing on better health and safety, Americans focus on money. Unfortunately, I do not see this going away anytime soon.

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  10. A comparison between how healthcare is handled around the world is an important task that governments should take into account. Health care is an important part of every society, leaders and healthcare professionals should have a consensus on what works and what does not work when caring and paying for the wellbeing of people. As an American nurse, I consider myself knowledgeable of the ways health insurance companies and the government distributes health care between people. As a Spanish natural, I have had the good fortune of experiencing firsthand the healthcare system of a completely different country, on a completely different continent. In my opinion, the American health care system is one of the most technologically advanced systems in the world. That still does not occult the fact that we are ranked number 37 of the World Health Organization’s list of best health cares, but why? Well frankly, I think the main reason is the unfairness of the American system. During my 15 years of living in Spain, I was never rejected any kind of care, from emergency to regular doctor’s visits. I was treated for knee problems due to my obsession with playing soccer, and many different infections, from the common cold to stomach infections, even pneumonia once. All this was covered by the government run health care system. I was fortunate enough to have a private plan, but that was mostly to get private hospitals and doctors, and I used in few occasions because the government plan was the only thing that I truly needed. I was never in a position where I had to get a big surgery or cancer treatment, so in that sense I cannot express my experience. On the contrary, in the United States, I have been rejected access to any health insurance due to pre-existing conditions because if not rejected, the premiums are too high to afford even in my nurse’s salary. The situation of being “scared to get sick because of no money” would be unthinkable in most developed countries. Although I still think the United States have the best treatments and professionals on the world, we still have a long journey in our path to health care equality.

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  11. Open dialogue between medical professionals like physicians, nurses, dietitians, physical/ occupational/ speech therapists, etc. is a integral part of deciding the best approach for maintaining or improving best practices. I believe that through a mutual respect we will benefit immensely by obtaining a holistic approach to patient care. The naivety to think that our methods are best is sophomoric at best and should really be avoided to be considered professional. Time and time again we find that a multi-disciplinary approach to healthcare provides a “whole” look at the patient and their needs. Evidence based research has proven that this must be attempted to give the patient the best outcome. Unfortunately not all of our colleagues have prescribed to this approach and allow their egos to interfere with collegial interaction. This “ego” based approach must be abolished in order to provide optimal patient care. Further more, just because a system is beneficial in one location, does not mean it will beneficial in all systems. For optimal care we should continually assess and reassess our “best practice” approaches. After this we can integrate the new system into the educational curriculum and renewal criteria for all health care professionals.

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  12. I think it is time the American healthcare system starts learning from the Australian healthcare system not the other way around. The American healthcare system which is mainly provided by private insurance is very expensive and not everyone can afford it. Furthermore, if the patient has a preexisting condition no insurance company in the American healthcare system will cover them and the expense of paying for anything reference the preexisting condition will send the patient into bankruptcy and break any chance of recovering financially. It is sad that a powerful and great country like America cannot take care of their public and provide a descent and impartial healthcare system for everyone. The Australian healthcare system seems to provide their public with a fair and just healthcare system. I know this is what all nurses around the world want for their patients care to be the primary focus before the concerned of cost. I hope the American healthcare system can open their minds and learn from other countries like Australia and succeed in this important area and provide a better healthcare for its public.

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  13. Hearing about Australia’s health care system and the setup of its health insurances gives me hope that one day the United States health care system could help the American people instead of the insurance companies. Should Australia be more like the U.S. in its healthcare? Definitely not for it is the U.S. who should be more like the Australians. The Australians don’t let people suffer just because they don’t have insurance or that their insurance won’t cover the cost. Here in America we have amazing nurses who provide great quality of care to those in need, unfortunately those most in need of our services are the ones who cannot afford it.

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  14. The Affordable Care Act became law on March 23, 2010 with the hope that all Americans, especially the ones over 18 and under 65 low-to-middle income, can get health insurance. United States spends in health care more than any other country in the world but we have the worse system. Accordingly with Young & Devoe (2012), the main issue to overcome it is to reduce costs without compromising quality, as we know, health care for more than 70% of people under 65 is through private insurance, we can do as Switzerland, they are not allowed to profit from primary health insurance products, only for supplemental policies. The impact of primary care in reduction of cost is never overstated. Reasonable expending, we cannot provide all possible services to all people is another main issue, as example Medicare just approve a prostate cancer drug (Provenge), each treatment cost $93,000 to increase life expectancy by 4 months, this is an example how things contribute to increase health care costs.

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  15. The United States is one of the high income country over the world. Most people wants to come here to indulge in its many opportunities which it has many to offer. Little did we know that the US that can offer us liberty and opportunity can also turn its back on us in the time of sickness. If we do not have high end insurance such as private insurance count your blessing and prepare for a funeral if you enter a private hospital for treatment. One will be quickly ship to a public institution for care. How many indigent patient and cost can these public institutions absorbed. Bills and workers need to be paid and we all know that the US still has not recovered from its financial problems. Again, prepare for a death wish of untreated individuals. Many Citizens died or suffered because of the inability to pay for care. It is the patient bill of right, a law that no institutions can refuse patient if they are unable to pay. But, is that the practice or it is just false advertisement. Why are many health institutions are still refusing patients… Many citizens cannot afford insurance because of the high price. Here in the States Healthcare is a profit and a business not merely to save life. Anyone can loose their job, health insurance and everything that they have worked for. Try to apply for governmental benefits you will die before it is approved. I have seen the cost of patient medical bills has been brought to the bedside, how so inhumane and unethical. The roller coaster that patients under go to become qualify for governmental help such as medicaid and more is debilitating. I would say to every Australians count your blessing and be proud of the healthcare system there.It is more efficient and cost effective compare to manage care system here. We the healthcare professionals including Md and all gave oath when we were licensed to do the greatest good, save life and veracity in our career. I think we all need to do that when we all start a job with accountability behind that signature line.
    I strongly believe that healthcare should be a right and not a privilege. Universal healthcare save life.

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  16. It is really unfortunate that we Americans do not have a health care system such as the one in Australia. I had the opportunity to talk to many Australians about their perceptions of their health care system. Their experiences dealing with their health care system always reflect satisfaction. Australians enjoy the benefits of a universal health care system founded by taxes. The Australian health care system covers all Australian residents despite of preexisting health conditions. I remember being speechless after hearing the story of an Australian man who needed heart surgery. He was air-lifted from his local hospital to a Sydney’s hospital where he had open heart surgery. This man had to pay nothing, since all the health care services he received were cover by the government. At the same time, telling Australians about how the American health care system works has left them with a feeling of disbelieve. They have told me how they cannot imagine how a country such as America can offer their people with such poor health care services.
    The reality is that the American health care system needs to improve. It is hard to believe that a country America, a world power, has not yet implemented universal health care. Anyone could agree that universal health care is a viable option for America just by looking at the results from the universal health care implementation in European countries, Japan, and Australia. Many Americans are very hopeful about the upcoming health care reform. The health care reform offers Americans hope that, at last, they would not have to live with a constant fear of getting sick. I believe that we Americans need to support the implementation of the health care reform by letting our legislators that we want changes on our health care system. Americans need to become active participants on the implementation of the health care reform in order for it to become a reality. Much will not change if we just wait for changes and not become involved in making those changes happen.

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  17. [...] for that. So thank you. A fair number of the comments were on posts from previous months, such as this post comparing U.S. and Australian health care systems. Is somebody by chance teaching a nursing course [...]

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  18. It is unfortunate that the health care system in the United States is not universal even though the U.S. has the highest growth domestic product (GDP) in the world. On the other hand, Australia, which is ranked number thirteen in GDP, is able to provide universal health care to all Australian citizens since 1975.

    Nowadays there are more than 49 million U.S. citizens that lack health insurance, restricting their access to health care services. Moreover, it is not uncommon to find individuals with high debt or who have to file for bankruptcy as result of expensive health care bills due to the lack of health insurance. It is necessary that the U.S. government promote changes in the health care reform in order to provide health care coverage to all Americans. However, it is important to realize that changes not only within the government but also within the health insurance companies are needed in the fight for achieving equal access to health care services.

    I truly believe that the U.S. health care system has a long as well as difficult journey toward the goal of achieving equal access to health care for all citizens. Working together for a better future in which all citizens are provided equal access to healthcare should be the common inspiration among nurses, doctors, and the rest of the health care team members.

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  19. Healthcare system in America is one of the most advanced in the World. America right now, is the only Super Power in the world, yet, this most advanced in every aspect Country have millions of citizens without healthcare insurance. What is wrong here, why are we fighting the new proposed health insurance that will provide healthcare coverage for all Americans? Most part of Europe practiced Universal Healthcare, including Australia and has succeeded. According to this article, nurses in Australia raved about the healthcare system of their country. I strongly believe that if we leave politics out of healthcare, we will able to see that, we are all Americans, we all make this country great, and that, if America did not exist, we would have to create one in order to have a country as great as this. Please support the new healthcare reform and lets take care of each other.

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  20. This is a very interesting post. Like many countries around the world, Australia provides adequate public health care coverage to its citizens through taxation. The United States should definitely be able to provide some form of universal healthcare coverage to its citizens. Instead, millions of Americans are without health insurance and as a result there is a major deficit in overall care for our citizens. This article brings up an interesting point however. No matter the financial circumstances in different nations, overall nursing care has always been the foundation of health care. We as nurses must always provide the best care we possibly can, and exhaust all the resources at our disposal.

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  21. It’s funny how the US, being one of the most powerful country in the world, cannot afford to provide its citizens with some form of health care coverage. After learning about the health care system in other countries around the world, I’ve come to the conclusion that Americans are getting the short end of the stick. A person may work multiple jobs to make ends meet but if he/she does not match the qualifications for insurance or does not have enough money to pay a monthly fee for coverage then he/she will be uninsured. I do not understand how every other developed country can afford to cover their citizens but the US can’t. Individuals in Australia, Spain, Japan, and France do not have to worry about being ill. They know if their child gets injured, if they need surgery, or if a simple vaccine is required they can get it without having to worry about how they will pay for it. I feel that the American system puts too much focus on fast food, money, and entertainment and not enough focus on a decent health care system.

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  22. Globalization has changed and transformed many aspects of our lives including health care. It is interesting to note how health care delivery systems vary worldwide. Furthermore what this article brings out is a very important fact that no matter how the health care system varies nurses are truly the common denominator. The glue of health care, the base, and nurses no matter what the tools, supplies or equipment available are always able to provide care. It is interesting to note that, you are always taught to work with what you got and no matter what you have you can always provide care. So no matter that situation or setting care is universal and can be given no matter what. If you have insurance or if your “covered” by any plans or by the government care is and will always be there.

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  23. I strongly believe that health care should be offered to each individual on the world. I like better the health care system in Australia than in the United Stated because all individuals in Australia have health insurance and look for medical help when they are sick. In Australia, all individuals have health insurance that is pay through their taxes; also individuals can have private insurance to support the public insurance. When Australians get sick, they immediately look for help because they are not afraid to be in debt due to medical bills. On the other hand in the United Stated, even though it is a high income country, it is one of the countries where the largest number of people are without medical insurance and when people look for health care is because they are really sick, they never go when the first symptoms start due to no access to health insurance and the debts that will be billed to them later. Usually insurance companies reject any person with preexistent condition. You need to get insurance to be paid monthly through a full time job, or pay out of pocket. The only people that are eligible for Medicaid are kids, old people and pregnant woman that have low income and Medicare are for people over 65 year old. The cost of health care is very high due to the develop of new technology equipment

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  24. I enjoyed this article very much, It is sad to know that our country which has enjoyed great economy and yet has not been able to achieve a health care system that will be fair and even to every citizen. Even other countries that don’t have as much money or resources like Spain and Canada. It will be interesting to see what will become of the new health care reform, hopefully this will provide a more reasonable access to health care and that health care quality won’t change. As an oncology nurse i was also surprised and impressed that even chemotherapy, which is a costly treatment is not delayed for those who don’t have private insurance in Australia. And i also feel happy to hear that i am a part a large group of professionals that have a common goal.

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  25. Reading posts like this makes me feel both sad and relieved. Sad because it proves how the arguments of those in favor of keeping the status quo of our health care system in the states seem to be out of touch with the reality that is present in the world. I feel relieved to know that a functional, universal health coverage with good quality of care is possible and works in many countries. I think that right are those people who claim we should bring the subject of universal health coverage discussion in a different dimension, moral rather than fiscal. As long as the discussion keeps circling around the numbers universal coverage has a chance of being rejected as “unsustainable”, whereas it is hard to argue against a fundamental right of a person to have a chance for a healthy, productive life. After all, how can one be supporting the system which makes people with cancer bankrupt because of mounting medical bills, or let a person suffer and ultimately die because his condition will not allow an insurance company make a profit. Is it not the ultimate question? Profitable vs non-profitable patients. Recently, I have learned about the fact that the bill was passed by the US congress prohibiting re-importation of the drugs from Canada to the United States. The same drugs that we consume here in states, only cheaper. This shows the level of determination and money involved in the “business” of keeping things the way they are. I think that the first step of approaching the issue would be to prohibit any lobbying for health care industry. Then, maybe we have a chance of coming to some solution with the universal health care in our country.

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  26. I agree with many of you, health care should be a right. We all should have easy access to healthcare. The United States is well known as developed country but based on health care insurance available in this country I think we are still behind. Many of us are just waiting to see if health care reform will bring any changes. There are people without any health care insurance and who can’t get the treatment needed to prevent many serious problems like high blood pressure, diabetes, and many other heart conditions. Many citizens wait till the problem become worse to seek medical treatment because they are uninsured. The United States needs to give a serious about the health care insurance and adopt a better health care program for health of the citizens.

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  27. I have been living in this country for the last twenty years. The health system here do not have universal healthcare. It is mostly employer-subsidized healthcare, private insurance and medicare covering people’s health expense. There are millions of people in this country with no health insurance coverage. While Australia’s system is not too different from the mixture of employer and public based funding found here in the US, Australia’s system provides universal coverage with a mixed public-private funding system. According to the WHO it provides some of the best care in the world as assessed by preventable mortality and healthiness of the population,. Their total costs are dramatically less than that of the US system and most people in general are happy with the system. On the opposite hand, here in the US the cost of health care rises more and more everyday. I think there are some sectors of the economy more interested in their own positive and profitable returns than in the well being of the population. As a result we are living in a sytem that is destroying itself.
    by fabio tamayo

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  28. Very interesting post. It’s true that the United States is one of the only high income countries that doesn’t have universal health care coverage. I find it so sad that the United States is considered the land of opportunities and wealth, but the government can’t afford to help keep it’s citizens alive. While private insurance companies are used as a back-up plan in Australia, it’s used as the only plan in the United States. And if you were unfortunate enough to be sick before applying for private insurance, you won’t even be able to get that. This is due to the fact that health insurance companies are often regulated by people who wish to stay rich and don’t want to have to pay any amount of money. It’s all about profit for them. In fact, I read recently that some insurance companies are charging women more for health insurance because they are more likely to have check-ups than men. So, women are being punished for spending a little money every year to monitor their health and prevent horrible diseases from developing, which will safe the insurance companies thousands in the long run. Does that seem right to you? The United States needs to get with the program, and regulate the health care system for the good of its citizens, the way Australia does.

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  29. I am a firm believer that access to health care should be a right. There is no reason why people should have to wait to get sicker and sicker because they are afraid of what it will cost them. It is incredible to think that such a rich country can’t come up with a feasible health system for their citizens. How is it that so many other countries are able to provide health care in a way that their people don’t end up in debt for the rest of their lives. We should have the same options as Australia and many of the other countries that provide similar health care coverage. Money is spent on many things in this country, and health care should be one of the primary things that we should worry about.

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  30. After reading this article it made realize that drug addicts are at increased risks for major problems besides their addictions. Drug addicts often put themselves in situations that exposes them to diseases just to get access to drugs. In my opinion, this program that the nurses came up with is very helpful. Recovering from addiction is a very long and costly process; therefore, if nurses can prevent making this process more difficult through prevention of secondary diseases this will help addicts recover faster. In the long run I think this program will beneficial for addicts that are at the greatest risk for secondary infections like homeless addicts.

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  31. It is obscene and insulting that this country has the funds to posses the largest and most sophisticated army in the world but cannot put together a decent universal health care program to protect its citizens. It seems to me that if we start all these wars to “protect our freedom” perhaps we should start by protecting the health of our citizens. It all comes down to the priorities of a nation and unfortunately our number one priority is profit. Just like companies profit from selling cars and TVs, the big health insurance companies are allowed by our government to suffer from human misery and suffering. How can you blame them when bribes are basically legalized in Congress? Lobbying anyone? The system its rotten at its core.

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  32. While the Australian healthcare system is not perfect, I believe that it is still better than the American healthcare system and that it should not become like the American healthcare system. According to the Australian nurses, citizens from Australia have access to public healthcare that is available to all the citizens. Those that can afford better healthcare can choose to buy backup private insurance for better service. Hopefully, the Healthcare Reform will be able to cover all of the American citizens. Optimistically, cost would not be the primary factor that decides the level of care a person gets since the Healthcare reform should focus mainly on quality and less on cost.

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  33. I strongly believe that an access to health care is the right, not the possibility to all of the people who legally live in the country. America spends more money on health care than any other country in the world and has almost 50 million people without health insurance. Obviously there is something wrong with that and the health care system has to be revised. In Australia, everybody has medical coverage and it is normal. American citizens who pay taxes and do not have health insurance is considered nonsense in my opinion. Debates about Health Care Reform and a possible decline in quality with the Universal healthcare can be reasonable, but I think that there should always be medical insurance available; even if it does not guarantee an access to the best hospitals, which is better than not to have any insurance at all. The reform has to bring to the Americans an opportunity to have an access to helath care and look toward the future with confidence.

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  34. It’s interesting to compare the health care system of Australia to the United States because they are pretty much the opposite of each other. I agree with what you said about how the main focus of a health care system should be the quality of care for patients. Achieving quality of care is the most challenging part of a health care system because of the need to devise a way to pay for it all. Here in the United States, health care is largely privatized, while in Australia, it is funded by the government sector with an “add on” privatized option. I think the Australian health care system is a good example of how it should be run because it seems to have everyone covered (for the most part). Prioritizing needs such as a cancer patient versus a hip replacement patient helps to determine which patient should be treated faster. When the American health care reform goes into effect in the next couple of years, it will be easier to compare the two systems because they will be more alike.

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  35. The Australian health care system shows us that the possibility of health care access void of exceeding cost and debt is not a hopeless cause. I believe that it is beneficial for the Australian citizens to have a health care system where health care costs are secondary to patient care. It is interesting to see how, in contrast to the U.S., the lack of private health insurance is not an issue when it comes to hospital care in Australia. Therefore, the Australian health care system’s imitation of the U.S. health care system is not necessary. On the contrary, it is an American’s hope that health care in the U.S. could be somewhat similar to that of Australia. Hopefully, with change, nurses and other medical professionals in the U.S. will be to exercise their care to all patients without the restriction of cost.

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  36. The fact that the U.S. does not provide health care to its citizens is puzzling since other countries are able to do it. The U.S. is more focused on cost than the actual well being of its citizens. Australia would be making a mistake in changing their system to be similar to the U.S. Australians have access to public health coverage, which is better than the system the U.S. has. I did not have any health insurance until I became an RN. Before I became an RN, I had to go to the ER for treatment of kidney stones. My bill ended up being thousands of dollars for the few hours that I spent in the ER. If I had been in Australia, this would not have been the case. Hopefully, the Health Care Reform will be successful in providing coverage to those that need it most.

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  37. Healthcare is a very touchy subject in the united states to some. I feel that health is something as human beings we cannot control what ailments we come across, healthcare should be availible to all Americans. We should have healthcare availible to everyone who lives in the USA, there shouldn’t be sanctions on what we can and not have when it comes to health. I have family who live in Paris, who have free healthcare, which is provided thru their taxes, and its a much big difference. My uncle doesn’t have to worry about receiving the health he needs, and sometimes that is a BIG stress reliever. So yes i agree with the one nurse who says wanting to become like the americans in that aspect is a mistake. I love the country i live in but i do feel like i should be given certain things if I pay for it and go to work everyday, and most importantly pay my TAXES.

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  38. I look forward to the day where our health care system here in the U.S. will change and provide comprehensive care for all. I keep hearing about different health care systems, such as Australian, where care is based on need and not an insurance policy. I think in the U.S., insurance providers and the whole financial aspect of health care have way too much control and power over health care. Health care should not focus on costs; this is ludicrous. I think that is you are in need of medical help because of illness or injury, you should have access without the added stress of medical expenses.

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  39. The Australian health care system should not be changed to imitate that of the American health care system. The citizens of Australia have access to public health options that are available to all Australian with the option to buy back up insurance if wanted unlike the United States. Australians are able to get care regardless of having insurance or not. The number one issue in health care reform should be quality of patient care and not the cost. If the Australian healthcare system was to change to the United States healthcare system many of the citizens would be without care.

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  40. I believe Australia’s system seems to be working quite well for its citizens. The fact that a patient can start treatment immediately after being diagnosed regardless of insurance issues, is something we do not see much here in the United States. Therefore, even as an American I must agree that the Australian health care system should not attempt to imitate that of the U.S. Patient care should always be the number one priority yet unfortunately, we see that money plays a significant role in health care and people are indeed turned away if they are not able to meet certain requirements. It is moving to see, however, that the common denominator across the globe really is the nurse’s desire to provide quality patient care, whether it is in the U.S or in Australia.

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  41. I know that it is sad to say that we are the only developed country that does not provide an universal health care access. I do not know much about the Australian health care system. However, by just offering public access to citizens makes better that the U.S health care system. I was also uninsured until I became a registered nurse and got a full time position. I spent 6 years without going to the doctor, having migraines and high blood pressure. It is also true that the costs of health care are increasing. I believe that high level of technology and pharmaceutical companies have a great part on that. I hope that the Health Care Reform brings positive changes to the health care system in our country. It is time for the US to provide its citizen with a human right, access to health care. We as nurses should always be patient’s advocates. We should always deliver the best quality of care and collaborate with the rest of the health care team (PT/OT, social worker, MD,) and the family.

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  42. [...] Travel nursing on steroids-At AJN a post about Nursing down under-mate! [...]

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  43. It seems that many other industrialized nations apart from Australia, such as Japan and Spain, provide for a public health option along with a private insurance component. It will be interesting to see how Health Care Reform in the United States will alter the accessibility of care to the estimated 49.9 million uninsured Americans, according to figures released by the the US Census Bureau in 2010. A common concern to this reform by Republicans appears to be the quality of care. Many bloggers on this site, including the author of the previous post, seem to indicate that “care was comparable between public and private” options. Let us hope the same holds true for the US come 2014 when Health Care Reform goes into affect. I, for one, am glad to see a national health care policy which takes the country one step further to accepting health care as a fundamental human right and not a free-market commodity.

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  44. Interesting post. This sounds quite like the health care system in Spain, where I lived for 10 years. There was a public option, paid for by taxes, and people could purchase private insurance if they desired. Unlike in the U.S., where purchasing insurance is usually expensive and sometimes not feasible, my private insurance in Spain cost me around $60.00 per month, with copays of around $5.00. Care was comparable between public and private–often physicians who worked in the public domain also had a private practice. I never had to wait on the feared long waiting lists people assume are in societies with public health care. I once was denied coverage of a test (a cardiac ultrasound) because of a pre-existing condition (mitral valve prolapse). However, whereas this test cost me over $1,000 in the U.S., in Spain I had to pay $100. All of the care I was given over the 10 years I lived in Spain, including surgery and a four-day hospital stay, was excellent. Sadly, I can’t say the same about my experience here, back home.

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