So Much Unfair

Medicare in Australia's brand.

(Photo credit: Wikipedia)

Today’s Daily Prompt: “Tell us about something you think is terribly unfair — and explain how you would rectify it.”

We live in a society that might be described as democratic capitalism (though if I am feeling argumentative I would disagree that we are truly either) and there is a great deal about the way we build that society that is “unfair”.

If you talk to the upper-middle class and rich in Australia they say it’s “unfair” that they have to pay taxes while people “bludge on the dole” and that people on the bottom “just don’t know how to work.”

Today I’d like to talk about unfairness at the other end. I’d like to talk about some benefits that the top get that don’t get down to the bottom. There are far too many to cover them all (how about public finding of private schools)

In Australia we have a publicly funded health care system called “Medicare”. This is funded through a levy. If you earn more than a little over $20,000 you pay the levy. If you don’t have private health insurance that covers at least hospital stays you pay an extra levy.

At the other end if you earn less than $130,000 then you will get a percentage of all of your private health insurance cost paid back to you.

Now Medicare often does not cover all the cost of medical expenses. Finding Doctors who will accept just the amount Medicare pays can be difficult, if not impossible. For example, I couldn’t find a psychotherapist who would accept less than $20 a session more than the Medicare rebate.

At the same time you can take out private health insurance that will cover this gap. It will also cover such things as chiropractors and psychologist appointments, dentistry, glasses and indeed gym fees and running shoes are covered in some.

This means that the Australian taxation system is paying for part of the cost of advanced health care for the middle class while charging people on low income for a system that does not cover all their medical costs. One of the other effects of this system is that for people who can afford private health insurance they are totally shielded from the cost of the gap between the amount Medicare will pay back and the amount charged so fees can spiral out of control making it even harder for people on a low income.

This is patently unfair.

How do we fix it?

The first step would be to remove the private health insurance rebate. The Australian taxpayer should not be helping you to get cover that includes gym fees and running shoes. It might be even better if we charged a levy on private health insurance fees and channeled that into the Medicare system. If you can afford private health insurance you can afford to pay a little more into Medicare.

Then we need to widen the health care that is covered by Medicare. Our previous government was looking to widen it to dental services and that would be a good start but we could add psychologists and glasses to that as well without any real argument that these are not required for good health.

Finally, we need to do something about the gap between the amount Medicare will return for a medical procedure and the amount charged for the service. I’m not exactly sure how to do that. One way might be to limit the amount of gap private health insurance covered so that everyone faced the same cost pressures.

9 thoughts on “So Much Unfair

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