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WORLD VIEW: Taking Health Coverage for Granted in Australia

Growing up in Australia and working there, I never really worried about health care. Sure, you had to spend some time in the doctor's waiting room (as we do here), but you were never turned away because you lacked insurance. Australia's Medicare health care system covers everyone (not just the elderly and disabled, as the US Medicare system does). Australia's Medicare, financed through general taxes, gives everyone in the country access to free or low-cost medical, vision and hospital care. It gives you free or subsidized care at the doctor's office and a discount on many prescription drugs. But we also had choices. We could get supplemental private health services and, in special circumstances, allied health services like chiropractors. That private option gives us services like dental work, emergency ambulance transfers (which aren't exorbitant there), a private hospital bed and so on.

As the Commonwealth Fund says, “The aim of the (Australian) national health care funding system is to give universal access to health care while allowing choice for individuals through a substantial private sector involvement in delivery and financing.” People buy insurance directly from the insurance company (not via an employer). Approximately 43 percent of Australians have private health insurance today. And if you do buy it, you receive a government rebate that subsidizes 30 percent of your insurance premiums, up to 40 percent if you are over age 65. There is a smorgasbord of private health insurance to choose from and it is relatively simple to compare options online.

I have lived in the U.S. now for nearly eight years and have experienced a wide range of health insurance—student health insurance, individual health insurance, and employer-based health insurance. By now, you'd think I would be an expert in getting health insurance and knowing what my policy covers. I'm not.

A recent report from the Robert Wood Johnson Foundation details the complex challenges people like me face when making choices about buying insurance (less so when I'm covered by a good work-based policy.) Trying to understand my health plan is akin to looking for a needle in a haystack. And when I do feel like I somewhat have a handle on it all, extra charges always seem to magically work themselves into the bill. Lot's of people living oustide the U.S. probably think we’re nuts.

Why can’t it be simpler? I do believe there is much to learn from other health care systems and I do recognize that the solution for the U.S. will have to be unique to the U.S.(Read more about some of New America's proposals here.) So when I hear my friends and family in Australia complain about health care, I kindly remind them that they should not take it for granted. You don’t know what you've got til it's gone.