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Everyone’s Covered


Down Under

he sting of a box jelly fish will kill you in 10 agonizing minutes, should you have the unfortunate opportunity to encounter one,” my Australian guide casually informed me. He went on to illustrate in excruciating detail that Australia is home to hundreds of venomous creatures that include the innocuous cone snail, the blue ringed octopus, the brown snake and the funnel-web spider, to name a few. Any of the friendly Australian natives can name these as if they were on a shopping list. But the creature they most fear is the dreaded saltwater crocodile. The mere mention of this prehistoric monster is enough to raise any Aussie’s eyebrows and cut short further uncomfortable conversation about the dangers Down Under. So it was that we began a recent family vacation to Australia with some paranoia we might encounter such creatures. To our great fortune we found none, but we did discover an environmental and social utopian paradise, which explains why no Australians ever want to move to California. This was surprising to my ethnocentric pride since it seemed on all of our prior travels that when you mention you’re from California, everyone says how lucky you are to live there. Indeed, there was much I liked about Australia, such as all school children wearing uniforms, sensible gun laws, elections on Saturdays, a working immigration policy, universal health coverage, no annoying TV drug commercials, and the Aussie sense of humor. I saw no homeless in Sydney, Brisbane and Melbourne. When I rented a car and drove on the left, other drivers allowed my lane changes, even when I inadvertently signaled by activating my windshield wipers. And, perhaps most striking of all was the overall level of happiness and satisfaction with their health care system. “I can’t believe you Americans pay so bloody much for drugs,” my Australian friend Greg, a dermatologist, noted. Evidently, under Australia’s national health care system—it’s called “Medicare,” but unlike the U.S. 4

Sierra Sacramento Valley Medicine

By Christian Serdahl, MD

program of the same name it guarantees health services to Australians of all ages—an independent board called the Pharmacy Benefit Scheme (PBS) sets one price. In the late 1990s, Australia and many other European countries realized that drug costs were on the rise and set up strict pricing regulations that have left America holding the proverbial bag for funding new drug development and Big Pharma profits. Let’s look at Humira, for example. In Australia two 40mg/0.8ml injection pens cost $1,269.60. At Costco, you will pay $5,130.76 for the same medicine. Medicare in Australia covers all citizens and is funded by a 2% tax on income. In order to reduce the burden on the public health care system, higher wage earners purchase private insurance. Additional funding comes from patient copays based on income. Physicians are paid via a combination of salary and fee for service, and there are public and private hospitals. General practitioners are paid reasonably well and there is no shortage. The government also sets prices for surgical procedures and exams, but many physicians have felt that the government panel has fallen behind in updating these fees, making private practice a bit more difficult. This hybrid model of health care has a relatively high level of satisfaction from both physicians and patients, particularly when it comes to drug pricing. While I am not excited about the prospect of a faceless panel of government bureaucrats negotiating prices for surgical procedures and exams, I am certainly in favor of Medicare setting prices on all the drugs we use in our country. The savings would be on the order of $10-$20 billion dollars each year and we would not have to watch drug commercials during the nightly news hour. Any country that even considered naming Melbourne, Australia’s most diverse and largest city, Batmania in 1837 has to have something Americans can learn from. In addition, of course, to staying away from saltwater crocodiles.

Profile for Sierra Sacramento Valley Medical Society

2019-Jul/Aug - SSV Medicine  

Sierra Sacramento Valley Medicine is the official journal of the Sierra Sacramento Valley Medical Society (SSVMS) and promotes the history,...

2019-Jul/Aug - SSV Medicine  

Sierra Sacramento Valley Medicine is the official journal of the Sierra Sacramento Valley Medical Society (SSVMS) and promotes the history,...