HEALTHCARE

Comparing Australian Universal Healthcare to the New US Healthcare System

Abstract

Most definitions of health cluster around one of two views: health as the absence of illness and infirmity (freedom from disease, dysfunction, and disability), or health as a positive well-being (a state of equilibrium, adaptation, harmony, and wholeness). The World Health Organization (WHO) emphasizes the importance of defining health in terms of positive states and defines health as a 'state of complete physical, mental and social well-being and not merely the absence of disease or infirmity' (WHO, 1948). Two additional themes that emerge from the many definitions of health are (1) that premature mortality is undesirable, and (2) that quality of life is important. Thus, healthcare practices in USA and Australia are concerned not only with the avoidance of death but also with the prevention and riddance of conditions that reduce quality of life.

Introduction

Australia and the United States had quite similar healthcare systems in the 1960s, the two countries now stand in marked contrast in terms of healthcare system provision and payment. The United States features a market-based system of delivery and payment (Reinhardt et. al., 2004), while healthcare delivery is organized in Australia by provincial governments, which also are responsible for most healthcare expenditures. One of the biggest differences between the two is that the United States is one of only a few industrialized countries not to guarantee healthcare for all of its citizens, while Australia represents an example of a country with universal healthcare guaranteed due to the heavy involvement of the government in providing funding for care.

Policy Development

Although the United States' healthcare policy is largely characterized by private provision, federal and state governments still play a substantial role in providing the funding for healthcare services, especially via large national entitlement programs, Medicare, Medicaid, and State Children's Health Insurance Program (SCHIP). Medicare provides direct payments from the federal government to private providers for physician and hospital services, and recently expanded to include funding for prescription drugs. Generally available to individuals over the age of 65, as well as certain other categories of people (such as those officially classified as disabled), Medicare and other public programs account for approximately 50 percent of all healthcare expenditures in the United States, and is funded via payroll taxes into a trust fund, one which is slated to run out of funds at some time in the 21st century without substantial overhaul of the program.

Obama's Health Care Reform

Obama's health care reform (2009-10) constitutes the process by which the social policies that regulate health care are created and modified. Health care reform, therefore, represents a subset of health care policy. In essence, health care reform is driven, to a large extent, by regulatory reform. However, it is important to recognize nonregulatory drivers of health care reform such as the impact of market forces on the level of quality of care, as with the Leapfrog group, and the recent report from the Institute of Medicine regarding medical errors. Health care reform can lead to changes in ...