Changes in Latitude: Comparing Health Care Systems with Nurses Down UnderOctober 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.
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.