Health systems and policy:
Making sense of the complex mosaic
Perhaps this is you—age twenty, third year at university, working part time, sharing a house with a couple of other students, playing some sport when you have the time, a non-smoker and generally in good health except for the occasional bout of a cold or the flu. One Sunday you are at your parents' house for a family birthday. When an advertisement for singles private insurance is shown on the television, your older sister suggests that you should consider taking out some health insurance cover. As a high-income earner on more than $90 000 per year she has already signed up rather than pay the Medicare surcharge. She also receives a rebate from the government for having private health insurance.
Your father, who is a long-term supporter of the Australian Labor Party and believes in Medicare and the right of universal access to medical service, advises you not to waste your money. Your grandmother, who has an ongoing medical problem which requires elective surgery and relies heavily on her private health insurance, urges you to do so.
What factors will influence your decision? Your sister argues that as there are queues at emergency departments in public hospitals, and for elective surgery, you need private health insurance to be able to access effective care when you need it. But is this really fair? As you are already paying taxes, aren't you entitled to free health care? If you join a private health fund and do not need to use it for many years, aren't you effectively subsidising elderly people and those with ongoing health problems?