August 26th 2000

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Articles from this issue:

COVER STORY: “Stolen Generation”: where to now?

EDITORIAL: Indonesia falls apart?

CANBERRA OBSERVED: Why Howard’s IVF hand-grenade rattled ALP

NATIONAL AFFAIRS: Protests to confront World Economic Forum

DRUGS: Victorian Liberals reject injecting rooms

Straws in the Wind

HEALTH: Ways to shorten hospital waiting lists

HEALTH: US-style Managed Care comes to Australia

'Fair trade' or 'free trade'


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US-style Managed Care comes to Australia

by Helen Spring

News Weekly, August 26, 2000
A society that does not protect its own is easy prey. For the predators, the strategy is brutally simple — divide and conquer. Select the most vulnerable first, and eliminate them one by one: the weak, the sick, the very young, the dying.

In America, this is the strategy of the health insurance industry. Vulnerable patients are expensive, so they are all selectively targetted, leaving only the young and healthy to be insured. This is “managed care”.

America’s experience is illuminating.

First they selected the mentally ill — an easy target, very vulnerable and reluctant or unable to protest publicly.

One public official remembers its thus: “Well, we just showed them the way out, gave them their pills in a paper bag, and let nature take its course”.

Or the story of a Virginia woman who underwent a double mastectomy: “She was discharged at her Health Maintenance Organisation’s insistence, 20 hours after surgery ... groggy from anaesthesia, in pain and with four drainage tubes attached to her body.

“She was given instructions on what to do for bleeding and blood clotting, prescriptions for painkillers and antibiotics, and exercise instructions, and sent home where she lived by herself.” (Horror Stories edited by Robert B. Raible).
Patients as commodities

This predatory strategy now operates here. And, like Americans, our social instincts are becoming blunted — we are becoming accustomed to seeing mentally ill homeless in the streets, our elderly suffering in sub-standard nursing homes.

Now, according to recent reports, a private health fund will impose a lifetime limit on treatment for lymphoedema that is, they will pay for only a limited number of treatment sessions in each patient’s lifetime. It usually requires long-term, expensive treatment. Approximately 150,000 Australians are afflicted (some having paid private health insurance premiums for years).

The Australian Medical Association has spoken strongly against this. The Federal President, Dr Kerryn Phelps, has warned such limits are typical of American-style managed care.

Are Australians so complacent as not to learn from the American experience where managed care has been described as “pig heaven for profiteers”? There the predators’ salaries have grown fat on their victims’ helplessness — some health fund executives receive salaries of more than A$50 million.

As one executive put it:

“We see people as numbers, not patients. It’s easier to make a decision. Just like Ford, we’re a mass-production medical assembly line, and there is no room for the human equation in our bottom line. Profits are king.”

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