I agree, it would be instructive to look to the Australian system but also
New Zealand. Australia arrived at a system of universal public health
insurance fairly late in the game. In 1984 Medicare was introduced after an
earlier failed attempt in 1975-76. Prior to that private insurance was the
norm. Having worked in the health system in Australia in the early 80's, it
is my observation that universal public insurance was never widely accepted
by many health professionals. I have family in Australia and could regale
you with many stories of the "two-tieredness" of the system. New Zealand, on
the other hand, was one of the first countries to implement a National
Health Service. The New Zealand experiment with the public-private mix  in
the late 80's and 90's is one that has received much attention in recent
years and it looks as if the political tides are swinging back toward more
public control of health care financing.

I'm enjoying this discussion.
Cathie.
----- Original Message -----
From: "frank timmermans" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Monday, March 13, 2000 9:32 AM
Subject: Re: Private and public...


>
>
>
> Dennis,
>
> I made this argument earlier in the discussion based on how my Canadian
> clinical colleagues, not just physicians, feel but also on international
> experience. The Australian experience is perhaps closest to ours.
Australia
> is 10 or 15 years further down the road and has a truly 2 tier system even
> though that was not the intent in the first place. At least they did not
> want to impoverish the public system in terms of resources but that is
> exactly what has happened. A quick walk through the public and private
wings
> of even the same hospital there are enlightening. I don't know whether you
> can find the hard evidence you are looking for but Australia may be a good
> start. Maybe there is an Australian out there who can help.
>
> Frank Timmermans
>