Hi @meltam, please accept this as fodder for discussion.
That is true of all ‘insurance’. If you wish to single out PHI one could make the same argument for introducing single payer public auto, home and contents, life, disability, income protection, pet, … , … insurances and put the insurance companies out of business. How about deposit insurance and reinsurance for large corporations? What about general liability insurance? Auto and the latter would effectively shield miscreants from repeated bad behaviour while health is usually the luck of the draw, but what about the impact of smokers and addicts (life choice) and the obese (life choice as well as sometimes an underlying medical condition)?
Where does a line get drawn and who draws it? The MP’s who we can always trust to do the right thing? (Ooops, fell off my chair laughing with that one ).
A good question, and as I wrote it is complex. If we go forward (since it is pragmatically impossible to wind back) a step that should be doable is to address the ideological problem with the rebate that is seen as no more than a political hand-out to the better off, that has become entrenched. The step is to change the PHI rebate into a tax deduction (with limits) for health insurance as a ‘cost of life’ similar to those who can deduct ‘costs of business’.
Considering tax brackets, deductions and credits, it would probably come out about even for most who buy into PHI. Admittedly those on low income would theoretically lose out via a deduction, but would they buy PHI under the current system, so deuce in practice. PHI and the parallel public-private systems would continue but the ideological problem with the rebate would be largely resolved in some if not all eyes, although I suspect even that change would be contentious in Canberra as point scoring overtook debate.
If PHI was wound up how would the medical community operate and behave with a reduced private patient base of only those who could pay 100%?
A single payer insurance system might be a viable option where everyone has insurance that covers everything not just in-patient (eg Medicare with a modified model), and the providers operate as if private.
How about this scenario (as a devil’s advocate), obviously contrived to make a point: You have been a model citizen with a dependent family. You have been diagnosed with an early, treatable, but very aggressive cancer and every day treatment is delayed matters. You are scheduled for surgery, but hours before the theatre is yours a drug addled known criminal is brought in with a serious wound from a gang fight and gets your theatre. You cannot be rescheduled for weeks and your own outcome has been jeopardised. Is that OK for you? Who makes the decisions on clinical necessity? Is ‘every pig’ (ref George Orwell) equal?
Human nature suggests the only way a public system acceptable to all can operate is if supply meets demand without rationing or statistical game playing. What are the odds, especially with the range of maladies humans experience and what is required to research/treat many of them?
Maybe more later, or not, but I trust I have thrown some thought provoking issues onto the table.