KC doctor in Australia calls on Trump to support Medicare-for-all system

Last week, Marie Shieh wrote a guest commentary in The Star affirming President Donald Trump’s position that the Australian health care system is better than America’s.

Shieh is a primary care physician in Australia who was raised in Kansas City. Before moving to Australia in 2015, she worked for more than a decade in health care systems in the U.S. and China. In a phone interview Wednesday from her home in Tanilba Bay, Shieh praised the Australian system, which is similar to the American Medicare system except that every Australian is covered for most health-care costs. The publicly funded system is commonly known as Medicare for all.

In Australia, patients pay a small out-of-pocket fee based on income, Shieh wrote. Costs vary slightly for things like medications ($7-$30), doctor visits ($0-$30) or X-rays ($0-$40).

Shieh sent a link by email to a site comparing American and Australian health outcomes, using data from the United Nations Population Division.

About 21 percent of Australians are obese, according to the data, while 30 percent of Americans are. The U.S. had about 1.5 more infant deaths per 1,000 live births than Australia. Life expectancy is about three years longer for both genders in Australia, and the country has more than twice as many hospital beds per 1,000 people than America.

Most Americans (60 percent) support a Medicare-for-all system, according to a Pew Research Center survey.

Some, though, are afraid such a system would cost more, Shieh said. “(But) if you look at the cost of health care in the U.S., it’s carried on the shoulders of Americans already.”

With a national system, Shieh said, the collective negotiating power of the population would bring costs down, as it does in Australia.

In the U.S., Shieh once paid $40 for asthma medication. The same medication is $6 in Australia, she said. When she gave birth in the U.S., she received a bill five times her monthly rent at the time for a normal, unmedicated delivery. Shieh used a subsidy to help pay the bill.

“I felt bad to do that,” she said, but collection agencies were calling.

These problems are less likely to arise in Australia and other countries with a national health care system, she said.

The system in Australia isn’t perfect. Shieh said treatments can be delayed sometimes because of specialists’ busy schedules in some areas.

Patients wait about a year for a knee replacement in Tanilba Bay, Shieh said, but when it’s finally performed, the surgery costs patients nothing.

Some of her patients recently needed cataract surgery. They had to pay $500 because they could not find an ophthalmologist who would perform the surgery on the public system. Even so, Shieh called the cost of the surgery reasonable.

After experiencing health care systems around the world, Shieh felt compelled to write her letter addressing Trump because of how impressed she is by the Australian system.

“I think if (Trump) really wants to do something in the best interest of the American people,” she said, “he would help our country to have a national health care system.”

This story was originally published May 31, 2017 at 12:12 PM with the headline "KC doctor in Australia calls on Trump to support Medicare-for-all system."