In short, Australia is way ahead of the U.S. when it comes to health care. While some Aussies are losing patience with Kevin Rudd’s lack of leadership to reform the system there, the system there is already universal. No one there has to worry about going bankrupt or becoming homeless due to medical costs. How civilized is that? Father Dave had some major health concerns himself last year and said worry about money was never part of the picture. Imagine that.

As someone with a doctorate in psychology, I can state with a high degree of clinical certainty that people who are recovering from major illnesses and surgeries will have faster recoveries and fewer complications, generally speaking, than people who are dogged by money worries while they are recovering. What that means is they incur fewer medical expenses than people who do have money worries because of medical expenses. Will we ever bring reason to bear on health care in this country?

Here’s the original post:

Oh, would that I were getting on a plane to actually fly to Australia!  Alas, this is instead a revisiting of the subject of Australia and its bureaucracies.  In some of my posts from many months ago, I looked a little at Australia’s election of Kevin Rudd, a long-time bureaucrat, and speculated–or maybe fantasized–that he might be able to inject a large dose of reason and professional practice into Australia’s bureaucracies.

I decided it was time to check in on the situation Down Under and see how it’s going.  I came across this article by Gary Sauer-Thompson about the politics and problems achieving health care reform there.  Many similarities with what’s happening here with health care reform.  No matter what reason and sound medical practice may dictate, there are irrational politics to deal with.  Early in his piece Sauer-Thompson cites this article by Ross Gittins at the Sydney Morning Herald. (And I cited Gittens in this post in May 2008.)  Gittins posits that the Rudd agenda suffers from lack of prioritization. Be that as it may, health care reform is encountering huge hurdles in the U.S. even though President Obama has made it a top priority.

I really haven’t read enough to offer any cogent analysis at this point, but I’ll do a bit more digging (I have a ‘secret’ connection in Oz) and perhaps have some analysis later.  My guess, regardless of the reasons for the problems one country to another, is that both are better off under current leadership than under previous leadership.  That’s not to make room for anyone to rest on his laurels, just acknowledging that we’re all still ahead of the game compared to a couple of years ago.

Peace.

Deborah Alicen

Two somewhat different takes on Rudd’s speech are found in Melbourne’s The Age and The Sydney Morning Herald, though both Ross Gittins in the SMH and Michelle Grattan in The Age seem to agree that the passing of the John Howard approach to bureaucracies and bureaucrats is a good thing. Even so—and perhaps I’m not reading him correctly—Gittins seems to suggest that Rudd’s commitment to building bureaucratic processes that aren’t driven by ideology is questionable:

A clear message to emerge from that speech is that Rudd is more a bureaucrat than he is a politician. As a consequence, he – and his Government – is low on ideology, but high on bureaucratic “process”.

On some of the touchstone ideological issues, Rudd is surprisingly uncommitted. “Policy design and policy evaluation should be driven by analysis of all the available options, and not by ideology,” he told the assembled troops. “I do not have an ideological preference for the public sector, nor for the private sector,” he said.

A bit later he refers to Rudd as “lacking ideology.” As a student of bureaucracies and the history of bureaucracies, I don’t see his commitment to policy and process based on “all the available options” rather than ideology as a negative. That is, after all, what we wish to see return to the likes of the U.S. Department of Justice–policy and process that are consistent across the board, rather than favoring one political ideology over another. I would suggest, however, that while we prefer our bureaucracies not be ideologically driven in the way the Bush administration departments have been politicized, advancing the idea of policies and processes that are responsive to their constituencies, as Rudd seems to have done, is expressive of an ideal, and in that way is putting forth a non-partisan ideology. Lacking a clear partisan ideology doesn’t mean that he’s “lacking ideology” altogether.

While Grattan awaits the proof in the pudding, she seems less concerned than Gittins:

A major difference between Rudd and John Howard is their attitude to the bureaucracy. When Howard became PM, he immediately got rid of one-third of the departmental heads. He was suspicious of the public service. His brother Bob once told me this went back a long way. “Our family in the 1940s and 1950s was very anti-public service … If he has a grudge against two groups, it’s the public service and academics.”

Rudd is just the opposite. He sees the public service as a strong source of ideas — albeit one that has been beaten down recently. He insists (the proof of this pudding will be in the eating) that he wants robust advice, not just what the bureaucrats think the Government wants to hear. That doesn’t mean he’s fully happy with the current service. He has made it clear he wants a more creative, in-touch bureaucracy, with new blood.

While both Grattan and Gittins write of Rudd’s wanting to see greater professionalization of Australia’s bureaucracies such that they become responsive to those they are meant to serve, Gittins does make note of an important omission in the list of stakeholders whom Rudd mentioned as being necessary to that process: labor unions. I would agree that labor unions are one of the constituencies that ought to be heard during Rudd’s reformation of bureaucracies.