In what should be familiar to readers from what you’ve heard about Canada or the United States’ Medicare program, Australia has a form of universal health care based on a single-payer system. Australia created their program—called Medicare—in 1984 to provide free public hospital care, substantial coverage for physician services, and pharmaceuticals. Australian citizens, residents with permanent visas, and interestingly, even some New Zealanders are covered under the scheme. Their federal government finances the Medicare system, but it has a very limited role in the actual delivery of health care.

Each of the six states in Australia own and manage service delivery for public hospitals, ambulances, public dental care, and community health, which can include anything from primary or preventative care to mental health care. Local governments play a role in the delivery of community health and preventive health programs, such as immunizations, which is obviously important during COVID.

Like in the United States, a substantial portion of the gross domestic product goes towards health care, but it’s only about 10 percent in Australia; in America it’s about 17 percent. I know we’ve been talking a lot about workforce oversupply in the U.S., but in Australia, there are workforce shortages, so physicians like Justin Hensley, MD, who moved from Texas to Australia last summer, benefit from the transition.

I recently spoke with Dr. Hensley about his experiences working as an emergency physician in Australia and what other differences he sees in health care in Australia.

You were an owner in the freestanding ED in Texas. One big difference between the U.S. and Australia is how fast reimbursement goes from public to private payers. Is it nearly as instantly as it seems?

Dr. Hensley: Ninety days was a good day to get reimbursed by any of the private insurers in the United States. It’s a reason why a significant number of freestanding clinics closed because they can’t keep the lights on if they’re not getting paid. The claims being pushed back by insurers was horrendous. It is significantly better here, yes.

Supposedly there’s an interoperable national eHealth program that’s based on personally controlled unique patient identifiers. I’m wondering how that works in comparison to the U.S. where we have so many different proprietary electronic medical record systems (EMRs), none of which seem to want to talk to one another, even if one hospital is across the street from another one?