I'm almost sorry I ever broached this subject back in that "unfinished stories" thread! It would be like trying to drain the ocean with a teaspoon.
I'm not at all familiar with OZ & public health, whether it's a private pay or public access or whatever.
The US has always been a 'fee for service' system. My first recollection was our family being chased across the US by aggressive bill collectors. My step-dad was a construction worker and a gambling alcoholic, so high wages in 1945 became scrabbling for meals on the table every week after he lost his paycheck to drinking and card games. Mom had horrible miscarriage in Virginia; lost the child and was permanently damaged. We were suddenly several thousands of dollars in debt. That began the constant threats and hounding from debt collectors.
Then in 1949 we were living in a motel room in Pocatello, ID while step-dad worked on a Snake River dam. I was playing on an asphalt pile left behind by a road crew, behind the motel. I fell and tore my pants over my knee, and embedded some tar-covered gravel under the skin. We left that week, step-dad "drug up" as he said, taking his pay and packing us up. We were driving to the next job on the west coast. We reached Oregon; I was feverish and unable to stay awake. Mom had a sister who lived in a rural area who worked at a local shoe factory. We made an emergency stop there. In short, I had developed "blood poisoning" with red streaks down my leg. Hospitalization was out of the question. We had no money and bill collectors still hot on our trail. "Auntie" called a local doctor who came, looked, and scared hell out of Mom. The kid might well lose that leg, or die. Keep him in bed, and make him drink three tall water glasses of hot sauerkraut juice three times a day. It's a natural blood purifier. And keep the dressing changed, the knee infection drained, and pray.
We were there for a month. I still have that leg, and for years carried angry circular scars from that infected, tar-crusted gravel. Try a tall glass of hot sauerkraut juice for kicks. I never did see the inside of a hospital in the US until I was a prisoner of Navy malpractice.
Next, I was just 12 and foolishly got bucked off the back of my colt. There was no hospital or clinic in our mountain valley. The nearest was 45 miles down to the river mouth. There was no program to support rural health care in the US.
Mom took me to the local rural doctor, who administered ether via the wire face mask with a cloth draped over it, to set my arm. That became my "near death" experience. No white tunnel; just a vivid experience in celestial surroundings. When I was pulled back, Mom complained I'd been swearing like a sailor. And we were another thousand dollars in debt.
I went to Kansas City, MO to a private radio technical college. Our family had bad teeth; we couldn't afford dental care. My mouth was hurting; I went to a KC dentist. He examined me, and asked where I worked. I explained I was a local technical student. He demanded that I leave his office. He wanted cash payment up front. My savings from summer jobs were too meager to do more than make monthly payments. He wouldn't accept that.
I joined the US Navy. As part of the induction process, they pulled half of my teeth and discarded them. There was no attempt to save them. Later, another tooth impacted while I was in Electronics School on Treasure Island, SF. It was a Friday afternoon. The Navy dentist started a root canal. The yeoman stuck her head in the door and reminded the Lieutenant that he had a golf date with the base commander. He dipped a wad of cotton in alcohol, stuffed in my open tooth, and sent me back to the barracks.
Monday afternoon I went back to finish the root canal. My lymph nodes under my chin and on both sides of my neck were swollen from infection caused by the open tooth. The Lieutenant looked, called another officer, and they both said, "Mumps!" That led to a mandatory involuntary "incarceration" at Oak Knoll Naval Hospital in Oakland. I never had the mumps. The infection cleared up and I was the victim of a malpractice cover-up.
Later, following my discharge, I paid considerable money to have the damage repaired. I told what happened, and as the dentist looked at the mangled, still open front tooth, he shook his head but couldn't openly condemn a fellow professional.
Years later, I bought a country newspaper. My wife was pregnant with our daughter. The community, a county seat town of a county the size of the state of Connecticut, used to have a small 'hospital' that served as area clinic and doctor's office. The state and federal government had forced it to close a few years earlier, because it was not able to meet increasing standards. The government, in its typical wisdom, decided that several thousand rural residents, isolated from any other health services by 60 miles in any direction, was best served by access to nothing, rather than something 'substandard.' That was our situation for several more years, until the volunteer EMT program came along, and then a rash of well-trained paramedics from the Vietnam debacle.
Our daughter was born 60 miles south after a midnight ride to a small area hospital in the next county.
Our county was 97-percent federal lands; a hugely popular recreation area in National Forest and National Recreation Area campgrounds. We had one nurse-practitioner in a tiny community clinic upriver in the neighboring valley, still in our county. During the summer season, she had to deal with an estimated transient population of 20,000 people! That was six times our county population. There was no federal program or money, no state money, and no assistance. Even law enforcement came under pressure; we received a small stipend from the federal government to subsidize one sheriff's deputy in the area.
My wife became an Advanced EMT via a state training program several years later; I was a volunteer ambulance driver for five years. Our entire community was volunteer. There were no professionals, other than a private dentist, in our area.
It is now safe to say that when we had a tragic ranch accident, or highway accident with severe injuries, our local pharmacy owner would volunteer to administer morphine to the victims as needed, so our volunteer, locally-obtained ambulance could transport the victims 60 miles downriver to the closest emergency treatment.
In brief, that was my life's experience with the American health care system. You got what you paid for, and if you couldn't pay, you got sick, suffered, then got well or died. Nobody much cared.
Today, they still don't much care. I know a number of people and families today who just gained access to health care which they couldn't possibly afford before, thanks to so-called "Obamacare." If current political threats to dismantle the program are successful, all those people will be cut off.
I guess we'll see. Since we live right on the edge of the Canadian border, I get to see the truth of the matter. The friends I have there feel sorry for us down here, but not too much. They consider our problems to be self-inflicted.
