澳洲的全民健保正在崩潰。還能挽救嗎？

In Streaky Bay, a picturesque town in South Australia, Dr. Victoria Bradley has dedicated her life to serving the local community as its only permanent doctor. With a stunning view of the coastline and a tranquil bay filled with playful dolphins, one might think her job is a dream come true. However, the reality is far from idyllic. Dr. Bradley has been on call nearly every hour of the day, juggling her responsibilities at the local hospital and general practitioner clinic. Her days are filled with patient appointments, hospital rounds, and emergency situations that often leave her with little time for breaks. After years of this relentless schedule, she reached a breaking point and decided to resign, leaving the town's healthcare system in a precarious position. Streaky Bay is now emblematic of a larger crisis facing Australia's healthcare system. The lack of adequate government funding has led to a severe shortage of healthcare professionals, resulting in longer wait times for patients and rising costs for medical services. Many Australians are now delaying or forgoing necessary medical care due to these financial burdens. As the nation approaches its election on May 3, healthcare has emerged as a critical issue for voters, with both major political parties pledging significant financial investments to address the crisis. However, experts warn that the proposed solutions may only serve as temporary fixes rather than addressing the root causes of the problem. The healthcare system in Australia was established over forty years ago with the introduction of Medicare, a public insurance scheme designed to provide affordable and accessible healthcare to all citizens. Under this system, Australians could visit a doctor or hospital and present their Medicare card, which would trigger a payment from the government based on tax revenues. This arrangement allowed for either completely free care or heavily subsidized treatment through private healthcare options. Medicare quickly became a cherished national institution, combining the best elements of the UK's National Health Service and the US healthcare system. Fast forward to today, and many in the healthcare industry believe that the system is on the verge of collapse. While emergency care remains relatively strong, the primary care sector, which is largely provided by private clinics, is facing significant challenges. Historically, most general practitioners accepted Medicare rebates as full payment, but this practice is becoming increasingly rare. Doctors argue that the rebates have not kept pace with the rising costs of providing care, leading to a growing number of patients who must pay out-of-pocket fees for their appointments. Recent government data indicates that approximately 30% of patients are now facing additional costs, averaging around A$40 for a standard visit. However, experts believe the actual number may be higher, as many individuals avoid seeking medical attention altogether due to escalating fees. For instance, Callum Bailey, a 25-year-old electrician, shared that he often suffers in silence rather than pay for a doctor's visit, as he feels the financial strain of everyday expenses. This situation is not unique to him; many Australians are grappling with similar dilemmas. The BBC has spoken to numerous individuals who have been forced to rely on charities for basic needs, avoid dental care for years, or even deplete their retirement savings to cover medical expenses. The burden of healthcare costs is particularly heavy for families with chronic illnesses, as they struggle to balance their children's medical needs with their own. The current state of healthcare in Australia has created a vicious cycle, where those who need care the most are often the ones who cannot access it. In Streaky Bay, Dr. Bradley felt a deep sense of responsibility to her community, which is why she returned to work after her brief resignation. However, she now works a reduced schedule, and the town has resorted to hiring temporary doctors at high costs to fill the gaps in care. This situation has led to a community that feels they are paying for healthcare three times over: through taxes, local council rates, and out-of-pocket expenses. As the election approaches, many Australians are questioning whether the current healthcare system can be saved. Both major political parties acknowledge the crisis but have different approaches to addressing it. The Labor Party has proposed increasing Medicare rebates and providing additional funding for training more healthcare professionals, while the Coalition has promised to invest in mental health services and regional healthcare training. However, many patients remain skeptical that these proposals will lead to meaningful change. They are calling for more comprehensive reforms, including better training and retention of rural doctors, regulation of private fees, and increased funding for public healthcare services. Experts argue that the way Medicare compensates healthcare providers needs to be fundamentally restructured to ensure that access to care remains universal. The longer the government delays these necessary reforms, the more costly the consequences will be. In Streaky Bay, residents like Penny Williams are left wondering if it is already too late to restore the healthcare system they once relied on. The community is facing a critical moment, and the decisions made in the upcoming election could determine the future of healthcare in Australia.