By Susanna Rodell
01:00 AM EDT on Thursday, July 6, 2006
HOBART, Tasmania

WHENEVER the lament goes up about the awful health-care system in America, there's a predictable response: Yes, we have our problems, but this country still has the best health care in the world. To those who still think this is true, I'd like to introduce Billy Badger, of the Australian state of Tasmania.

Dr. Badger (a Ph.D., not a medical doctor) inhabits the office next to mine at the University of Tasmania. He is a professor of German. He is also the brand-new father of a baby girl.


Billy has no private health insurance. He and his wife, Christina, have relied entirely on the public system for prenatal care, for the birth, and for postnatal care of baby and mother. I asked him to describe the experience.


"We had no idea what to expect," he told me. Both parents were healthy and had never as adults set foot in a hospital. Upon finding out they were expecting a baby, they went to a doctor, who directed them to the maternity ward at the Royal Hobart Hospital.


At the Royal, Hobart's big public hospital, they were given the choice of three systems: 1) They could go to a birthing center, run entirely by midwives. 2) They could go to a doctor at the hospital. 3) Or they could stay in the hospital and use a system called KYM, which stands for Know Your Midwife: At prenatal visits they would meet all the hospital's midwives, so that whoever was on duty when the time came, it would be someone familiar. Christina and Billy chose the KYM system.


At first monthly, they visited the hospital's maternity unit and had checkups with midwives. As the pregnancy advanced, the intervals between visits were shorter, becoming weekly in the last month. They saw an obstetrician at their first visit and at the 20th and 36th weeks. If the midwives had seen any problems, the couple would have seen a doctor more often.


"We were never kept waiting at any of these appointments for more than five minutes," Billy said. "There were five or six midwives in all, and they were all pretty good. It was like a family; you had a community feeling."


On the day that Christina went into labor, she and Billy went to the hospital, at first to a PAC, or Pregnancy Assessment Center. This was a two-bed hospital room with a bathroom attached, where Christina was monitored until the staff judged her to be fully in labor. Then they went to the birthing suite.


The suite consisted of a large room with a double bed, a table and chairs, and its own adjoining bathroom. "It was comfortable," said Billy. "It was clean enough in a hospital sense, but also homey enough."


Here the midwives kept an eye on the couple but also tried to stay out of the way unless they were needed. The birth was straightforward.


Emergency equipment was available, just in case, and a doctor was also present, but a midwife eased the baby into the world as Billy stayed in bed with Christina.


"You didn't necessarily get the feeling you were being watched or intruded on," Billy said. "It was more like we were doing it, and they were there to help." For example, after the birth a midwife lifted the baby's legs and said, "Have a look and see what you've got" -- rather than telling them the child's sex.


"After that they left us pretty much alone," Billy said. "The baby was obviously all right, so they just left us for about an hour." Any time they needed help, it was nearby.


Billy, Christina, and the baby stayed together in the suite for five days, just getting to know each other and calling on the staff when they needed a little help with establishing breast-feeding and giving the baby her first bath.


"We could have stayed for up to two weeks if we had wanted," Billy recalled with wonderment. The food was good, too -- a special menu, since the couple are vegetarians.


When they decided to go home, the staff encouraged them to stay another night if they felt at all unsure. The staff also said that the new family could come back and stay a few more nights, if needed, up to the two-week limit.


When the family left, they took with them free diapers and baby wipes. Whatever was needed, said Billy, "if you didn't have it, you got it."


After the family was home, midwives visited every day for three days. A child-health-service nurse also visited, giving Christina and Billy phone numbers they could call at any time of day or night with any problem.

Christina made an appointment with a postnatal physical therapist, who spent 45 minutes with her, coaching her on exercises to get her body back in shape. In six weeks she will be able to go to postnatal-exercise classes with her baby.


How much, I asked Billy, did all this cost the couple?


Nothing, said Billy. Not the prenatal care, not the hospital, not the supplies, not the postnatal care, not the physical therapy. He and Christina have not spent a penny.


And there's more. In the next few weeks, the couple will receive a check from the government for $3,500, to help with the expenses of a new child.


How does Australia pay for all this? With a flat 1.5-percent levy on everyone's income, plus a 1-percent surcharge on people with higher incomes ($50,000 for an individual, $100,000 for a family). So if your taxable income is $45,000, you pay $675 a year.


Still think we in America have the world's best health-care system?


Susanna Rodell, editorial-page editor of The Charleston (W.Va.) Gazette, is teaching journalism at the University of Tasmania (
Online at:


Bullet Points for Legislators

  • Single Payer saves money.  For the past 20 years, states have commissioned studies on different types of health care systems.   In EVERY case, single payer was shown to be the only way to cover everyone and the only system that saved money and controlled costs.

  • Publicly financed does not mean government run health care.  YOU have publicly finance health coverage, but the government does not make decisions regarding your health care.

  • Cost conscious patients often don't get the care they need.   Most decisions are made by the doctor in concert with the patient, but the patient relies on the doctor's knowledge to make a decision.  Expensive tests and treatments cannot be ordered by the patient, only the doctor.

  • Lifestyle choices are not what is fueling high costs in health care.   The United States ranks low in general health indicators, but high in good health habits.  We smoke less, drink less and consume less animal fat that many other countries with better health indicators and much lower health care costs.

  • Businesses can accurately determine their health care costs and are not subject to unanticipated large premium increases.

  • It will reduce labor costs due to a more efficient way of financing health care, eliminating much wasteful administration.

  • Workers' Compensation costs will be reduced, likely by half, due to the fact that everyone has health coverage and there is no need for the medical portion.

  • It reduces the need for part time employees and provides easier recruiting.  There are no pre-existing conditions or Cobra issues.

  • Eliminates the oversight of health benefits and bargaining health coverage with employees.

  • It creates healthier personnel and more stable employees, reduces absenteeism and eliminates employer health coverage complaints.

  • It reduces employee health related debt and personal bankruptcies.

  • It frees up family income that can be spent on other goods and services, thus stimulating the economy.

Tips for Writing Letters to Editor

Follow guidelines for your local paper (word count, submission instructions, etc.)

Frame your letter in relation to a recent news item Use state specific data whenever possible (let us know if you need help finding some!)

Address counter arguments

Be aware of your audience and emphasize how Medicare for All is good for ALL residents of the state

Criticize other positions, not people Include your credentials (especially if you work in the healthcare field)

Avoid jargon and abbreviations

Don’t overload on statistics and minor details

Cover only one or two points in a single letter

Avoid rambling and vagueness


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