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The cost of health care in Australia
Editorial
KCNA/Xinhua Press/Corbis
North Korea: evidence of intolerable human rights violations
For the Report of Commission of Inquiry on human rights in the Democratic People’s Republic of Korea see http:// www.ohchr.org/EN/HRBodies/ HRC/CoIDPRK/Pages/ ReportoftheCommission ofInquiryDPRK.aspx
On Feb 17, the Commission of Inquiry on human rights in the Democratic People’s Republic of Korea, set up by the UN’s Human Rights Council in March, 2013, revealed details of “unspeakable atrocities” committed in the country. During a year-long investigation into systematic human rights violations in North Korea, the panel gathered evidence and testimony from victims and witnesses. The Commission now calls for decisive action by the international community to address the human rights situation in the country, including referral to the International Criminal Court. Those responsible for these humanitarian crimes—including the country’s leader, Kim Jong-un—should face justice. Even considering what is already known about North Korea, the report’s findings are shocking. The Commission’s Chairman, Michael Kirby, describes North Korea as a totalitarian state that is comparable to Nazi Germany. According to the report, “these crimes against humanity entail extermination, murder, enslavement, torture, imprisonment, rape, forced abortions and
other sexual violence, persecution on political, religious, racial and gender grounds, the forcible transfer of populations, the enforced disappearance of persons and the inhumane act of knowingly causing prolonged starvation.” Defectors who are repatriated from China are not treated with respect, and for women in this situation forced abortion and infanticide are common. The Commission did not support sanctions, due to the dire social and economic plight of North Korea’s beleaguered population. Instead, it calls for the international community to act together to protect the country’s people. Pressure is mounting on China, the only ally of North Korea, to break its silence and intervene. China discourages investigations into human rights, and generally opposes politicisation of such issues. But the evidence is now publicly available to persuade China to work together with the international community, not only to contribute to humanitarian relief, but also to work to end the undeniable and unacceptable suffering of North Korea’s people. The Lancet
Jon Hicks/Corbis
The cost of health care in Australia
For the Transcript of interview with Peter Dutton on ABC’s 7.30 Report see http://www.abc. net.au/7.30/content/2013/ s3948295.htm For the Australian Bureau of Statistics: Private Healthcare see http://www.abs.gov.au/ ausstats/[email protected]/ mf/4815.0.55.001
756
Plans for radical changes to Medicare, the Australian national health service, were discussed last week by Peter Dutton, health minister, in a speech to parliament and also on national television. The changes may include the introduction of patient copayment fees for all routine doctor visits and may further encourage use of private health insurance. Critics say this would turn Australia away from universal health coverage towards a US-style health system. Dutton’s stated aim is to “modernise and strengthen” Medicare, but public protest has been widespread—hundreds of people demonstrated last week in Sydney. Only weeks ago the coalition government denied that it would introduce AUS$6 charges for general practitioner visits, but Dutton has now paved the way for copayment. Medicare gives all citizens and residents access to primary health-care services. It is primarily funded via an income tax levy of 1·5%, supplemented by direct government health spend. The current annual health budget is $62billion, but Dutton claims that this may rise to $75billion by 2016–17. The principle
of free national health coverage is well established in Australia. But among a population of 23 million, 11 million people have some form of private health insurance. Consequently, Dutton’s call to further “grow the opportunity for those Australians who can afford to do so to contribute to their own healthcare costs” has caused consternation. Obesity rates are rising in Australia. The government believes that this burden is causing related treatment costs to spin out of control and that Medicare needs to adapt. Concurrently, it has abolished a national scheme agreed upon under the previous government to label the calorific content of foods. Critics, including the Australian Medical Association and the Shadow Labor Cabinet, have suggested that the proposed changes amount to the dismantling of a successful universal health-care system, and that prevention of disease would be a more costeffective strategy. In short, Australian health policy needs to develop opportunities not only for the rich to pay for health care, but also for the poor to live longer, healthier, and more productive lives. The Lancet www.thelancet.com Vol 383 March 1, 2014
KCNA/Xinhua Press/Corbis
North Korea: evidence of intolerable human rights violations
For the Report of Commission of Inquiry on human rights in the Democratic People’s Republic of Korea see http:// www.ohchr.org/EN/HRBodies/ HRC/CoIDPRK/Pages/ ReportoftheCommission ofInquiryDPRK.aspx
On Feb 17, the Commission of Inquiry on human rights in the Democratic People’s Republic of Korea, set up by the UN’s Human Rights Council in March, 2013, revealed details of “unspeakable atrocities” committed in the country. During a year-long investigation into systematic human rights violations in North Korea, the panel gathered evidence and testimony from victims and witnesses. The Commission now calls for decisive action by the international community to address the human rights situation in the country, including referral to the International Criminal Court. Those responsible for these humanitarian crimes—including the country’s leader, Kim Jong-un—should face justice. Even considering what is already known about North Korea, the report’s findings are shocking. The Commission’s Chairman, Michael Kirby, describes North Korea as a totalitarian state that is comparable to Nazi Germany. According to the report, “these crimes against humanity entail extermination, murder, enslavement, torture, imprisonment, rape, forced abortions and
other sexual violence, persecution on political, religious, racial and gender grounds, the forcible transfer of populations, the enforced disappearance of persons and the inhumane act of knowingly causing prolonged starvation.” Defectors who are repatriated from China are not treated with respect, and for women in this situation forced abortion and infanticide are common. The Commission did not support sanctions, due to the dire social and economic plight of North Korea’s beleaguered population. Instead, it calls for the international community to act together to protect the country’s people. Pressure is mounting on China, the only ally of North Korea, to break its silence and intervene. China discourages investigations into human rights, and generally opposes politicisation of such issues. But the evidence is now publicly available to persuade China to work together with the international community, not only to contribute to humanitarian relief, but also to work to end the undeniable and unacceptable suffering of North Korea’s people. The Lancet
Jon Hicks/Corbis
The cost of health care in Australia
For the Transcript of interview with Peter Dutton on ABC’s 7.30 Report see http://www.abc. net.au/7.30/content/2013/ s3948295.htm For the Australian Bureau of Statistics: Private Healthcare see http://www.abs.gov.au/ ausstats/[email protected]/ mf/4815.0.55.001
756
Plans for radical changes to Medicare, the Australian national health service, were discussed last week by Peter Dutton, health minister, in a speech to parliament and also on national television. The changes may include the introduction of patient copayment fees for all routine doctor visits and may further encourage use of private health insurance. Critics say this would turn Australia away from universal health coverage towards a US-style health system. Dutton’s stated aim is to “modernise and strengthen” Medicare, but public protest has been widespread—hundreds of people demonstrated last week in Sydney. Only weeks ago the coalition government denied that it would introduce AUS$6 charges for general practitioner visits, but Dutton has now paved the way for copayment. Medicare gives all citizens and residents access to primary health-care services. It is primarily funded via an income tax levy of 1·5%, supplemented by direct government health spend. The current annual health budget is $62billion, but Dutton claims that this may rise to $75billion by 2016–17. The principle
of free national health coverage is well established in Australia. But among a population of 23 million, 11 million people have some form of private health insurance. Consequently, Dutton’s call to further “grow the opportunity for those Australians who can afford to do so to contribute to their own healthcare costs” has caused consternation. Obesity rates are rising in Australia. The government believes that this burden is causing related treatment costs to spin out of control and that Medicare needs to adapt. Concurrently, it has abolished a national scheme agreed upon under the previous government to label the calorific content of foods. Critics, including the Australian Medical Association and the Shadow Labor Cabinet, have suggested that the proposed changes amount to the dismantling of a successful universal health-care system, and that prevention of disease would be a more costeffective strategy. In short, Australian health policy needs to develop opportunities not only for the rich to pay for health care, but also for the poor to live longer, healthier, and more productive lives. The Lancet www.thelancet.com Vol 383 March 1, 2014