Did you know the definition of high blood pressure (hypertension) in the United States was recently greatly expanded? Overnight, tens of millions of people were reclassified, leaving one in every two adults with a diagnosis of hypertension.
The move has been welcomed by some but also widely criticised, amid concerns the expanded definition may bring more harm than good to many people, from unnecessary illness labels and unneeded drugs. (more…)
Regulation in this country around the advertising of unhealthy products – alcohol, junk food and gambling – is a hodgepodge of black letter law; codes of practice; industry voluntary schemes; and policy-led arrangements variously administered by the Commonwealth, states/territories and local government across the range of broadcast, print, online, outdoor, branded merchandise and sponsorships. What a mess.
For a very large and growing number of poorer Australians, the high out-of-pocket expenses for medical care in Australia to which Ross Gittins refers (SMH ‘Prevention is better than cure’, April 24), are tearing major holes in the safety net Medicare was designed to provide to us all, rich and poor. (more…)
Climate change causes many health problems and will have enormous impacts on Australia’s health system. Yet most Australian governments have been slow to prepare the health services for the inevitable challenges. Fifty health, social welfare and conservation groups, representing over one million Australians, have issued an open letter to all political parties and candidates in the forthcoming election, calling for the next government to develop and implement a National Strategy on Climate, Health and Well-being.
Health policy reform is difficult. There are an abundance of powerful stakeholders whose number one priority is definitely not optimum health care for all Australians. But most Australians do share the view that our health care system (which isn’t really a system) needs improving. There are two broad aspects to optimising health. The first is equitable timely access to high quality care. The second is addressing all those factors outside the health system which affect health. These are the social determinants of health and of productivity. Healthy people are more productive. The key social determinant is income inequality, both absolute and relative. (more…)
The Thodey review has stimulated a wide variety of diagnoses of what’s wrong with the APS, but one has been missed. Could it be that its problem is hubris? (more…)
The National Health and Medical Research Council (NH&MRC) is Australia’s pre-eminent provider of advice on science and health to government and the community. Concerned that taxpayer’s dollars might be wasted subsidising private health insurance payments for a range of “Alternative”clinical services, the federal government asked the NH&MRC in 2015 whether there was credible scientific evidence of benefit to support this subsidy. (more…)
The Opposition Leader has announced the biggest investment in Medicare for a generation, $2.3 billion to be spent eliminating the co-payments faced by those with cancer who see specialists, need diagnostic imaging and radiotherapy. It is also guaranteeing all new drugs approved by the Pharmaceutical Advisory Committee (PBAC) will be listed for subsidy. The latter means prescription costs will be a maximum of about $6 or $40 a month for pensioners and health care card holders or non card holders respectively. Cancer is scary. It is debilitating. It is life changing. It is often fatal. Furthermore, as Mr Shorten correctly pointed out “cancer makes you sick and all too often makes you poor”. Labor is to be commended for addressing this challenging issue. (more…)
Given that polls constantly have Australians saying that healthcare is a top issue in every election, expectations are high that our politicians will describe a commitment to those structural reforms so badly needed to improve equity of access to excellent health care that is cost effective. While Labor had made a number of important announcements over the last few months that were not presented in Bill Shorten’s speech (worrying) the Coalition only announced one major new program that is problematic to say the least. (more…)
This year’s Government budget documents and the Opposition’s response are budgetary in name only – they should be seen as election campaign commitments. As such, they provide a telling story about the parties’ focus on health and healthcare and the underlying political ideologies. (more…)
Recently social media and then the mainstream media exploded with outrage following the publication of a photo showing a Melbourne chiropractor “treating” a newborn baby by suspending the child in midair, holding its foot high as it thrashed around in protest. (more…)
In last night’s budget the Government had been proposing to deliver cheaper medicines by doubling the number of medications that could be dispensed from a single prescription for conditions such as high blood pressure and cholesterol. Taxpayers and patients would have benefitted but true to form the Pharmacy Guild lobbied the government and Minister Hunt ran for cover. It happens time and time again with the public interest ignored. (more…)
For many years several of us in Pearls and Irritations have argued that we need an independent and professional health commission to lead an informed public discussion on health issues and recommend to the Commonwealth Government and COAG on how to improve our health system. In world terms we have a good system, but it is really unchanged since the Hawke government in 1983 introduced Medicare which was based on the Whitlam government’s Medibank of 1975. (more…)
One of my patients has epilepsy. She sees a neurologist for that and he charges $200 out of pocket per visit. He has controlled her epilepsy very well. She is on a disability support pension. She believes she will get better care seeing him privately despite the fact that he also works in the public system.
Out of pocket (OOP) costs have been in the news particularly since 4 Corners exposed huge costs impacting significant financial hardship on many sick Australians. As a result of a Ministerial Committee report the Health Minister has proposed tackling the issue with a website of specialist charges and an education campaign for patients. The Committee consisted of ten health care provider representatives and one consumer representative. My suggestion to the Minister that more consumer representatives might be appropriate resulted in an intensely angry response. (more…)
Can you imagine an Australia where visiting a dentist was as simple as visiting a GP? The Grattan Institute has released a report: Filling the dental gap: A universal dental scheme for Australia, that does just this. The report begins by highlighting the disparity between a routine health check with a GP and visiting the dentist; those visiting the dentist might expect it to hurt more, but usually in the pocket more than anywhere else.
Surely my disgust at the Coalition’s decision to spend more than a billion dollars re-opening the Christmas Island detention centre to make sure that none of those nasty murderers, rapists and paedophiles ever get to real Australia for any medical care, is widely shared. There is so much real health that could be purchased with those dollars. (more…)
“Oral health is fundamental to overall health, wellbeing and quality of life. It is an important part of general health, affecting not only the individual, but also the broader health system and economy.” So says the 2017 Performance Monitoring Baseline Report for Australia’s National Oral Health Plan 2015 – 2024. This acknowledgement that oral health is an essential component of a healthy life is promising, but how do we know if we are moving towards enshrining good oral health for all Australians?
At the end of February the Federal Government released the report, twelve months in the making, from the Ministerial Advisory Committee on Out-of-Pocket Costs and outlined a national strategy to tackle excessive out-of-pocket costs. It is our opinion that the report’s recommendations and the Government’s response (for a website that provides information about medical specialists’ costs and for an education campaign to improve the understanding of OOP costs for consumers, GPs and medical specialists) do not go far enough, given the substantial and widespread impact of OOP costs. Our recently published paperoffers a road map for tackling the problems associated with OOP costs through short- and long- term initiatives, backed by evidence and informed by on-going consultation and evaluation.
March 15 has been flagged as a coordinated day of school strikes by teenagers around the world. Let us hope that they will start a new movement to bring home the urgency for real action around the world, but particularly in Australia, to ensure that our children, grandchildren and all future generations do actually have a planet to live on! So, let us all support them – they surely deserve it.
LESLEY RUSSELL. Can Primary Health Networks (PHNs) Drive Needed Primary Care Reforms?
A strong primary care system is essential to the equity, efficiency and effectiveness of the healthcare system and for improvements in health outcomes. However, the structure and funding of primary care has not kept pace with changes to disease patterns, the economic pressures on the healthcare system, workforce needs and evidence about the impact of social factors on health. In a paper recently published with my colleague Dr Paresh Dawda, we analyse the current operations and funding of Primary Health Networks and explore whether they are fit-for-purpose to drive and foster primary care reforms.
Politicians, the media and the public focus on iconic hospitals rather than health. We have too many hospitals and too many hospital beds. We need to focus health improvement not in hospitals, but in primary care in the community – general practice, community clinics and at home. The expensive and wasteful hospital frenzy must end. (more…)
Beyond the image of the vagabond and the impaired bodies and minds of homeless people there are untapped veins of intellect and potential; this is where our focus should be.
“The homeless are our most important dreamers, prophets and poets for they challenge our apathy….” (Sydney from Below, McCarthy F, Matthew Talbot Hostel)
There are a number of unsatisfactory elements of the so-called “national” scheme for regulating doctors (and all health professionals) but the most problematic from day one in 2010 has been the requirement for mandatory reporting of ill doctors by their treating doctors. As we reported here in 2017, the state and territory health ministers chose to reject unambiguous advice provided by their consultant, Mr Kim Snowball, who conducted an independent review of the national scheme. He advised the ministers in 2015 that “the National Law (to) be amended to reflect the same mandatory notification exemptions for treating practitioners established in the Western Australian law.” Instead the ministers embarked on a further round of consultation wasting four years to reach their final conclusion that only a very minor change was needed to the mandatory reporting provisions, thereby maintaining a regressive regime. For those interested in the use of language, the minor change (see page 20) is to alter the threshold for mandatory reporting from the existing ‘risk of substantial harm’ to a ‘substantial risk of harm’. In all the public consultations held over mandatory reporting, the medical profession has repeatedly advised health ministers that mandatory reporting is contrary not only to the health and well-being of doctors but also contrary to the best interests of the community because it deters unwell doctors from seeking help. (more…)
“About 15 years ago, we realised the solution to these problems is not more hospitals but to think about how we can deliver healthcare in a different way,” says Hans Erik Henriksen, CEO of Healthcare DENMARK.
“We aim to deliver as many services as possible through primary healthcare, municipalities, health centres and outpatient clinics and as little healthcare as possible from our hospitals.
The major challenges that beset our health system are well articulated with the obvious commitment to strengthening Medicare, making it fairer and tackling some of the major funding deficits introduced over the past decade such as the Medicare rebate freeze. The major and anticipated announcement of the establishment of the Australian Health Reform Commission is very welcome – but will it bring real change to the health system. Will preventive care and public health be funded appropriately, will we start to focus on health systems instead of just on hospitals. Lets hope so. The system needs real and probably disruptive reform – lets hope that a Labor Government will really set in place the mechanisms and governance structures for lasting change. All Australians deserve nothing less for a system that is good BUT could be GREAT. (more…)
ALP health spokesperson Catherine King addressed the National Press Club this week to expound Labor’s vision of health care changes if it wins office. Perhaps the highlight of the address was a restatement of Labor’s vision
‘of a truly universal health care system in which every Australian has affordable access to the high-quality health care they need whenever they need it.’
But will such a vision be wholeheartedly pursued under a Labor Government? (more…)
Will meaningful and significant reform of the Australian health care system occur at last?
Will there be bipartisan political support for the initiatives proposed by Labor? 2019 could be the year that delivers. (more…)
Shadow health minister, Catherine King, in an address to the National Press Club, has detailed the major health initiatives Labor would embrace if elected in May. Her plans indicate that she has heard and accepted many of the priorities for reform proposed by would be health reformists. The status quo is unacceptable. Most encouraging was her recognition that patient-centred reforms, which must include truly integrated care, was impossible if the current jurisdictional division of responsibility for health care continued. The portfolio of reforms she presented are welcomed and would be readily understood by electors if they could hear these plans. Fears were expressed at her presentation that totally unjustified scare tactics about boarder security might so dominate election debates that these important promises might get little attention. Certainly there has so far been very little media reporting on the health initiatives announced with some of the few comments made by journalists suggesting they did not understand the proposals.
It’s time to stop the shrillness. The boats have stopped. Both sides of politics are now committed to turnbacks. Both Scott Morrison and Bill Shorten will do whatever it takes to stop asylum seekers setting sail from Indonesia. If asylum seekers do set sail, they will be returned. (more…)
Labor’s announcement on Wednesday that it would establish a permanent Australian Health Reform Commission has been welcomed though all eyes will of course be on the detail and the funding commitments to emerge in the leadup to the next federal election. (more…)